Guo-Chong Chen, Daniel Nyarko Hukportie, Wei-Dong Fan, Jie-Qiong Lyu, Hai-Peng Wang, Liqiang Qin, Xian-Bo Wu, Fu-Rong Li
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引用次数: 0
摘要
背景:评估糖尿病微血管疾病和可改变的风险因素及其组合在心律失常发生中的作用:评估糖尿病微血管疾病和可改变的风险因素及其组合在心律失常发生中的作用:我们纳入了在英国生物库研究中招募期间无心律失常的 2 型糖尿病(T2D)患者。我们研究了微血管疾病状态(定义为存在视网膜病变、周围神经病变或慢性肾病)、四种可改变的心律失常风险因素(体重指数、吸烟、收缩压和糖化血红蛋白)及其与心律失常事件的关联:在中位随访 12.3 年的 25 632 位 T2D 患者中,8482 位患有微血管疾病的患者中有 1705 人(20.1%)出现心律失常,17150 位无微血管疾病的患者中有 2017 人(11.8%)出现心律失常。患有三种微血管疾病中的任何一种,都会使心律失常的发病风险增加 48%。将微血管疾病状态与 11 种传统风险因素一起纳入模型可显著提高心律失常的预测能力。此外,与没有微血管疾病的人相比,微血管疾病患者的心律失常风险因素为零到一个、两个、三个或四个的最佳水平,其HR分别为2.05(95% CI 1.85,2.27)、1.67(95% CI 1.53,1.83)、1.35(95% CI 1.22,1.50)和0.91(95% CI 0.73,1.13):尽管微血管疾病这一非传统风险因素与糖尿病患者心律失常的发生有关,但拥有最佳水平的风险因素可降低这一风险。
Microvascular disease, modifiable risk factor profiles and incident arrhythmias in type 2 diabetes.
Background: To assess the roles of diabetic microvascular disease and modifiable risk factors and their combination in the development of arrhythmias.
Methods: We included participants with type 2 diabetes (T2D) who were free of arrhythmias during recruitment in the UK Biobank study. The associations of microvascular disease states (defined by the presence of retinopathy, peripheral neuropathy or chronic kidney disease), four modifiable arrhythmic risk factors (body mass index, smoking, systolic blood pressure and glycosylated haemoglobin) and their joint associations with incident arrhythmias were examined.
Results: Among the 25 632 participants with T2D, 1705 (20.1%) of the 8482 with microvascular disease and 2017 (11.8%) of the 17 150 without microvascular disease developed arrhythmias during a median follow-up of 12.3 years. Having any of the three microvascular diseases was associated with a 48% increase in the hazard of developing arrhythmias. Incorporating microvascular disease states into a model alongside 11 traditional risk factors significantly enhanced arrhythmia prediction. Furthermore, individuals with microvascular disease who had optimal levels of zero to one, two, three or four arrhythmic risk factors showed an HR of 2.05 (95% CI 1.85, 2.27), 1.67 (95% CI 1.53, 1.83), 1.35 (95% CI 1.22, 1.50) and 0.91 (95% CI 0.73, 1.13), respectively, compared with those without microvascular disease.
Conclusions: Although microvascular disease, a non-traditional risk factor, was associated with incident arrhythmias in individuals with T2D, having optimal levels of risk factors may mitigate this risk.
期刊介绍:
Heart is an international peer reviewed journal that keeps cardiologists up to date with important research advances in cardiovascular disease. New scientific developments are highlighted in editorials and put in context with concise review articles. There is one free Editor’s Choice article in each issue, with open access options available to authors for all articles. Education in Heart articles provide a comprehensive, continuously updated, cardiology curriculum.