Advanced Cardiovascular-Kidney-Metabolic Risk and Risk-Factor Control in Patients With Type 2 Diabetes Without Established Cardiovascular Disease

IF 5.9 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2026-10-19 DOI:10.1111/1753-0407.70279

Hai Nguyen Ngoc Dang, The Trung Le, Anh Kiem Pham, Linh Duy Le, Nam Van Duc Nguyen, Thanh Thien Tran, Thinh Ba Le, Ny Ha Tuyet Le, Nam Van Le, Hau Phuc Tran, Hung Minh Vu, Duong Hung Tran, Bich Ngoc Hoang Thi, Huy Nhu Pham, Hieu Minh Le, Thang Chi Doan, Binh Anh Ho, Tien Anh Hoang, Minh Van Huynh, Thang Viet Luong

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引用次数: 0

Abstract

Background

Cardiovascular-kidney-metabolic (CKM) risk stratification may identify patients with type 2 diabetes mellitus (T2DM) who require more intensive primary prevention, but real-world data from Vietnam are limited. We aimed to describe advanced CKM risk and risk-factor control in Vietnamese patients with T2DM without established cardiovascular disease (CVD).

Methods

This multicenter cross-sectional study enrolled 1436 adults with T2DM without CVD in Vietnam. Advanced CKM risk was defined as 10-year total CVD risk ≥ 20% or eGFR < 60 mL/min/1.73 m². Guideline-based control of HbA1c, blood pressure, LDL-C, triglycerides, and non-HDL-C was evaluated. Logistic regression assessed associations between advanced CKM risk and target achievement.

Results

Advanced CKM risk was identified in 551 patients (38.4%). Despite a relatively low prevalence of BMI ≥ 25 kg/m² (26.9%), hypertriglyceridemia was the most common metabolic abnormality, affecting 88.0% of participants. Risk-factor control was generally low, with 33.3% achieving glycemic control, 33.5% blood pressure control, 18.8% LDL-C control, 12.0% triglyceride control, and 21.1% non-HDL-C control. After adjustment, advanced CKM risk was associated with poorer blood pressure control (adjusted OR = 0.466, 95% CI = 0.359–0.603, p < 0.001) and triglyceride control (adjusted OR = 0.677, 95% CI = 0.473–0.969, p = 0.033), but not with achievement of HbA1c, LDL-C, non-HDL-C, or combined lipid control.

Conclusions

Advanced CKM risk was common among Vietnamese patients with T2DM without established CVD and was consistently associated with poorer blood pressure control. CKM-based risk assessment may identify high-risk patients earlier and support guideline-directed risk-factor management. Frequent hypertriglyceridemia with relatively low obesity supports a CKM-based strategy tailored to this metabolic risk pattern.

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无心血管疾病的2型糖尿病患者的晚期心血管-肾-代谢危险及危险因素控制

背景：心血管-肾代谢（CKM）风险分层可以识别需要更强化一级预防的2型糖尿病（T2DM）患者，但来自越南的真实数据有限。我们的目的是描述未确诊心血管疾病（CVD）的越南T2DM患者的晚期CKM风险和风险因素控制。方法：这项多中心横断面研究在越南招募了1436名无心血管疾病的成年T2DM患者。晚期CKM风险定义为10年CVD总风险≥20%或eGFR 2。评估了基于指南的HbA1c、血压、LDL-C、甘油三酯和非hdl - c控制。Logistic回归评估晚期CKM风险与目标实现之间的关系。结果：551例（38.4%）患者存在晚期CKM风险。尽管BMI≥25 kg/m2的患病率相对较低（26.9%），但高甘油三酯血症是最常见的代谢异常，影响了88.0%的参与者。风险因素控制总体较低，33.3%的患者血糖得到控制，33.5%的患者血压得到控制，18.8%的患者LDL-C得到控制，12.0%的患者甘油三酯得到控制，21.1%的患者非hdl - c得到控制。调整后，晚期CKM风险与较差的血压控制相关（调整后OR = 0.466, 95% CI = 0.359-0.603, p）。结论：晚期CKM风险在越南无心血管疾病的T2DM患者中很常见，并且始终与较差的血压控制相关。基于ckm的风险评估可以更早地识别高危患者，并支持指导的风险因素管理。频繁的高甘油三酯血症与相对较低的肥胖率支持针对这种代谢风险模式的基于ckm的策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.