Cardiovascular disease incidence, mortality and case fatality related to diabetes and metabolic syndrome: A community-based prospective study (Ansung-Ansan cohort 2001-12)
Cardiovascular disease incidence, mortality and case fatality related to diabetes and metabolic syndrome: A community-based prospective study (Ansung-Ansan cohort 2001-12)
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DOI：
10.1111/1753-0407.12248
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发表时间：
2015-11-01
影响因子：
4.5
通讯作者：
Lee, Moon-Kyu
中科院分区：
文献类型：
--
作者：
Bae, Ji Cheol;Cho, Nam H.;Lee, Moon-Kyu
背景我们评估了代谢综合征 (MS) 和糖尿病对心血管疾病 (CVD)、CVD 死亡率和病死风险 (CFR) 的单独和联合影响。方法根据是否存在 MS 和糖尿病（患有 MS、患有糖尿病、同时患有或不患有任何一种）将 8898 名受试者分为四组。我们比较了 CVD 事件的发生、死亡率和 CFR。结果在平均 8.0 年的随访中，690 名受试者出现了 CVD。共有 434 人死亡，其中 101 人死于心血管疾病。单独患有糖尿病、单独患有 MS 或两者兼而有之，与 CVD 事件和 CVD 死亡率风险增加相关。与单纯 MS 组相比，单纯糖尿病组 CVD 事件和 CVD 死亡率的调整后风险比 (HR) 分别为 1.07（95% 置信区间 [CI] 0.77-1.48）和 2.02（95% CI 0.99-1.72）。在糖尿病患者中，MS 的存在并没有显着增加 CVD 风险和 CVD 死亡率。糖尿病患者与非糖尿病患者的 CVD CFR 调整比值比（包括对 MS 存在的调整）为 2.11（95% CI 1.34-3.31）。 结论 单纯糖尿病患者和单纯 MS 患者之间发生 CVD 的风险没有差异，而仅患有糖尿病的个体的 CVD 死亡率要高得多。 MS 的存在并未对糖尿病患者的 CVD 风险和死亡率产生附加影响。无论是否存在多发性硬化症，糖尿病患者的心血管病死亡率均较高。
BackgroundWe evaluated the separate and combined effect of metabolic syndrome (MS) and diabetes on incident cardiovascular disease (CVD), CVD mortality and case fatality risk (CFR).Methods8898 subjects were categorized into four groups on the basis of the presence of MS and diabetes (with MS, with diabetes, with both or without either). We compared the development of CVD events, mortality and CFR.ResultsOver a mean follow-up of 8.0 years, 690 subjects developed CVD. There were 434 deaths, of which 101 were from CVD. The presence of diabetes alone, MS alone, or both was associated with an increased risk for incident CVD and CVD mortality. Compared with the MS only group, the adjusted hazard ratio (HR) for CVD events and CVD mortality in the diabetes only group was 1.07 (95% confidence interval [CI] 0.77-1.48) and 2.02 (95% CI 0.99-1.72), respectively. Among individuals with diabetes, the presence of MS did not significantly increase CVD risk and CVD mortality. The adjusted odds ratio for CVD CFR, including adjustment for the presence of MS, in subjects with diabetes versus without diabetes was 2.11 (95% CI 1.34-3.31).ConclusionsThere was no difference in the risk of incident CVD between individuals with diabetes alone and MS alone, whereas CVD mortality was much higher in individuals with diabetes only. The presence of MS did not exhibit an additive effect on CVD risk and mortality in individuals with diabetes. Individuals with diabetes had a higher CVD case fatality regardless of the presence of MS.