ACCORD 试验参与者与美国中老年糖尿病患者的代表性比较。

IF 4.7 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Epidemiology Pub Date : 2024-07-01 Epub Date: 2024-05-20 DOI:10.1097/EDE.0000000000001746

Ryo Ikesu, Yingyan Wu, Scott C Zimmerman, Kosuke Inoue, Peter Buto, Melinda C Power, Catherine A Schaefer, M Maria Glymour, Elizabeth Rose Mayeda

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引用次数: 0

摘要

背景：我们评估了具有里程碑意义的控制糖尿病心血管风险行动（ACCORD）试验的参与者是否代表了年龄≥40岁的美国成人糖尿病患者：利用具有全国代表性的 2017-2020 年大流行前全国健康与营养调查（NHANES）数据，我们对 ACCORD 的资格标准进行了操作性定义。我们计算了年龄≥40 岁、患有糖尿病且 HbA1c≥6.0% 或≥7.5%、符合 ACCORD 操作资格标准的个体所占的百分比：对 715 名年龄≥40 岁、患有糖尿病且 HbA1c ≥6.0% 的 NHANES 参与者（代表 29,717,406 人）应用调查抽样权重，12%（95% 置信区间 [CI]：8-18%）符合 ACCORD 操作资格标准。如果HbA1c≥7.5%，39%（95% 置信区间：28-51%）的受访者符合 ACCORD 标准：ACCORD 代表了少数美国中老年糖尿病患者。鉴于 ACCORD 参与者与普通糖尿病患者的风险状况不同，推断试验结果可能并不合适。

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Representativeness of Participants in the ACCORD Trial Compared to Middle-aged and Older Adults Living with Diabetes in the United States.

Background: We evaluated whether participants in the landmark Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial represent US adults aged ≥40 with diabetes.

Methods: Using the nationally representative 2017-2020 prepandemic National Health and Nutrition Examination Survey data, we made operational definitions of ACCORD eligibility criteria. We calculated the percentage of individuals aged ≥40 with diabetes and HbA1c ≥ 6.0% or ≥ 7.5% who met operational ACCORD eligibility criteria.

Results: Applying survey sampling weights to 715 National Health and Nutrition Examination Survey participants aged ≥40 with diabetes and HbA1c ≥ 6.0% (representing 29,717,406 individuals), 12% (95% confidence interval [CI] = 8%, 18%) met the operational ACCORD eligibility criteria. Restricting to HbA1c ≥ 7.5%, 39% (95% CI = 28%, 51%) of respondents met the operational ACCORD eligibility criteria.

Conclusions: ACCORD represented a minority of US middle-aged and older adults with diabetes. Given the differential risk profile between ACCORD participants and the general population with diabetes, extrapolating the trial findings may not be appropriate.

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来源期刊

Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

6.70

自引率

3.70%

发文量

177

审稿时长

6-12 weeks

期刊介绍： Epidemiology publishes original research from all fields of epidemiology. The journal also welcomes review articles and meta-analyses, novel hypotheses, descriptions and applications of new methods, and discussions of research theory or public health policy. We give special consideration to papers from developing countries.