The significant effect of diabetes duration on coronary heart disease morality - The Framingham Heart Study
The significant effect of diabetes duration on coronary heart disease morality - The Framingham Heart Study
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DOI：
10.2337/diacare.27.3.704
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发表时间：
2004-03-01
期刊：
影响因子：
16.2
通讯作者：
Wilson, PWF
中科院分区：
文献类型：
--
作者：
Fox, CS;Sullivan, L;Wilson, PWF
目的：2型糖尿病患者冠心病（CHD）的风险比普通人群高2 - 3倍，但糖尿病病程对CHD风险的影响尚未得到很好的表征。我们假设糖尿病病程是糖尿病患者发生冠心病的重要预测因素。研究设计和方法--在FRAYTECHART研究的原始和后代队列中，对糖尿病患者的糖尿病病程（空腹血糖126 mg/dl，随机血糖大于或等于200 mg/dl，或口服降糖药或胰岛素的使用）进行评估。仅纳入了年龄在30 - 74岁之间、无酮症酸中毒史且基线评价时无心血管疾病的糖尿病受试者。考克斯比例风险模型被用来估计冠心病事件和死亡率的风险比超过12年的后续periods. Results模型进行了调整已知的冠心病危险因素-在588人检查糖尿病（平均年龄58 +/- 9岁，56%的男性），有86冠心病事件，包括36例死亡。校正年龄、性别和冠心病危险因素后，糖尿病病程每增加10年，冠心病风险增加1.38倍（95% CI 0.99-1.92），冠心病死亡风险是正常对照组的1.86倍（1.17-2.93）对于相同的糖尿病病程的增加。结论-糖尿病病程增加冠心病死亡的风险，与共存的危险因素无关。进一步的研究是必要的，以了解这种增加的风险的病理生理学。
OBJECTIVE - The risk of coronary heart disease (CHD) in type 2 diabetes is two- to threefold higher than in the general population, but the effect of diabetes duration on CHD risk has not been well characterized. We hypothesized that duration of diabetes is an important predictor of incident CHD among people with diabetes.RESEARCH DESIGN AND METHODS- The duration of diabetes (fasting glucose 126 mg/dl, random glucose greater than or equal to200 mg/dl, or use of an oral hypoglycemic agent or insulin) was assessed in participants with diabetes in the original and offspring cohorts of the Framingham Heart Study. Only subjects with diabetes diagnosed between the ages of 30 and 74 years, without a history of ketoacidosis, and free of cardiovascular disease at the baseline evaluation were included. Cox proportional hazards models were used to estimate the hazard ratio of incident CHD events and mortality over a 12-year follow-up period; models were adjusted for known CHD risk factors.RESULTS- Among 588 person-exams with diabetes (mean age 58 +/- 9 years, 56% men), there were 86 CHD events, including 36 deaths. After adjustment for age, sex, and CHD risk factors, the risk of CHD was 1.38 times higher for each 10-year increase in duration of diabetes (95% CI 0.99-1.92), and the risk for CHD death was 1.86 times higher (1.17-2.93) for the same increase in duration of diabetes.CONCLUSIONS- Duration of diabetes increases the risk of CHD death independent of coexisting risk factors. Further research is necessary to understand the pathophysiology of this increased risk.