Eric Yuk Fai Wan1, Daniel Yee Tak Fong2, Colman Siu Cheung Fung3, Cindy Lo Kuen Lam4. 1. Department of Family Medicine and Primary Care, the University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong; School of Nursing, the University of Hong Kong, 4/F, William M. W., Mong Block 21 Sassoon Road, Pokfulam, Hong Kong. Electronic address: yfwan@hku.hk. 2. School of Nursing, the University of Hong Kong, 4/F, William M. W., Mong Block 21 Sassoon Road, Pokfulam, Hong Kong. Electronic address: dytfong@hku.hk. 3. Department of Family Medicine and Primary Care, the University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong. Electronic address: cfsc@hku.hk. 4. Department of Family Medicine and Primary Care, the University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong. Electronic address: clklam@hku.hk.
Abstract
AIMS: This study aimed to estimate the 5-year incidence rate of cardiovascular disease (CVD) and determine predictive factors of new CVD in Chinese patients with type 2 diabetes mellitus (T2DM). METHODS: A retrospective cohort study was conducted on 115,470 T2DM patients aged ≥18 years without any history of CVD. Cox Proportional Hazard regression stratified by gender was performed to explore predictive factors of CVD. RESULTS: For 5.3 years median follow-up, the overall incidence rate of CVD per 1,000 person-years was 17.2 (95% CI: 16.9-17.6), without significant gender difference. Predictors of higher risk of CVD were older age, current smoking, longer duration of T2DM, more severe stage of chronic kidney disease, anti-hypertensive and oral anti-diabetic drugs needed, and higher body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP), total cholesterol/high-density lipoprotein-cholesterol ratio (TC/HDL-C ratio) and urine albumin/creatinine ratio (ACR). Lipid-lowering agents needed in men, and ex-smoking and higher hemoglobin A1c (HbA1c) in female were the additional predictive factors of increased CVD risk. CONCLUSIONS: Smoking, BMI, HbA1c, SBP, DBP, TC/HDL-C ratio and ACR were found to be modifiable risk factors of new CVD in Chinese T2DM patients, which should be targeted as tertiary preventive interventions. The lack of association between HbA1c and CVD in men found in this study deserves further investigation.
AIMS: This study aimed to estimate the 5-year incidence rate of cardiovascular disease (CVD) and determine predictive factors of new CVD in Chinese patients with type 2 diabetes mellitus (T2DM). METHODS: A retrospective cohort study was conducted on 115,470 T2DM patients aged ≥18 years without any history of CVD. Cox Proportional Hazard regression stratified by gender was performed to explore predictive factors of CVD. RESULTS: For 5.3 years median follow-up, the overall incidence rate of CVD per 1,000 person-years was 17.2 (95% CI: 16.9-17.6), without significant gender difference. Predictors of higher risk of CVD were older age, current smoking, longer duration of T2DM, more severe stage of chronic kidney disease, anti-hypertensive and oral anti-diabetic drugs needed, and higher body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP), total cholesterol/high-density lipoprotein-cholesterol ratio (TC/HDL-C ratio) and urine albumin/creatinine ratio (ACR). Lipid-lowering agents needed in men, and ex-smoking and higher hemoglobin A1c (HbA1c) in female were the additional predictive factors of increased CVD risk. CONCLUSIONS: Smoking, BMI, HbA1c, SBP, DBP, TC/HDL-C ratio and ACR were found to be modifiable risk factors of new CVD in Chinese T2DM patients, which should be targeted as tertiary preventive interventions. The lack of association between HbA1c and CVD in men found in this study deserves further investigation.
Authors: Eric Yuk Fai Wan; Esther Yee Tak Yu; Weng Yee Chin; Colman Siu Cheung Fung; Ruby Lai Ping Kwok; David Vai Kiong Chao; King Hong Chan; Eric Ming-Tung Hui; Wendy Wing Sze Tsui; Kathryn Choon Beng Tan; Daniel Yee Tak Fong; Cindy Lo Kuen Lam Journal: BMJ Open Date: 2018-10-15 Impact factor: 2.692