Risk Factors for Cardiovascular Disease (CVD) in Adults with Type 1 Diabetes: Findings from Prospective Real-life T1D Exchange Registry
Autor: | Rodica Pop-Busui, Kristen J. Nadeau, Jennifer L. Sherr, Paul Hiers, Linda A. DiMeglio, Fida Bacha, Richard E. Pratley, Mengdi Wu, Shivani Agarwal, Sarit Polsky, Michelle Katz, Ryan Bailey, Janet K. Snell-Bergeon, Viral N. Shah, Ingrid Libman, Nicole C. Foster, Sanjeev N. Mehta, Kara Mizokami-Stout, Eda Cengiz, Jill P. Crandall |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Statin medicine.drug_class Endocrinology Diabetes and Metabolism Clinical Biochemistry 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Biochemistry Cohort Studies Young Adult 03 medical and health sciences 0302 clinical medicine Endocrinology Risk Factors Interquartile range Diabetes mellitus Internal medicine medicine Humans Prospective Studies Registries Type 1 diabetes business.industry Biochemistry (medical) Middle Aged medicine.disease United States Diabetes Mellitus Type 1 Cardiovascular Diseases Heart Disease Risk Factors Cohort Female business Body mass index Diabetic Angiopathies Dyslipidemia Cohort study |
Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 105:e2032-e2038 |
ISSN: | 1945-7197 0021-972X |
Popis: | Context Cardiovascular disease (CVD) is a major cause of mortality in adults with type 1 diabetes. Objective We prospectively evaluated CVD risk factors in a large, contemporary cohort of adults with type 1 diabetes living in the United States. Design Observational study of CVD and CVD risk factors over a median of 5.3 years. Setting The T1D Exchange clinic network. Patients Adults (age ≥ 18 years) with type 1 diabetes and without known CVD diagnosed before or at enrollment. Main Outcome Measure Associations between CVD risk factors and incident CVD were assessed by multivariable logistic regression. Results The study included 8,727 participants (53% female, 88% non-Hispanic white, median age 33 years [interquartile ratio {IQR} = 21, 48], type 1 diabetes duration 16 years [IQR = 9, 26]). At enrollment, median HbA1c was 7.6% (66 mmol/mol) (IQR = 6.9 [52], 8.6 [70]), 33% used a statin, and 37% used blood pressure medication. Over a mean follow-up of 4.6 years, 325 (3.7%) participants developed incident CVD. Ischemic heart disease was the most common CVD event. Increasing age, body mass index, HbA1c, presence of hypertension and dyslipidemia, increasing duration of diabetes, and diabetic nephropathy were associated with increased risk for CVD. There were no significant gender differences in CVD risk. Conclusion HbA1c, hypertension, dyslipidemia and diabetic nephropathy are important risk factors for CVD in adults with type 1 diabetes. A longer follow-up is likely required to assess the impact of other traditional CVD risk factors on incident CVD in the current era. |
Databáze: | OpenAIRE |
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