Body-weight variability and risk of cardiovascular outcomes in patients with type 1 diabetes: a retrospective observational analysis of data from the DCCT/EDIC population.

Autor: Petria I; School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy., Albuquerque S; Institut Necker-Enfants Malades, Université Paris Cité, INSERM UMR-S1151, CNRS UMR-S8253, Paris, France.; SODA, INRIA, Saclay, France., Varoquaux G; SODA, INRIA, Saclay, France., Vie JJ; SODA, INRIA, Saclay, France., Venteclef N; Institut Necker-Enfants Malades, Université Paris Cité, INSERM UMR-S1151, CNRS UMR-S8253, Paris, France., Mohammedi K; Bordeaux University and Hospital, INSERM U1034, Bordeaux, France., Roussel R; Institut Necker-Enfants Malades, Université Paris Cité, INSERM UMR-S1151, CNRS UMR-S8253, Paris, France.; Université Paris Cité, UFR de Médecine, Paris, France.; Department of Diabetology, Endocrinology and Nutrition, Assistance Publique - Hôpitaux de Paris, Bichat Hospital, Paris, France., Camoin M; Department of Diabetology, Endocrinology and Nutrition, Assistance Publique - Hôpitaux de Paris, Bichat Hospital, Paris, France., Perseghin G; School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.; Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy., Velho G; Institut Necker-Enfants Malades, Université Paris Cité, INSERM UMR-S1151, CNRS UMR-S8253, Paris, France., Potier L; Institut Necker-Enfants Malades, Université Paris Cité, INSERM UMR-S1151, CNRS UMR-S8253, Paris, France. louis.potier@aphp.fr.; Université Paris Cité, UFR de Médecine, Paris, France. louis.potier@aphp.fr.; Department of Diabetology, Endocrinology and Nutrition, Assistance Publique - Hôpitaux de Paris, Bichat Hospital, Paris, France. louis.potier@aphp.fr.
Jazyk: angličtina
Zdroj: Cardiovascular diabetology [Cardiovasc Diabetol] 2022 Nov 17; Vol. 21 (1), pp. 247. Date of Electronic Publication: 2022 Nov 17.
DOI: 10.1186/s12933-022-01689-0
Abstrakt: Background: Cardiovascular risk and body-weight management are both emerging challenges of type 1 diabetes care. We evaluated the association between intraindividual variability of body-weight and risk of cardiovascular events in people with type 1 diabetes.
Methods: We analyzed 1,398 participants from the DCCT/EDIC studies. Five indices of intraindividual variability of body-weight were calculated for each participant taking into account body-weight measures obtained during the DCCT follow-up (average 6 ± 2 years). The Average Successive Variability (ASV) index, the main variable of interest, was defined as the average absolute difference between successive body-weight measures. The primary outcome was a composite of major adverse cardiovascular events (MACE: nonfatal myocardial infarction or stroke, or cardiovascular death) occurring during the subsequent EDIC follow-up (20 ± 3 years). All-cause death was a secondary outcome. Risk of outcomes were assessed by Cox proportional hazards regression analyses, adjusted for traditional cardiovascular risks factors, including BMI.
Results: The cumulative incidence of MACE and all-cause death during follow-up were 5.6% (n = 79) and 6.8% (n = 95), respectively. The adjusted Hazard Ratio (HR) for MACE by every increase of 1 standard deviation (SD) of ASV was 1.34 (95% CI, 1.06-1.66), p = 0.01. For all-cause death, the adjusted HR for 1 SD increase of ASV was 1.25 (1.03-1.50), p = 0.03. Similar results were observed when considering the other indices of intraindividual variability of body-weight.
Conclusions: High body-weight variability (body-weight cycling) is associated with increased risk of MACE and all-cause death in people with type 1 diabetes, independently of the BMI and traditional cardiovascular risk factors.
(© 2022. The Author(s).)
Databáze: MEDLINE
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