Strategies for glycemic control in nonobese and obese type 2 diabetic patients with coronary artery disease.
Strategies for glycemic control in nonobese and obese type 2 diabetic patients with coronary artery disease.
复制标题
患有冠状动脉疾病的非肥胖和肥胖 2 型糖尿病患者的血糖控制策略。
DOI：
10.1016/j.ijcard.2019.02.008
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发表时间：
2019
影响因子：
3.5
通讯作者：
Tetsuro Tsujimoto and Hiroshi Kajio
中科院分区：
文献类型：
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作者：
Tsujimoto Tetsuro;Kajio Hiroshi;Tetsuro Tsujimoto and Hiroshi Kajio;Tetsuro Tsujimoto and Hiroshi Kajio;Tetsuro Tsujimoto and Hiroshi Kajio
背景本研究旨在评估胰岛素提供（IP）或胰岛素增敏（IS）治疗对非肥胖糖尿病冠心病患者血糖控制的策略，这些患者可能比肥胖糖尿病冠心病患者心血管风险更高，胰岛素分泌更低。方法我们使用旁路血管成形术血运重建研究2型糖尿病（巴里2D）试验的数据计算风险比（HR）。使用考克斯比例风险模型，对2型糖尿病和CAD患者结局事件的95%置信区间（95%CI）进行分析。使用巴里2D试验的随机化设计，分别对非肥胖（n = 1021）和肥胖（n = 1319）患者进行IP组和IS组之间的比较。主要结局是一个复合终点，包括全因死亡，心肌梗死，中风。ResultsDuring the follow up，231 nonobese和295肥胖患者有一个确认的主要结局事件。在非肥胖患者中，IP组的主要结局事件风险显著高于IS组（HR：1.30，95%CI：1.00- 1.68，P = 0.04），而肥胖患者两组之间的主要结局事件风险无显著差异。此外，在非肥胖患者中，IP组中无腹型肥胖的患者发生主要结局事件的风险显著高于IS组（HR：1.51，95%CI：1.05- 2.19，P = 0.02）。有没有显着的相互作用之间的策略，血糖控制和非肥胖patients.ConclusionsIn非肥胖2型糖尿病和CAD患者的各个亚组，IS治疗策略可能是更有益的IP治疗策略。
BackgroundThis study aimed to assess strategies of insulin-providing (IP) or insulin-sensitizing (IS) therapy for glycemic control in nonobese diabetic patients with coronary artery disease (CAD) with possibly higher cardiovascular risk and lower insulin secretion than obese diabetic patients with CAD.MethodsWe used data from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial to calculate hazard ratio (HR) with 95% confidence interval (95%CI) for outcome events in patients with type 2 diabetes and CAD using Cox proportional hazard models. The comparison between the IP and IS groups was performed using the randomized design of the BARI 2D trial separately for nonobese (n = 1021) and obese (n = 1319) patients. The primary outcome was a composite endpoint including all-cause death, myocardial infarction, and stroke.ResultsDuring the follow-up, 231 nonobese and 295 obese patients had one confirmed primary outcome event. In nonobese patients, the risk of primary outcome events was significantly higher in the IP group than the IS group (HR: 1.30, 95%CI: 1.00–1.68,P= 0.04), whereas that in obese patients did not differ significantly between the two groups. Moreover, in nonobese patients, the risk of primary outcome events in those without abdominal obesity was significantly higher in the IP group than that in the IS group (HR: 1.51, 95%CI: 1.05–2.19,P= 0.02). There were no significant interactions between the strategy for glycemic control and various subgroups of nonobese patients.ConclusionsIn nonobese patients with type 2 diabetes and CAD, the IS treatment strategy may be more beneficial than the IP treatment strategy.
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DOI：
10.1111/dom.13039
发表时间：
2018-01
期刊：
Diabetes, obesity & metabolism
影响因子：
--
作者：
Tsujimoto T;Kajio H;Sugiyama T
通讯作者：
Sugiyama T
影响因子：
2.9
作者：
Clar C;Gill JA;Court R;Waugh N
通讯作者：
Waugh N
DOI：
10.1056/nejmoa1304501
发表时间：
2014-01-16
期刊：
The New England journal of medicine
影响因子：
--
作者：
Tobias DK;Pan A;Jackson CL;O'Reilly EJ;Ding EL;Willett WC;Manson JE;Hu FB
通讯作者：
Hu FB
DOI：
10.1056/nejmoa0805796
发表时间：
2009-06-11
期刊：
The New England journal of medicine
影响因子：
--
作者：
BARI 2D Study Group;Frye RL;August P;Brooks MM;Hardison RM;Kelsey SF;MacGregor JM;Orchard TJ;Chaitman BR;Genuth SM;Goldberg SH;Hlatky MA;Jones TL;Molitch ME;Nesto RW;Sako EY;Sobel BE
通讯作者：
Sobel BE
老年患者单纯收缩期高血压的病理生理学：多普勒超声心动图见解。
影响因子：
4.8
作者：
Tomasz J. Pasierski;Anthony C. Pearson;A. Labovitz
通讯作者：
A. Labovitz