Lipid control and use of lipid-regulating drugs for prevention of cardiovascular events in Chinese type 2 diabetic patients: a prospective cohort study.
Lipid control and use of lipid-regulating drugs for prevention of cardiovascular events in Chinese type 2 diabetic patients: a prospective cohort study.
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脂质控制和使用脂质调节药物预防中国2型糖尿病患者的心血管事件：一项前瞻性队列研究。
DOI：
10.1186/1475-2840-9-77
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发表时间：
2010-11-22
影响因子：
9.3
通讯作者：
Ma RC
中科院分区：
文献类型：
--
作者：
Ting RZ;Yang X;Yu LW;Luk AO;Kong AP;Tong PC;So WY;Chan JC;Ma RC
血脂异常是2型糖尿病患者心血管疾病（CVD）的重要但可改变的危险因素。然而，亚洲人缺乏调脂药物的有效性。我们研究了血脂控制和调脂药物治疗对中国2型糖尿病患者新发心血管疾病的影响。在这个前瞻性队列中，包括4521例2型糖尿病患者，这些患者从1996年至2005年连续招募，没有CVD病史，并且未经调脂治疗，在中位随访4.9年后，371例发生CVD。我们使用考克斯比例风险回归来获得血脂和使用调脂药物对CVD风险的风险比（HR）。高LDL-胆固醇（≥ 3.0 mmol/L）患者中CVD的多变量校正HR（95%置信区间）为1.36（1.08 - 1.71），与较低值相比。使用HDL-胆固醇的整个范围值，HDL-胆固醇每增加1 mmol/L，CVD的风险降低41%。血浆甘油三酯不能预测CVD。使用他汀类药物与较低的心血管疾病风险相关[HR = 0.66（0.50 - 0.88）]。在子队列分析中，他汀类药物使用与高LDL-胆固醇（≥ 3.0 mmol/L）患者的HR为0.60（0.44 - 0.82）和低HDL-胆固醇患者的HR为0.49（0.28 - 0.88）相关。在LDL-胆固醇< 3.0 mmol/L的患者中，使用贝特类药物与HR 0.34（0.12 - 1.00）相关。只有他汀类药物能有效降低代谢综合征患者的心血管事件[（HR = 0.58（0.42--0.80）]。在中国2型糖尿病患者中，高LDL-胆固醇和低HDL-胆固醇可预测CVD事件。总体而言，与非使用者相比，接受他汀类药物治疗的患者CVD风险降低了40-50%。
Dyslipidaemia is an important but modifiable risk factor of cardiovascular disease (CVD) in type 2 diabetes. Yet, the effectiveness of lipid regulating drugs in Asians is lacking. We examined the effects of lipid control and treatment with lipid regulating drugs on new onset of CVD in Chinese type 2 diabetic patients. In this prospective cohort consisting of 4521 type 2 diabetic patients without history of CVD and naïve for lipid regulating treatment recruited consecutively from 1996 to 2005, 371 developed CVD after a median follow-up of 4.9 years. We used Cox proportional hazard regression to obtain the hazard ratios (HR) of lipids and use of lipid regulating drugs for risk of CVD. The multivariate-adjusted HR (95% confidence interval) of CVD in patients with high LDL-cholesterol (≥ 3.0 mmol/L) was 1.36 (1.08 - 1.71), compared with lower values. Using the whole range value of HDL-cholesterol, the risk of CVD was reduced by 41% with every 1 mmol/L increase in HDL-cholesterol. Plasma triglyceride did not predict CVD. Statins use was associated with lower CVD risk [HR = 0.66 (0.50 - 0.88)]. In sub-cohort analysis, statins use was associated with a HR of 0.60 (0.44 - 0.82) in patients with high LDL-cholesterol (≥ 3.0 mmol/L) and 0.49 (0.28 - 0.88) in patients with low HDL-cholesterol. In patients with LDL-cholesterol < 3.0 mmol/L, use of fibrate was associated with HR of 0.34 (0.12 - 1.00). Only statins were effective in reducing incident CVD in patients with metabolic syndrome [(HR = 0.58(0.42--0.80)]. In Chinese type 2 diabetic patients, high LDL-cholesterol and low HDL-cholesterol predicted incident CVD. Overall, patients treated with statins had 40-50% risk reduction in CVD compared to non-users.
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影响因子：
--
作者：
Almdal, T;Scharling, H;Vestergaard, H
通讯作者：
Vestergaard, H
影响因子：
3.5
作者：
PIWERNETZ, K;HOME, PD;KRANS, M
通讯作者：
KRANS, M
影响因子：
2.7
作者：
Cheng, CWR;Woo, KS;You, JHS
通讯作者：
You, JHS
影响因子：
16.2
作者：
Scott R;O'Brien R;Fulcher G;Pardy C;D'Emden M;Tse D;Taskinen MR;Ehnholm C;Keech A;Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study Investigators
通讯作者：
Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study Investigators
DOI：
10.1056/nejmoa1001282
发表时间：
2010-04-29
期刊：
The New England journal of medicine
影响因子：
--
作者：
ACCORD Study Group;Ginsberg HN;Elam MB;Lovato LC;Crouse JR 3rd;Leiter LA;Linz P;Friedewald WT;Buse JB;Gerstein HC;Probstfield J;Grimm RH;Ismail-Beigi F;Bigger JT;Goff DC Jr;Cushman WC;Simons-Morton DG;Byington RP
通讯作者：
Byington RP