医学
狼牙棒
危险系数
糖尿病
内科学
心肌梗塞
体质指数
人口
比例危险模型
1型糖尿病
置信区间
内分泌学
经皮冠状动脉介入治疗
环境卫生
作者
Iulia Petria,Samuel Albuquerque,Gaël Varoquaux,Jill-Jênn Vie,Nicolas Venteclef,Kamel Mohammedi,Ronan Roussel,Marion Camoin,Gianluca Perseghin,Gilberto Velho,Louis Potier
标识
DOI:10.1186/s12933-022-01689-0
摘要
Abstract 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.
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