糖尿病发病时心血管风险因素和生活方式的性别和年龄差异:西班牙初级卫生保健横断面研究。

Pilar Vich-Perez, Belen Taulero-Escalera, Victoria Garcia-Espinosa, Laura Villanova-Cuadra, Paula Regueiro-Toribio, Ignacio Sevilla-Machuca, Julia Timoner-Aguilera, Mario Martinez-Grandmontagne, Tania Abos-Pueyo, Cristina Alvarez-Hernandez-Canizares, German Reviriego-Jaen, Alberto Serrano-Lopez-Hazas, Ines Gala-Molina, Mar Sanz-Pascual, Miguel A Salinero-Fort, LADA-PC consortium
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The variables were obtained\nfrom their electronic medical records, physical examination, complete analysis, and\nlifestyle questionnaires.\nResults\nThe main comorbidities were: hypercholesterolemia (64.4%; 95% CI, 60.6-68.2),\nhypertension (55.2%; 95% CI, 51.3-59.1), obesity (58.9%; 95% CI, 55.2-62.6),\nmetabolic syndrome (58.5%; 95% CI, 54.6-62.5); and hypertriglyceridemia (25.3%;\n95% CI, 21.9-28.7). Despite being newly diagnosed, 7.6% (95% CI, 5.4-9.8) had\nmicroalbuminuria, and 10.3% (95% CI, 8.0-12.6) cardiovascular disease. The main\nunhealthy lifestyles were: low physical activity (52%; 95% CI, 48.1-55.9), alcohol\nconsumption (47.7%; 95% CI, 44.0-51.5) and smoking (19.2%; 95% CI, 16.2-22.3).\nCompared with men, women had more morbid obesity (9.7% vs 4.6%, p=.014), worse\nlipid profile (total cholesterol: 184 (IQR, 158-207) vs. 165 (IQR, 144-192), p<.01), less\ntreatment with metformin (74.8% vs. 84.4%, p<.01) and antiplatelet agents (8.1%\nvs.18.6%, p<.01), but women had fewer comorbidities. Patients with a high educational\nlevel (OR= 1.90, 95% CI, 1.28-2.81) ) and those >60 years (OR= 1.49; 95% CI, 1.01-\n2.21) were more adherent to the Mediterranean diet, and the older ones did less\nintense exercise (OR= 0.34, 95% CI, 0.16-0.75). Normal blood pressure was\nassociated with Mediterranean diet (OR= 1.52; 95% CI, 1.05-2.21) and high physical\nactivity (OR= 4.03; 95% CI, 1.69-9.61); and body mass index was inversely associated\nwith physical activity (OR= 0.92; 95% CI, 0.85-0.99).\nConclusions\nPatients newly diagnosed with diabetes mellitus have crucial cardiovascular risk\nfactors and comorbidities at the onset of the disease. 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The patients\\nwere treated in primary care centers in Madrid (Spain). The variables were obtained\\nfrom their electronic medical records, physical examination, complete analysis, and\\nlifestyle questionnaires.\\nResults\\nThe main comorbidities were: hypercholesterolemia (64.4%; 95% CI, 60.6-68.2),\\nhypertension (55.2%; 95% CI, 51.3-59.1), obesity (58.9%; 95% CI, 55.2-62.6),\\nmetabolic syndrome (58.5%; 95% CI, 54.6-62.5); and hypertriglyceridemia (25.3%;\\n95% CI, 21.9-28.7). Despite being newly diagnosed, 7.6% (95% CI, 5.4-9.8) had\\nmicroalbuminuria, and 10.3% (95% CI, 8.0-12.6) cardiovascular disease. 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引用次数: 0

