Rebecka Bergdal, Valma Harjutsalo, Per-Henrik Groop, Stefan Mutter
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引用次数: 0
Abstract
Background: Hyperglycaemia and dyslipidaemia are well-known risk factors for coronary artery disease (CAD) in type 1 diabetes. The impact of long-term cumulative exposure to these risk factors is less explored. We investigated the relationship between cumulative glycaemic and lipid exposure and CAD in individuals with type 1 diabetes.
Methods: This longitudinal study included 3495 adults with type 1 diabetes from the FinnDiane cohort, without end-stage kidney disease and no history of CAD or stroke at the study baseline. Total cumulative glycaemic exposure (CGEtot) and cumulative hyperglycaemic exposure (CGEhg), accounting only for time spent above an HbA1c of 53 mmol/mol (7%), were calculated from diabetes diagnosis.
Results: During a median follow-up of 19.38 years, 534 participants had their first-ever CAD event. CGEhg (odds ratio 1.03 [95% CI 1.02-1.05], p < 0.001) and cumulative exposure to LDL cholesterol, triglycerides, and non-HDL cholesterol all significantly increased the odds for incident CAD. The highest tertile of CGEhg associated with a twofold odds increase for incident CAD. CGEtot was not significantly associated with CAD after adjusting for cumulative lipid exposure.
Conclusions: Both hyperglycaemia and dyslipidaemia are independently associated with CAD in type 1 diabetes. These findings emphasize the importance of reaching an HbA1c below 53 mmol/mol (7%) and minimizing lipid exposure, as well as calling on health care professionals to not settle for suboptimal care, but to continue their support and encouragement towards better management of diabetes.
背景:高血糖和血脂异常是众所周知的1型糖尿病冠状动脉疾病(CAD)的危险因素。长期累积暴露于这些危险因素的影响较少被探讨。我们研究了1型糖尿病患者累积血糖和脂质暴露与冠心病之间的关系。方法:这项纵向研究包括来自FinnDiane队列的3495名成人1型糖尿病患者,在研究基线时无终末期肾脏疾病,无CAD或卒中史。总累积血糖暴露(CGEtot)和累积高血糖暴露(CGEhg),仅考虑HbA1c高于53 mmol/mol的时间(7%),从糖尿病诊断计算。结果:在中位随访19.38年期间,534名参与者首次出现CAD事件。CGEhg(比值比1.03 [95% CI 1.02-1.05]), p hg与冠心病发生率增加两倍相关。在调整累积脂质暴露后,CGEtot与CAD无显著相关性。结论:高血糖和血脂异常与1型糖尿病的冠心病独立相关。这些发现强调了HbA1c低于53 mmol/mol(7%)和尽量减少脂质暴露的重要性,并呼吁卫生保健专业人员不要满足于次优护理,而是继续支持和鼓励更好地管理糖尿病。
期刊介绍:
Cardiovascular Diabetology is a journal that welcomes manuscripts exploring various aspects of the relationship between diabetes, cardiovascular health, and the metabolic syndrome. We invite submissions related to clinical studies, genetic investigations, experimental research, pharmacological studies, epidemiological analyses, and molecular biology research in this field.