The effect of intensive glycemic treatment on coronary artery calcification in type 1 diabetic participants of the diabetes control and complications Trial/Epidemiology of diabetes interventions and complications (DCCT/EDIC) study
The effect of intensive glycemic treatment on coronary artery calcification in type 1 diabetic participants of the diabetes control and complications Trial/Epidemiology of diabetes interventions and complications (DCCT/EDIC) study
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DOI：
10.2337/db06-0653
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发表时间：
2006-12-01
期刊：
影响因子：
7.7
通讯作者：
Nathan, David M.
中科院分区：
文献类型：
--
作者：
Cleary, Patricia A.;Orchard, Trevor J.;Nathan, David M.
糖尿病干预和并发症的流行病学（EDIC）研究是对糖尿病控制和并发症试验（DCCT）1型糖尿病队列的一项观察性随访。该研究在DCCT结束约7 - 9年后，用计算机断层扫描（CT）对1205名EDIC患者测量了冠状动脉钙化（CAC）这一动脉粥样硬化指标。我们研究了DCCT期间之前6.5年的常规治疗与强化治疗以及心血管疾病危险因素对CAC的影响。CAC>0和>200阿加斯顿单位的患病率分别为31.0%和8.5%。与常规治疗组相比，在主要的视网膜病变预防队列中，强化治疗组的CAC几何均数得分显著更低，CAC>0的患病率更低，但在二级干预队列中并非如此，且在联合队列中CAC>200的患病率更低。在CT检查之前或当时的腰臀比、吸烟、高血压和高胆固醇血症在单变量和多变量分析中与CAC显著相关。CAC与入选前、DCCT期间和EDIC研究期间的平均糖化血红蛋白（HbA₁c，A1C）水平相关。DCCT期间之前的强化糖尿病治疗与较少的动脉粥样硬化相关，这主要是因为DCCT期间A1C水平降低。
The Epidemiology of Diabetes Interventions and Complications (EDIC) study, an observational follow-up of the Diabetes Control and Complications Trial (DCCT) type 1 diabetes cohort, measured coronary artery calcification (CAC), an index of atherosclerosis, with computed tomography (CT) in 1,205 EDIC patients at similar to 7-9 years after the end of the DCCT. We examined the influence of the 6.5 years of prior conventional versus intensive diabetes treatment during the DCCT, as well as the effects of cardiovascular disease risk factors, on CAC. The prevalences of CAC > 0 and > 200 Agatston units were 31.0 and 8.5%, respectively. Compared with the conventional treatment group, the intensive group had significantly lower geometric mean CAC scores and a lower prevalence of CAC > 0 in the primary retinopathy prevention cohort, but not in the secondary intervention cohort, and a lower prevalence of CAC > 200 in the combined cohorts. Waist-to-hip ratio, smoking, hypertension, and hypercholesterolemia, before or at the time of CT, were significantly associated with CAC in univariate and multivariate analyses. CAC was associated with mean HbA(1c) (A1C) levels before enrollment, during the DCCT, and during the EDIC study. Prior intensive diabetes treatment during the DCCT was associated with less atherosclerosis, largely because of reduced levels of A1C during the DCCT.