{"title":"糖尿病患者和非糖尿病患者中与生活方式相关的可改变风险因素与心血管疾病发病率之间的差异。","authors":"Kaoruko Komuro, Hidehiro Kaneko, Jin Komuro, Yuta Suzuki, Akira Okada, Atsushi Mizuno, Katsuhito Fujiu, Norifumi Takeda, Hiroyuki Morita, Koichi Node, Hideo Yasunaga, Norihiko Takeda, Masaki Ieda, Issei Komuro","doi":"10.1093/eurjpc/zwae221","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Individuals with diabetes have a high risk of developing cardiovascular disease (CVD). Little was known whether the association between modifiable risk factors and incident CVD would change according to the presence of diabetes.</p><p><strong>Methods and results: </strong>In this study, we analysed 4 132 006 individuals including 173 262 individuals (4.2%) with diabetes registered in the JMDC Claims Database, and compared the association between modifiable risk factors and risk of CVD between individuals with and without diabetes. The median age was 44 years, and 57.5% were men. Multivariable Cox regression analyses showed that the relationship of obesity, hypertension, and dyslipidaemia with incident CVD was attenuated in individuals with diabetes, whereas that of non-ideal eating habits, smoking, and physical inactivity with incident CVD was pronounced in those with diabetes. The hazard ratio per 1-point increase in non-ideal lifestyle-related factors was 1.03 [95% confidence interval (CI), 1.03-1.04] in individuals with non-diabetes, whereas 1.09 (95% CI, 1.07-1.11) in individuals with diabetes (P-value for interaction < 0.001). Further, hazard ratios for developing CVD were 1.02 (95% CI, 1.01-1.04) in individuals not having diabetes, whereas 1.09 (95% CI, 1.04-1.13) in individuals having diabetes for the increase of lifestyle-related factors after 1-year follow-up (P-value for interaction 0.007).</p><p><strong>Conclusion: </strong>Our analysis utilizing a nationwide epidemiological dataset presented that the relationship of lifestyle-related factors with incident CVD would be pronounced in people having diabetes, suggesting that the maintenance of a healthy lifestyle would play a more important role in the development of CVD in individuals having diabetes.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"376-383"},"PeriodicalIF":8.4000,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Differences in the association of lifestyle-related modifiable risk factors with incident cardiovascular disease between individuals with and without diabetes.\",\"authors\":\"Kaoruko Komuro, Hidehiro Kaneko, Jin Komuro, Yuta Suzuki, Akira Okada, Atsushi Mizuno, Katsuhito Fujiu, Norifumi Takeda, Hiroyuki Morita, Koichi Node, Hideo Yasunaga, Norihiko Takeda, Masaki Ieda, Issei Komuro\",\"doi\":\"10.1093/eurjpc/zwae221\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>Individuals with diabetes have a high risk of developing cardiovascular disease (CVD). Little was known whether the association between modifiable risk factors and incident CVD would change according to the presence of diabetes.</p><p><strong>Methods and results: </strong>In this study, we analysed 4 132 006 individuals including 173 262 individuals (4.2%) with diabetes registered in the JMDC Claims Database, and compared the association between modifiable risk factors and risk of CVD between individuals with and without diabetes. The median age was 44 years, and 57.5% were men. Multivariable Cox regression analyses showed that the relationship of obesity, hypertension, and dyslipidaemia with incident CVD was attenuated in individuals with diabetes, whereas that of non-ideal eating habits, smoking, and physical inactivity with incident CVD was pronounced in those with diabetes. The hazard ratio per 1-point increase in non-ideal lifestyle-related factors was 1.03 [95% confidence interval (CI), 1.03-1.04] in individuals with non-diabetes, whereas 1.09 (95% CI, 1.07-1.11) in individuals with diabetes (P-value for interaction < 0.001). Further, hazard ratios for developing CVD were 1.02 (95% CI, 1.01-1.04) in individuals not having diabetes, whereas 1.09 (95% CI, 1.04-1.13) in individuals having diabetes for the increase of lifestyle-related factors after 1-year follow-up (P-value for interaction 0.007).