糖尿病门诊患者的人体测量与心血管风险的关系

Kylie Divashnee Konar, S. Pillay
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引用次数: 0

摘要

肥胖是2型糖尿病(T2DM)患者心血管疾病(CVD)的一个有充分证据的危险因素,越来越多的证据表明,内脏肥胖是比体重指数(BMI)更大的CVD危险因素。目的探讨艾滋病流行地区糖尿病患者高血压(HPT)与人体测量的关系。方法回顾性研究分析了2019年1月1日至2019年12月31日南非彼得马里茨堡哈里·格瓦拉地区医院糖尿病诊所的标准化临床病历数据。研究使用了957名PLWD患者的数据,其中大多数患有T2DM (811;86.2%)。大约六分之一的队列感染了艾滋病毒(146;15.3%)。未感染HIV(77.9%)和感染HIV (PLWDHIV)的PLWD(78.1%)之间HPT患病率无显著差异。多因素分析显示,腰围(WC)和腰高比(WTHR)增加的女性患高血压的可能性分别为57.8倍(95% CI 3.04 ~ 1096.33) (p = 0.007)和87.2倍(95% CI 4.88 ~ 1558.28) (p = 0.002)。相比之下,只有男性BMI与HPT相关,AOR为5.294 (95% CI 1.54 - 18.22) (p = 0.008)。HIV状态对人体测量预测PLWD患者HPT无贡献。结论我们的研究发现人体测量指标并非都是HPT的预测指标。作者主张在PLWD中对人体测量的性别划分进行本地指导。
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Association between anthropometry and cardiovascular risk in patients attending a diabetic clinic
Background Obesity is a well-documented risk factor for cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM), with increasing evidence to suggest visceral adiposity as a greater risk factor for CVD than body mass index (BMI). Objectives To determine a relationship between hypertension (HPT) and anthropometry in people living with diabetes (PLWD) in an HIV endemic area. Methods This was a retrospective study analysing data captured from standardised clinic sheets from the DM clinic at the Harry Gwala Regional Hospital, Pietermaritzburg, South Africa, from January 1, 2019 to December 31, 2019. Results Data from 957 PLWD were used for the study, the majority of whom had T2DM (811; 86.2%). Approximately one-sixth of the cohort had HIV infection (146; 15.3%). There was no significant difference in HPT prevalence between the HIV-uninfected (77.9%) and PLWD who had HIV (PLWDHIV) (78.1%). Multivariate analysis revealed females with increased waist circumference (WC) and waist-to-height ratio (WTHR) were 57.8 (95% CI 3.04–1096.33) (p = 0.007) and 87.2 (95% CI 4.88–1558.28) (p = 0.002) times more likely to be hypertensive respectively. By contrast, only BMI in males was associated with HPT with a AOR 5.294 (95% CI 1.54 - 18.22) (p = 0.008). HIV status was non-contributory to anthropometry in predicting HPT in PLWD. Conclusion Our study found that anthropometric indices are not all equal predictors of HPT. The authors advocate for local guidance on gender-specific cut-offs on anthropometry in PLWD.
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