Cause-specific risk of major adverse cardiovascular outcomes and hypoglycemic in patients with type 2 diabetes: a multicenter prospective cohort study.
机构:[1]Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410078, China [2] Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of pharmacogenetics, Changsha 410078, China [3]Data Analysis Technology Lab, School of Mathematics and Statistics, Henan University, Kaifeng 475004, China [4]Beijing Hypertension League Institute, 24 Shijingshan Road, Beijing 100043, China [5]Department of Laboratory Medicine, National Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China四川大学华西医院
Glycated hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) was identified to account for the risk of cardiovascular diseases in type 2 diabetic patients, but no study evaluated the risk based on both HbA1c and FPG levels. We described the risk of major adverse cardiovascular events (MACE) and hypoglycemic in type 2 diabetic patients according to both HbA1c and FPG levels.
With the usage of databases of Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation (ADVANCE), 1815 patients from 61 centers in China was identified and grouped according to the criterion value of HbA1c and FPG: Good glycemic control (HbA1c < 6.5%, FPG < 6.1 mmol/L); Insufficient glycemic control (HbA1c < 6.5%, FPG ≥ 6.1 mmol/L or HbA1c ≥ 6.5%, FPG < 6.1 mmol/L); Poor glycemic control (HbA1c ≥ 6.5%, FPG ≥ 6.1 mmol/L). Time-varying multivariable Cox proportional hazards models were employed.
Average age was 64.8 ± 5.8 years, with a median of 4.8 years of follow-up. Overall, the incidence rates of MACE were 20.6 per 1000-person-years in Good glycemic control compared with 45.9 per 1000-person-years in Insufficient glycemic control (adjusted hazard ratio (aHR): 1.99; 95% CI 1.11-3.56; p = 0.02) and 54.7 per 1000-person-years in Poor glycemic control (aHR: 2.46; 95% CI 1.38-4.40; p = 0.002), respectively. The risk of hypoglycemic was highest in Insufficient glycemic control; 67.3 per 1000-person-years compared with 46.3 per 1000-person-years in Good glycemic control (aHR: 1.62; 95% CI 1.03-2.56; p = 0.04). Apart from this, we also observed that both MACE (aHR:1.41; 95% CI 1.13-1.77; p = 0.003) and hypoglycemic episodes (aHR: 1.82; 95% CI 1.48-2.24; p < 0.001) were sufficiently more frequent in the insulin-exposed group than the non-exposed group. In a post-hoc analysis, the risk of MACE (aHR:1.43; 95% CI 1.09-1.86; p = 0.01) and hypoglycemic (aHR: 1.99; 95% CI 1.46-2.69; p < 0.001) were more pronounced in Insufficient glycemic control with insulin exposure.
We observed a significant association of cause-specific risk of MACE and hypoglycemic with Insufficient glycemic control, particularly with insulin exposure.
基金:
National Key Research
and Development Program (No. 2016YFC0905000), National Natural
Science Foundation of China (No 81522048, 81573511) and the
Innovation Driven Project of Central South University (No
2016CX024).
语种:
外文
PubmedID:
中科院(CAS)分区:
出版当年[2019]版:
大类|2 区医学
小类|3 区内分泌学与代谢
最新[2023]版:
大类|3 区医学
小类|3 区内分泌学与代谢
第一作者:
第一作者机构:[1]Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410078, China [2] Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of pharmacogenetics, Changsha 410078, China
通讯作者:
通讯机构:[1]Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410078, China [2] Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of pharmacogenetics, Changsha 410078, China
推荐引用方式(GB/T 7714):
Bao Sun,Fazhong He,Lei Sun,et al.Cause-specific risk of major adverse cardiovascular outcomes and hypoglycemic in patients with type 2 diabetes: a multicenter prospective cohort study.[J].Endocrine.2019,63(1):44-51.doi:10.1007/s12020-018-1715-0.
APA:
Bao Sun,Fazhong He,Lei Sun,Jiecan Zhou,Jiayi Shen...&Wei Zhang.(2019).Cause-specific risk of major adverse cardiovascular outcomes and hypoglycemic in patients with type 2 diabetes: a multicenter prospective cohort study..Endocrine,63,(1)
MLA:
Bao Sun,et al."Cause-specific risk of major adverse cardiovascular outcomes and hypoglycemic in patients with type 2 diabetes: a multicenter prospective cohort study.".Endocrine 63..1(2019):44-51