Microvascular Disease, Cardiovascular Health, and Risk of Coronary Heart Disease in Type 2 Diabetes: A UK Biobank Study.
J Clin Endocrinol Metab
; 109(9): 2335-2342, 2024 Aug 13.
Article
in En
| MEDLINE
| ID: mdl-38412317
ABSTRACT
CONTEXT The interplay between cardiovascular health metrics (CVHMs) and microvascular disease (MVD) in relation to the risk of incident coronary heart disease (CHD) among individuals with type 2 diabetes mellitus (T2DM) remains to be evaluated. OBJECTIVE:
To investigate the role of MVD and CVHMs in the development of CHD among T2DM.DESIGN:
We included 19 664 participants with T2DM from the UK Biobank who had CVHM data and were free of CHD during recruitment. CVHMs were defined based on 5 behavioral (body mass index, diet, sleep duration, smoking, and regular exercise) and 3 biological (glycemic control, hyperlipidemia, and hypertension) factors. MVD was defined as the presence of retinopathy, peripheral neuropathy, or chronic kidney disease. Hazard ratio (HR) and 95% CI of CHD were estimated by multivariable Cox regression models.RESULTS:
There were 3252 incident cases of CHD recorded after a median follow-up of 12.3 years. After multivariable adjustment, each MVD was separately associated with risk of CHD, and those who had 1 or ≥â¯2 MVD had a 27% and an 87% increased risk of developing CHD, respectively. Each unfavorable CVHM was associated with a higher risk of CHD. As compared with MVD-free participants who had ideal CVHMs, those who had ≥â¯2 MVD and had poor CVHMs were at particularly high risk of incident CHD (HR = 4.58; 95% CI 3.58, 5.86), similarly when considering behavioral CVH or biological CVH separately. On an additive scale, there was a positive statistically significant interaction between number of MVD and CVHMs.CONCLUSION:
Coexistence of multiple MVDs was associated with a substantially higher risk of CHD among individuals with T2DM. Such association may be amplified by unfavorable CVHMs.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Biological Specimen Banks
/
Coronary Disease
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Diabetes Mellitus, Type 2
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
J Clin Endocrinol Metab
Year:
2024
Document type:
Article
Affiliation country:
China