Ten-year hemoglobin A1c trajectories and outcomes in type 2 diabetes mellitus: The Diabetes & Aging Study.
Ten-year hemoglobin A1c trajectories and outcomes in type 2 diabetes mellitus: The Diabetes & Aging Study.
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DOI：
10.1016/j.jdiacomp.2016.07.023
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发表时间：
2017-01
影响因子：
3
通讯作者：
Huang ES
中科院分区：
文献类型：
--
作者：
Laiteerapong N;Karter AJ;Moffet HH;Cooper JM;Gibbons RD;Liu JY;Gao Y;Huang ES
对诊断 2 型糖尿病后患者的长期 HbA1c 值轨迹进行分类，并检查每个轨迹与随后的微血管和大血管事件以及死亡率的关联。对 28,016 名新诊断的 2 型糖尿病患者进行纵向随访。潜在生长混合模型可确定十年 HbA1c 轨迹。 Cox 比例风险模型用于评估 HbA1c 轨迹与事件（微血管和大血管）和死亡率的关系。我们确定了 5 种 HbA1c 轨迹：“低稳定”(82.5%)、“后期中度增加”(5.1%)、“早期高降低”(4.9%)、“后期中度达到峰值”(4.1%) 和“早期中度达到峰值”(3.3%)。调整平均 HbA1c 后，与低稳定轨迹相比，所有不稳定轨迹均与较高的微血管事件发生率相关（风险比 (HR) 范围为 1.28 (95% CI, 1.08-1.53)（早期高下降）至 1.45 (95% CI, 1.20-1.75)（早期中度峰值）。高下降早期轨迹与死亡风险增加相关（HR，1.27（95% CI，1.03-1.58））。不稳定的 HbA1c 轨迹与微血管事件和死亡率较高的风险相关。这些发现表明，早期糖尿病检测、优先考虑良好的血糖控制以及长期维持控制具有潜在益处。
To classify trajectories of long term HbA1c values in patients after diagnosis of Type 2 diabetes and examine each trajectory's associations with subsequent microvascular and macrovascular events and mortality. Longitudinal follow-up of 28,016 patients newly diagnosed with Type 2 diabetes. Latent growth mixture modeling to identify ten-year HbA1c trajectories. Cox proportional hazards models to assess how HbA1c trajectories were associated with events (microvascular and macrovascular) and mortality. We identified 5 HbA1c trajectories: “low stable” (82.5%), “moderate increasing late” (5.1%), “high decreasing early” (4.9%), “moderate peaking late” (4.1%) and “moderate peaking early” (3.3%). After adjusting for average HbA1c, compared to the low stable trajectory, all non-stable trajectories were associated with higher incidences of microvascular events (hazard ratio (HR) range, 1.28 (95% CI, 1.08-1.53) (high decreasing early) to 1.45 (95% CI, 1.20-1.75) (moderate peaking early). The high decreasing early trajectory was associated with an increased mortality risk (HR, 1.27 (95% CI, 1.03-1.58)). Trajectories were not associated with macrovascular events. Non-stable HbA1c trajectories was associated with greater risk of microvascular events and mortality. These findings suggest a potential benefit of early diabetes detection, prioritizing good glycemic control, and maintaining control over time.
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影响因子：
16.2
作者：
Riddle MC;Ambrosius WT;Brillon DJ;Buse JB;Byington RP;Cohen RM;Goff DC Jr;Malozowski S;Margolis KL;Probstfield JL;Schnall A;Seaquist ER;Action to Control Cardiovascular Risk in Diabetes Investigators
通讯作者：
Action to Control Cardiovascular Risk in Diabetes Investigators
影响因子：
1.9
作者：
Muthén, B;Shedden, K
通讯作者：
Shedden, K
影响因子：
168.9
作者：
Turner, RC;Holman, RR;Ward, JD
通讯作者：
Ward, JD
影响因子：
158.5
作者：
Holman, Rury R.;Paul, Sanjoy K.;Neil, H. Andrew W.
通讯作者：
Neil, H. Andrew W.
影响因子：
3
作者：
Ma, Wen-Ya;Li, Hung-Yuan;Su, Ching-Chieh
通讯作者：
Su, Ching-Chieh