Predictors of macrovascular disease in patients with type 2 diabetes mellitus.
Journal - Mayo Clinic proceedings. Mayo Clinic (United States )
OBJECTIVE: To assess the importance of classic and nonclassic risk factors in the development of coronary artery disease (CAD) or cerebrovascular disease (CVD) in patients with type 2 diabetes mellitus (DM). PATIENTS AND METHODS: In this community-based, prospective cohort study, quantitative measurements for cholesterol, triglycerides (TGs), glucose, and lipoprotein(a) detected as a sinking pre-beta-lipoprotein band on electrophoresis were obtained from 1968 through 1982 from 449 patients who were free of CAD and CVD but had type 2 DM. Demographic data and covariables obtained were age, body mass index, duration of diabetes, sex, smoking, and hypertension. The relationship of individual continuous factors to the development of CAD and CVD as well as multivariate models were evaluated with use of the Cox proportional hazards model. The primary outcome was to determine which risk factors are associated with development of CAD or CVD in patients with type 2 DM. RESULTS: After a mean follow-up of 13 years, 216 CAD and 115 CVD events had developed. The hazard ratio estimates with 95% confidence intervals (CIs) for CAD after multivariate analysis were significant for age, 1.45 (95% CI, 1.27-1.67); fasting glucose levels at enrollment, 1.63 (95% CI, 1.17-2.25); smoking, 1.45 (95% CI, 1.10-1.91); and TGs, 1.49 (95% CI, 1.15-1.92). The hazard ratio estimates for CVD were significant for age, 1.95 (95% CI, 1.59-2.38); hypertension, 1.89 (95% CI, 1.30-2.74); fasting glucose levels at enrollment, 1.69 (95% CI, 1.06-2.70); and smoking, 1.57 (95% CI, 1.07-2.30). CONCLUSION: In diabetic patients, age, fasting glucose levels, smoking, and TG levels are independent risk factors for development of CAD events. Age, hypertension, glucose, and smoking predicted development of CVD events.
|ISSN : ||0025-6196|
|Mesh Heading : ||Age Distribution Age Factors Aged Blood Glucose Body Mass Index Cerebrovascular Disorders Cholesterol Coronary Disease Diabetes Mellitus, Type 2 Female Humans Hypertension Lipoprotein(a) Male Middle Aged Multivariate Analysis Predictive Value of Tests Proportional Hazards Models Prospective Studies Risk Factors Smoking Time Factors Triglycerides analysis blood blood complications blood adverse effects blood|
|Mesh Heading Relevant : ||etiology etiology complications|