摘要

目的描述最近确诊的糖尿病患者在合并症、心血管风险因素和健康生活方式方面的主要特征,并按性别和年龄组进行分类。方法对 681 名年龄在 30 岁以下、在过去 4 年中确诊为糖尿病的患者进行横断面、多中心、观察性研究。这些患者在马德里(西班牙)的初级保健中心接受治疗。结果主要合并症有:高胆固醇血症(64.4%;95% CI,60.6-68.2)、高血压(55.2%;95% CI,51.3-59.1)、肥胖(58.9%;95% CI,55.2-62.6)、代谢综合征(58.5%;95% CI,54.6-62.5)和高甘油三酯血症(25.3%;95% CI,21.9-28.7)。尽管刚确诊,但有 7.6%(95% CI,5.4-9.8)的人患有微量白蛋白尿,10.3%(95% CI,8.0-12.6)的人患有心血管疾病。主要的不健康生活方式是:体力活动少(52%;95% CI,48.1-55.9)、饮酒(47.7%;95% CI,44.0-51.5)和吸烟(19.2%;95% CI,16.2-22.3)。与男性相比,女性有更多的病态肥胖(9.7% vs. 4.6%,p=.014)、更差的血脂状况(总胆固醇:184(IQR,158-207) vs. 165(IQR,144-192),p<.01)、更少使用二甲双胍(74.8% vs. 84.4%,p<.01)和抗血小板药物(8.1%vs.18.6%,p<.01),但女性合并症较少。高学历患者(OR=1.90,95% CI,1.28-2.81)和 60 岁患者(OR=1.49;95% CI,1.01-2.21)更坚持地中海饮食,而老年人的运动强度较低(OR=0.34,95% CI,0.16-0.75)。正常血压与地中海饮食(OR= 1.52;95% CI,1.05-2.21)和高运动量(OR= 4.03;95% CI,1.69-9.61)相关;体重指数与运动量成反比(OR= 0.92;95% CI,0.85-0.99)。这些都可以通过健康的生活方式加以改变。
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Sex and age differences in cardiovascular risk factors and lifestyle at the onset of diabetes mellitus: a cross-sectional study in Spanish Primary Health Care.
Aims To describe the main characteristics of patients recently diagnosed with diabetes mellitus in terms of comorbidities, cardiovascular risk factors and healthy lifestyle by sex and age group. Methods A cross-sectional, multicenter, observational study of 681 patients aged >30 years diagnosed with diabetes mellitus in the previous 4 years was performed. The patients were treated in primary care centers in Madrid (Spain). The variables were obtained from their electronic medical records, physical examination, complete analysis, and lifestyle questionnaires. Results The main comorbidities were: hypercholesterolemia (64.4%; 95% CI, 60.6-68.2), hypertension (55.2%; 95% CI, 51.3-59.1), obesity (58.9%; 95% CI, 55.2-62.6), metabolic syndrome (58.5%; 95% CI, 54.6-62.5); and hypertriglyceridemia (25.3%; 95% CI, 21.9-28.7). Despite being newly diagnosed, 7.6% (95% CI, 5.4-9.8) had microalbuminuria, and 10.3% (95% CI, 8.0-12.6) cardiovascular disease. The main unhealthy lifestyles were: low physical activity (52%; 95% CI, 48.1-55.9), alcohol consumption (47.7%; 95% CI, 44.0-51.5) and smoking (19.2%; 95% CI, 16.2-22.3). Compared with men, women had more morbid obesity (9.7% vs 4.6%, p=.014), worse lipid profile (total cholesterol: 184 (IQR, 158-207) vs. 165 (IQR, 144-192), p<.01), less treatment with metformin (74.8% vs. 84.4%, p<.01) and antiplatelet agents (8.1% vs.18.6%, p<.01), but women had fewer comorbidities. Patients with a high educational level (OR= 1.90, 95% CI, 1.28-2.81) ) and those >60 years (OR= 1.49; 95% CI, 1.01- 2.21) were more adherent to the Mediterranean diet, and the older ones did less intense exercise (OR= 0.34, 95% CI, 0.16-0.75). Normal blood pressure was associated with Mediterranean diet (OR= 1.52; 95% CI, 1.05-2.21) and high physical activity (OR= 4.03; 95% CI, 1.69-9.61); and body mass index was inversely associated with physical activity (OR= 0.92; 95% CI, 0.85-0.99). Conclusions Patients newly diagnosed with diabetes mellitus have crucial cardiovascular risk factors and comorbidities at the onset of the disease. These can be modified through a healthy lifestyle.
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