Relation between age and cardiovascular disease in men and women with diabetes compared with non-diabetic people: a population-based retrospective cohort study
Relation between age and cardiovascular disease in men and women with diabetes compared with non-diabetic people: a population-based retrospective cohort study
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DOI：
10.1016/s0140-6736(06)68967-8
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发表时间：
2006-07-01
期刊：
影响因子：
168.9
通讯作者：
Tu, Jack V.
中科院分区：
文献类型：
--
作者：
Booth, Gillian L.;Kapral, Moira K.;Tu, Jack V.
背景：成人糖尿病患者被认为具有心血管疾病（CVD）的高风险，无论其年龄如何。这项研究的主要目的是找出糖尿病患者发生心血管疾病高风险的年龄，定义为：相当于10年风险20%或以上的事件率;方法我们进行了一项基于人群的回顾性队列研究，使用省级健康声明来识别所有患有心肌梗死的成年人，（n=379 003）和（n=9 018 082），1994年4月1日居住在加拿大安大略，无糖尿病。个人随访记录心血管事件，直到2000年3月31日。结果-糖尿病男性和女性的高风险类别的转变发生在一个年轻的年龄比那些没有糖尿病（平均差异14.6年）。对于急性心肌梗死（AMI）、中风或任何原因导致的死亡，男性和女性糖尿病患者分别在47.9岁和54.3岁时进入高风险类别。当我们使用一个更广泛的定义，心血管疾病，也包括冠状动脉或颈动脉血运重建，年龄分别为41.3和47.7岁的男性和女性的糖尿病。然而，一般来说，年轻的糖尿病患者（40岁或以下）似乎并不存在CVD的高风险。在针对糖尿病患者降低风险时应考虑年龄。
Background Adults with diabetes are thought to have a high risk of cardiovascular disease (CVD), irrespective of their age. The main aim of this study was to find out the age at which people with diabetes develop a high risk of CVD, as defined by: an event rate equivalent to a 10-year risk of 20% or more; or an event rate equivalent to that associated with previous myocardial infarction.Methods We did a population-based retrospective cohort study using provincial health claims to identify all adults with (n=379 003) and (n=9 018 082) without diabetes mellitus living in Ontario, Canada, on April 1, 1994. Individuals were followed up to record CVD events until March 31, 2000.Findings The transition to a high-risk category occurred at a younger age for men and women with diabetes than for those without diabetes (mean difference 14.6 years). For the outcome of acute myocardial infarction (AMI), stroke, or death from any cause, diabetic men and women entered the high-risk category at ages 47.9 and 54.3 years respectively. When we used a broader definition of CVD that also included coronary or carotid revascularisation, the ages were 41.3 and 47.7 years for men and women with diabetes respectively.Interpretation Diabetes confers an equivalent risk to ageing 15 years. However, in general, younger people with diabetes (age 40 or younger) do not seem to be at high risk of CVD. Age should be taken into account in targeting of risk reduction in people with diabetes.