</p><p><strong>Conclusion: </strong>Our analysis utilizing a nationwide epidemiological dataset presented that the relationship of lifestyle-related factors with incident CVD would be pronounced in people having diabetes, suggesting that the maintenance of a healthy lifestyle would play a more important role in the development of CVD in individuals having diabetes.</p>\",\"PeriodicalId\":12051,\"journal\":{\"name\":\"European journal of preventive cardiology\",\"volume\":\" \",\"pages\":\"376-383\"},\"PeriodicalIF\":8.4000,\"publicationDate\":\"2025-04-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European journal of preventive cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/eurjpc/zwae221\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of preventive cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/eurjpc/zwae221","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
目的:糖尿病患者罹患心血管疾病(CVD)的风险很高。可改变的风险因素与心血管疾病之间的关系是否会因糖尿病的存在而发生变化,人们对此知之甚少:在这项研究中,我们分析了 4,132,006 人,其中包括在 JMDC 索偿数据库中登记的 173,262 名糖尿病患者(4.2%),并比较了糖尿病患者和非糖尿病患者的可改变风险因素与心血管疾病风险之间的关系:中位年龄为44岁,57.5%为男性。多变量考克斯回归分析表明,肥胖、高血压和血脂异常与心血管疾病发病的关系在糖尿病患者中减弱,而非理想饮食习惯、吸烟和缺乏运动与心血管疾病发病的关系在糖尿病患者中明显。非糖尿病患者的非理想生活方式相关因素每增加 1 个点的危险比为 1.03 [95% 置信区间 (CI) 1.03-1.04],而糖尿病患者为 1.09 [95% CI 1.07-1.11](交互作用的 p 值 < 0.001)。此外,随访1年后,如果生活方式相关因素增加,未患糖尿病者患心血管疾病的危险比为1.02 [95% 1.01-1.04],而患糖尿病者为1.09 [95% CI 1.04-1.13](交互作用的P值为0.007):我们利用全国性流行病学数据集进行的分析表明,生活方式相关因素与心血管疾病发病率的关系在糖尿病患者中更为明显,这表明保持健康的生活方式在糖尿病患者心血管疾病的发病中将发挥更重要的作用。(244个字)。
Differences in the association of lifestyle-related modifiable risk factors with incident cardiovascular disease between individuals with and without diabetes.
Aims: Individuals with diabetes have a high risk of developing cardiovascular disease (CVD). Little was known whether the association between modifiable risk factors and incident CVD would change according to the presence of diabetes.
Methods and results: In this study, we analysed 4 132 006 individuals including 173 262 individuals (4.2%) with diabetes registered in the JMDC Claims Database, and compared the association between modifiable risk factors and risk of CVD between individuals with and without diabetes. The median age was 44 years, and 57.5% were men. Multivariable Cox regression analyses showed that the relationship of obesity, hypertension, and dyslipidaemia with incident CVD was attenuated in individuals with diabetes, whereas that of non-ideal eating habits, smoking, and physical inactivity with incident CVD was pronounced in those with diabetes. The hazard ratio per 1-point increase in non-ideal lifestyle-related factors was 1.03 [95% confidence interval (CI), 1.03-1.04] in individuals with non-diabetes, whereas 1.09 (95% CI, 1.07-1.11) in individuals with diabetes (P-value for interaction < 0.001). Further, hazard ratios for developing CVD were 1.02 (95% CI, 1.01-1.04) in individuals not having diabetes, whereas 1.09 (95% CI, 1.04-1.13) in individuals having diabetes for the increase of lifestyle-related factors after 1-year follow-up (P-value for interaction 0.007).
Conclusion: Our analysis utilizing a nationwide epidemiological dataset presented that the relationship of lifestyle-related factors with incident CVD would be pronounced in people having diabetes, suggesting that the maintenance of a healthy lifestyle would play a more important role in the development of CVD in individuals having diabetes.
期刊介绍:
European Journal of Preventive Cardiology (EJPC) is an official journal of the European Society of Cardiology (ESC) and the European Association of Preventive Cardiology (EAPC). The journal covers a wide range of scientific, clinical, and public health disciplines related to cardiovascular disease prevention, risk factor management, cardiovascular rehabilitation, population science and public health, and exercise physiology. The categories covered by the journal include classical risk factors and treatment, lifestyle risk factors, non-modifiable cardiovascular risk factors, cardiovascular conditions, concomitant pathological conditions, sport cardiology, diagnostic tests, care settings, epidemiology, pharmacology and pharmacotherapy, machine learning, and artificial intelligence.