Risk factors for mortality and ischemic heart disease in patients with long-term type 1 diabetes
Risk factors for mortality and ischemic heart disease in patients with long-term type 1 diabetes
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DOI：
10.1016/j.jdiacomp.2009.05.003
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发表时间：
2010-07-01
影响因子：
3
通讯作者：
Sjolie, Anne Katrin
中科院分区：
文献类型：
--
作者：
Grauslund, Jakob;Jorgensen, Trine M. M.;Sjolie, Anne Katrin
目的：本研究的目的是评估血糖调节、血脂异常和肾功能障碍对死亡率（全因和心血管）和缺血性心脏病（MID）的影响，该研究对丹麦1型糖尿病患者进行了长期随访，这些患者至少患有20年糖尿病。方法：以人群为基础的1型糖尿病患者队列于1973年7月1日确定（n=727）。1993年至1996年，对该队列进行了重新评估，并从389例患者的血液和尿液样本中收集了基线数据。基线期间的平均值（血糖调节和血脂）和最高值（肌酐和蛋白尿）用于预测基线至2006年期间的死亡率和[HD]。死亡率和发病率数据由丹麦民事登记系统、丹麦死亡原因登记处和丹麦国家患者登记处提供。结果：2006年随访时，存活患者256例（65.8%）。在调整了年龄、性别和糖尿病病程的统计模型中，以下参数与全因死亡率和心血管死亡率相关：血糖调节、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇（负相关）、总胆固醇、肌酐和大量蛋白尿。此外，除大量蛋白尿外，所有标志物均与IHD相关。基线时的微量白蛋白尿与任何终点都无关。结论：在对丹麦1型糖尿病患者13年的长期随访中，血糖调节、血脂异常和肾功能障碍均与死亡率和RID相关。这些结果强调了严格控制的1型糖尿病患者的更好结果，即使是长期幸存者。(C) 2010爱思唯尔公司版权所有。
Aims: The purpose of this study is to evaluate the effect of glycemic regulation, dyslipidemia, and renal dysfunction on mortality (all-cause and cardiovascular) and ischemic heart disease (MID) in a long-term follow-up of a population-based cohort of Danish type 1 diabetic patients with at least 20 years of diabetes. Methods: A population-based cohort of type 1 diabetic patients was identified as of July I, 1973 (n=727). In 1993 to 1996, the cohort was reassessed and baseline data were collected from blood and urine samples in 389 patients. Mean (glycemic regulation and lipids) and highest values (creatinine and albuminuria) of the baseline period were used to predict mortality and [HD between baseline and 2006. Data of mortality and morbidity were provided by the Danish Civil Registration System, the Danish Causes of Death Registry, and the Danish National Patient Registry. Results: At the follow-up in 2006, 256 patients (65.8%) were still alive. In a statistical model adjusted for age, sex and duration of diabetes, the following parameters were related to all-cause mortality and cardiovascular mortality: glycemic regulation, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (inversely), total cholesterol, creatinine, and macroalbuminuria. Furthermore, all markers except macroalbuminuria were associated with IHD. Microalbuminuria at baseline was not related to any of the endpoints. Conclusions: Glycemic regulation, dyslipidemia, and renal dysfunction were all related to mortality and RID in a 13-year follow-up of long-term Danish type 1 diabetic patients. These results underscore the better outcome for tightly regulated type I diabetic patients, even in long-term survivors. (C) 2010 Elsevier Inc. All rights reserved.