Cardiovascular disease and its risk factors in IDDM in Europe
Cardiovascular disease and its risk factors in IDDM in Europe
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DOI：
10.2337/diacare.19.7.689
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发表时间：
1996-07-01
期刊：
影响因子：
16.2
通讯作者：
Sharp, R
中科院分区：
文献类型：
--
作者：
Koivisto, VA;Stevens, LK;Sharp, R
目的 - 研究欧洲不同国家的 IDDM 患者心血管疾病 (CVD) 的患病率、其危险因素及其关联。 研究设计和方法 - 在一项横断面研究中，对来自 16 个欧洲国家的 3,250 名 IDDM 患者进行了 CVD（既往史或心电图异常）的患病率及其危险因素（EURODIAB IDDM 并发症研究）。这些患者在 31 个中心接受了检查，并根据年龄、性别和糖尿病病程在不同中心之间进行了分层。糖尿病的平均 +/- SD 病程为 14.7 +/- 9.3 年。 结果 - 男性 CVD 患病率为 9%，女性为 10%。患病率随着年龄的增长（从 15-29 岁患者的 6% 增加到 45-59 岁患者的 25%）和糖尿病病程而增加。整个人群的中心间变异是从？至 19%。无论男女，患有 CVD 的患者的东甘油三酯浓度均高于未患有 CVD 的患者，而 HDL 胆固醇则较低。在男性中，心血管疾病患者的糖尿病持续时间更长、腰臀比更大、高血压更常见。在女性中，BMI 越高，CVD 患病率越高。胰岛素剂量、HbA(1c)水平、年龄调整的白蛋白排泄率或吸烟状况与CVD之间没有关联。腰臀比，特别是男性，与年龄、年龄调整后的 HbA(1c)、吸烟率、每日胰岛素剂量、白蛋白排泄率和空腹甘油三酯浓度呈正相关。结论 - 这些 IDDM 患者的 CVD 总体患病率与 10% 相似，随着年龄和糖尿病病程的增加而增加，不同欧洲中心之间的差异为六倍。 CVD 患病率与甘油三酯升高和高密度脂蛋白胆固醇浓度降低密切相关。 CVD也与蛋白尿有关，但当根据年龄调整后，这种关联就消失了。腰臀比的增加与许多不良特征相关，特别是 IDDM 男性，反映了先前在其他人群中描述的代谢综合征。
OBJECTIVE - To study the prevalence of cardiovascular disease (CVD), its risk factors, and their associations in IDDM patients in different European countries.RESEARCH DESIGN AND METHODS - The prevalence of CVD (a past history or electrocardiogram abnormalities) and its risk factors were examined in a cross-sectional study in 3,250 IDDM patients from 16 European countries (EURODIAB IDDM Complications Study). The patients were examined in 31 centers and were stratified between centers for age, sex, and duration of diabetes. The mean +/- SD duration of diabetes was 14.7 +/- 9.3 years.RESULTS - The prevalence of CVD was 9% in men and 10% in women. The prevalence increased with age (from 6% in patients 15-29 years old to 25% in patients 45-59 years old) and with duration of diabetes. The between-center variation for the whole population was from ? to 19%. In both sexes, Easting triglyceride concentration was higher and HDL cholesterol lower in those patients with CVD than in those without. In men, duration oi diabetes was longer, waist-to-hip ratio greater, and hypertension more common in patients with CVD. In women, a greater BMI was associated with increased prevalence of CVD. There was no association between insulin dose, HbA(1c) level, age-adjusted rate of albumin excretion, or smoking status and CVD. Waist-to-hip ratio, particularly in men, was positively associated with age, age-adjusted HbA(1c), prevalence of smoking, daily insulin dose, albumin excretion rate, and fasting triglyceride concentrations.CONCLUSIONS - The overall prevalence of CVD in these IDDM patients was similar to 10%, increasing with age and duration of diabetes and with a sixfold variation between different European centers. CVD prevalence was most strongly associated with elevated triglyceride and decreased HDL cholesterol concentrations. CVD was also associated with albuminuria, but when adjusted by age, this association vanished. Increasing waist-to-hip ratio was associated with a number of adverse characteristics, particularly in IDDM men, reflecting the metabolic syndrome previously described in other populations.