Diabetes Complications and Comorbidities as Risk Factors for MACE in People With Type 2 Diabetes and Their Development Over Time: A Danish Registry-Based Case–Control Study

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2025-03-26 DOI:10.1111/1753-0407.70076

Asger Ahlmann Bech, Mia Daugaard Madsen, Annika Vestergaard Kvist, Peter Vestergaard, Nicklas Højgaard-hessellund Rasmussen

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Abstract

Aim

This study aimed to investigate the association between cardiovascular risk factors and major adverse cardiovascular events (MACE) in people with type 2 diabetes, while assessing potential changes over time.

Methods

Utilizing data from Danish registries, this study identified people with type 2 diabetes between 2002 and 2021 (n = 372 328) and subdivided them into two 10-year time periods: TP1: 2002–2011 and TP2: 2012–2021, and further categorized into cases and controls. Cases were defined as having suffered a first-time three-point MACE (n_TP1 = 12 713, n_TP2 = 8981) and matched 1:1 with controls on age, sex, and type 2 diabetes duration. Exposures were preselected diabetes complications and comorbidities.

Results

Fewer were affected by MACE during TP2 compared to TP1 (p < 0.001). Diabetes complications associated with MACE were nephropathy (OR_TP1 = 1.54, 95% CI 1.30–1.83, OR_TP2 = 1.47, 95% CI 1.20–1.79), neuropathy (OR_TP1 = 2.02, 95% CI 1.84–2.21 OR_TP2 = 1.58, 95% CI 1.44–1.73) and retinopathy (OR_TP1 = 1.10, 95% CI 0.98–1.23, OR_TP2 = 1.38, 95% CI 1.17–1.63). Comorbidities associated with MACE included hypertension (OR_TP1 = 1.30, 95% CI 1.22–1.38 OR_TP2 = 1.31, 95% CI 1.22–1.41), atrial flutter or fibrillation (OR_TP1 = 1.46, 95% CI 1.35–1.58, OR_TP2 = 1.37, 95% CI 1.26–1.50), heart failure (OR_TP1 = 1.53, 95% CI 1.401.67-, OR_TP2 = 1.37, 95% CI 1.23–1.54) and hypercholesterolemia (OR_TP1 = 1.13, 95% CI 1.07–1.20, OR_TP2 = 1.02, 95% CI 0.96–1.10). Hypercholesterolemia (p = 0.038) and neuropathy (p = 0.038) exhibited a significant decrease in association with MACE between the time periods.

Conclusions

The prevalence of first-time MACE decreased over time, despite a relatively stable prevalence of type 2 diabetes. Several diabetes-related complications and comorbidities were significantly associated with MACE. The associations of neuropathy and hypercholesterolemia with MACE lessened over time, suggesting potential improvements in risk management or treatment strategies.

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.