Diabetes‐Related Macrovascular Complications Are Associated With an Increased Risk of Diabetic Microvascular Complications: A Prospective Study of 1518 Patients With Type 1 Diabetes and 20 802 Patients With Type 2 Diabetes in the UK Biobank

Autor: Xinyu Zhang, Shuzhi Zhao, Yikeng Huang, Mingming Ma, Bo Li, Chenxin Li, Xinyu Zhu, Xun Xu, Haibin Chen, Yili Zhang, Chuandi Zhou, Zhi Zheng
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 13, Iss 11 (2024)
Druh dokumentu: article
ISSN: 2047-9980
DOI: 10.1161/JAHA.123.032626
Popis: Background Diabetic vascular complications share common pathophysiological mechanisms, but the relationship between diabetes‐related macrovascular complications (MacroVCs) and incident diabetic microvascular complications remains unclear. We aimed to investigate the impact of MacroVCs on the risk of microvascular complications. Methods and Results There were 1518 participants with type 1 diabetes (T1D) and 20 802 participants with type 2 diabetes from the UK Biobank included in this longitudinal cohort study. MacroVCs were defined by the presence of macrovascular diseases diagnosed after diabetes at recruitment, including coronary heart disease, peripheral artery disease, stroke, and ≥2 MacroVCs. The primary outcome was incident microvascular complications, a composite of diabetic retinopathy, diabetic kidney disease, and diabetic neuropathy. During a median (interquartile range) follow‐up of 11.61 (5.84–13.12) years and 12.2 (9.50–13.18) years, 596 (39.3%) and 4113 (19.8%) participants developed a primary outcome in T1D and type 2 diabetes, respectively. After full adjustment for conventional risk factors, Cox regression models showed significant associations between individual as well as cumulative MacroVCs and the primary outcome, except for coronary heart disease in T1D (T1D: diabetes coronary heart disease: 1.25 [0.98–1.60]; diabetes peripheral artery disease: 3.00 [1.86–4.84]; diabetes stroke: 1.71 [1.08–2.72]; ≥2: 2.57 [1.66–3.99]; type 2 diabetes: diabetes coronary heart disease: 1.59 [1.38–1.82]; diabetes peripheral artery disease: 1.60 [1.01–2.54]; diabetes stroke: 1.50 [1.13–1.99]; ≥2: 2.66 [1.92–3.68]). Subgroup analysis showed that strict glycemic (glycated hemoglobin
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