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IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Nutrition Metabolism and Cardiovascular Diseases Pub Date : 2025-01-24 DOI:10.1016/j.numecd.2025.103869

Jamal S Rana, Fatima Farrukh, Howard H Moffet, Jennifer Y Liu, Ankeet S Bhatt, Pierre Sabouret, Andrew J Karter

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引用次数: 0

摘要

背景和目的：人们对糖尿病导致的过早发生动脉粥样硬化性心血管疾病（ASCVD）的风险知之甚少。我们评估了糖尿病对年轻男性和女性未来罹患 ASCVD 风险的影响：观察性队列研究的对象是综合医疗保健服务系统 Kaiser Permanente Northern California 的年轻成年人（30-55 岁），他们没有确诊 ASCVD（截至 2006 年 1 月 1 日）。调整了人口统计学因素（年龄、种族）和传统风险因素（高血压、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、总胆固醇、吸烟）。根据糖尿病状态：无糖尿病（参考值）与未接受治疗的糖尿病、仅接受口服降糖药（OH）与接受口服降糖药加胰岛素治疗的糖尿病，建立特定模型以估算发生 ASCVD 事件的风险比 (RRs)。事件性 ASCVD 事件定义为 2020 年 12 月 31 日前非致命性心肌梗死、缺血性中风或冠心病死亡的综合结果。在完全调整模型中，与非糖尿病患者相比，使用胰岛素的糖尿病患者发生 ASCVD 事件的风险女性高 5 倍（RR：5.44；95 % CI：4.90-6.05），男性高 3 倍（RR：3.13；95 % CI：2.84-3.45）：结论：医护人员对年轻糖尿病患者的 ASCVD 风险管理采取积极主动的态度，有助于改善与这种复杂的代谢和心血管疾病相互作用相关的发病率和死亡率。

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Diabetes and risk of premature atherosclerotic cardiovascular disease.

Background and aim: Risk of premature atherosclerotic cardiovascular disease (ASCVD) attributable to diabetes is poorly understood. We evaluated the impact of diabetes on future risk of ASCVD in young men and women.

Methods and results: Observational cohort study of young adults (ages 30-55 years) without established ASCVD (as of January 1, 2006) who were members of Kaiser Permanente Northern California, an integrated healthcare delivery system. Adjusted demographics (age, race) and traditional risk factors (hypertension, LDL-cholesterol, HDL- C, total cholesterol, smoking). Models were specified to estimate risk ratios (RRs) for incident ASCVD events by diabetes status: no diabetes (reference) versus diabetes with no treatment, with oral hypoglycemic (OH) only and with OH plus insulin. Incident ASCVD events were defined as a composite of nonfatal myocardial infarction, ischemic stroke, or coronary heart disease death through December 31, 2020. In fully adjusted models, individuals with diabetes using insulin exhibited a 5-fold higher risk among women (RR: 5.44; 95 % CI: 4.90-6.05) and a 3-fold higher risk among men (RR: 3.13; 95 % CI: 2.84-3.45) for incident ASCVD events compared to those without diabetes.

Conclusions: A proactive stance towards ASCVD risk management in young individuals with diabetes, healthcare professionals can help improve the morbidity and mortality associated with this complex interplay of metabolic and cardiovascular disease.

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来源期刊

Nutrition Metabolism and Cardiovascular Diseases 医学-内分泌学与代谢

CiteScore

6.80

自引率

2.60%

发文量

332

审稿时长

57 days

期刊介绍： Nutrition, Metabolism & Cardiovascular Diseases is a forum designed to focus on the powerful interplay between nutritional and metabolic alterations, and cardiovascular disorders. It aims to be a highly qualified tool to help refine strategies against the nutrition-related epidemics of metabolic and cardiovascular diseases. By presenting original clinical and experimental findings, it introduces readers and authors into a rapidly developing area of clinical and preventive medicine, including also vascular biology. Of particular concern are the origins, the mechanisms and the means to prevent and control diabetes, atherosclerosis, hypertension, and other nutrition-related diseases.