Birth Weight, Cardiovascular Health, and Microvascular Complications in Individuals with Diabetes Mellitus.

IF 6.8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Chaolun Yu, Anping Feng, Xia Zou, Siqi Chen, Lingyan Dai, Qingmei Cui, Xiaojing Kuang, Gaoli She, Ying Ma, Haixia Guan, Jie Li
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Abstract

Background: Diabetes often leads to microvascular complications, including nephropathy, neuropathy, and retinopathy. Understanding the impact of early-life factors like birth weight and modifiable behaviors such as cardiovascular health (CVH) is essential for preventing these complications.

Methods: We included 11,515 participants with diabetes but without microvascular complications at baseline from the UK Biobank Study. CVH was evaluated using the Life's Essential 8 score. Independent and joint associations of birth weight and CVH with microvascular complications were analyzed using Cox proportional hazard models. Two-sample Mendelian randomization (MR) analyses estimated unconfounded associations between birth weight and microvascular complications.

Results: Over a median follow-up of 13.1 years, 3,010 microvascular complications occurred. Compared with normal birth weight (2.5-4.0 kg), low birth weight (LBW; <2.5 kg) was associated with 15% higher risk of diabetic nephropathy (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.01 to 1.31), but not with neuropathy and retinopathy. High birth weight (>4.0 kg) was not associated with the risk of diabetic microvascular complications. MR analysis confirmed the association between LBW and nephropathy. Adherence to high CVH was associated with a reduced risk of microvascular complications compared to low CVH, regardless of birth weight. The HRs were 0.70 (95% CI, 0.59 to 0.84) for the LBW group and 0.74 (95% CI, 0.68 to 0.80) for the group with birth weight ≥2.5 kg (P for interaction=0.69).

Conclusion: LBW was an independent risk factor for nephropathy among diabetic patients. However, the detrimental effects of LBW might be mitigated by improvement in CVH.

糖尿病患者的出生体重、心血管健康和微血管并发症
背景:糖尿病常导致微血管并发症,包括肾病、神经病变和视网膜病变。了解早期生活因素的影响,如出生体重和可改变的行为,如心血管健康(CVH),对于预防这些并发症至关重要。方法:我们纳入了来自英国生物银行研究的11515名糖尿病患者,但在基线时没有微血管并发症。CVH是用生命基本8分来评估的。使用Cox比例风险模型分析出生体重和CVH与微血管并发症的独立和联合关联。双样本孟德尔随机化(MR)分析估计了出生体重和微血管并发症之间的明确关联。结果:在13.1年的中位随访中,发生了3010例微血管并发症。与正常出生体重(2.5 ~ 4.0 kg)相比,低出生体重(LBW;4.0 kg)与糖尿病微血管并发症的风险无关。MR分析证实了LBW与肾病之间的关联。与低CVH相比,无论出生体重如何,坚持高CVH与微血管并发症的风险降低有关。低体重组的hr为0.70 (95% CI, 0.59 ~ 0.84),出生体重≥2.5 kg组的hr为0.74 (95% CI, 0.68 ~ 0.80)(相互作用P =0.69)。结论:低体重是糖尿病肾病的独立危险因素。然而,LBW的有害影响可能会因CVH的改善而减轻。
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来源期刊
Diabetes & Metabolism Journal
Diabetes & Metabolism Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
10.40
自引率
6.80%
发文量
92
审稿时长
52 weeks
期刊介绍: The aims of the Diabetes & Metabolism Journal are to contribute to the cure of and education about diabetes mellitus, and the advancement of diabetology through the sharing of scientific information on the latest developments in diabetology among members of the Korean Diabetes Association and other international societies. The Journal publishes articles on basic and clinical studies, focusing on areas such as metabolism, epidemiology, pathogenesis, complications, and treatments relevant to diabetes mellitus. It also publishes articles covering obesity and cardiovascular disease. Articles on translational research and timely issues including ubiquitous care or new technology in the management of diabetes and metabolic disorders are welcome. In addition, genome research, meta-analysis, and randomized controlled studies are welcome for publication. The editorial board invites articles from international research or clinical study groups. Publication is determined by the editors and peer reviewers, who are experts in their specific fields of diabetology.
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