Duration of Diabetes Predicts Aortic Pulse Wave Velocity and Vascular Events in Alström Syndrome.
Duration of Diabetes Predicts Aortic Pulse Wave Velocity and Vascular Events in Alström Syndrome.
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DOI：
10.1210/jc.2015-1577
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发表时间：
2015-08
期刊：
影响因子：
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通讯作者：
Geberhiwot T
中科院分区：
文献类型：
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作者：
Paisey RB;Smith J;Carey C;Barrett T;Campbell F;Maffei P;Marshall JD;Paisey C;Steeds RP;Edwards NC;Bunce S;Geberhiwot T
阿尔斯特伦综合征的特点是从童年起患心血管疾病的风险增加。目的：探讨阿尔斯特伦综合征心血管疾病危险因素、主动脉脉搏波速度和血管事件之间的关系。横断面分析，随访5年。英国国民健康保险制度在全国范围内委托专门诊所治疗阿尔斯特伦综合症。31名Alström患者接受了血管风险评估、心脏研究和主动脉脉搏波速度测量。记录随后的临床结果。胰岛素抵抗用生活方式干预和二甲双胍治疗，糖尿病用格列酮、胰升糖素样肽1激动剂和/或胰岛素治疗。甲状腺和睾酮缺乏症得到纠正。血脂异常用他汀类药物和烟酸衍生物治疗。心肌病按要求按标准治疗。评估年龄、性别和心血管疾病危险因素与主动脉脉搏波速度的关系，并将其与左心功能降低的效果相关联。监测血管事件5年。主动脉脉搏波速度与糖尿病病程呈正相关(P=.001)，与左心室射血分数呈负相关(P=.036)。在有心血管事件的队列中，有5人的主动脉脉搏波速度较高(P=.0247)，并且都有较长的糖尿病病程。糖尿病病程预测阿尔斯特伦综合征患者的主动脉脉搏波速度，进而预测心血管事件。这为二级预防带来了希望，因为生活方式干预可以延缓或逆转2型糖尿病。
Alström syndrome is characterized by increased risk of cardiovascular disease from childhood. To explore the association between risk factors for cardiovascular disease, aortic pulse wave velocity, and vascular events in Alström syndrome. Cross-sectional analyses with 5-year follow-up. The UK NHS nationally commissioned specialist clinics for Alström syndrome. Thirty-one Alström patients undertook vascular risk assessment, cardiac studies, and aortic pulse wave velocity measurement. Subsequent clinical outcomes were recorded. Insulin resistance was treated with lifestyle intervention and metformin, and diabetes with the addition of glitazones, glucagon-like peptide 1 agonists, and/or insulin. Thyroid and T deficiencies were corrected. Dyslipidemia was treated with statins and nicotinic acid derivatives. Cardiomyopathy was treated with standard therapy as required. The associations of age, gender, and risk factors for cardiovascular disease with aortic pulse wave velocity were assessed and correlated with the effects of reduction in left ventricular function. Vascular events were monitored for 5 years. Aortic pulse wave velocity was positively associated with the duration of diabetes (P = .001) and inversely with left ventricular ejection fraction (P = .036). Five of the cohort with cardiovascular events had higher aortic pulse wave velocity (P = .0247), and all had long duration of diabetes. Duration of diabetes predicted aortic pulse wave velocity in Alström syndrome, which in turn predicted cardiovascular events. This offers hope of secondary prevention because type 2 diabetes can be delayed or reversed by lifestyle interventions.