دورية أكاديمية
Microvascular complications burden (nephropathy, retinopathy and peripheral polyneuropathy) affects risk of major vascular events and all-cause mortality in type 1 diabetes: A 10-year follow-up study
| العنوان: | Microvascular complications burden (nephropathy, retinopathy and peripheral polyneuropathy) affects risk of major vascular events and all-cause mortality in type 1 diabetes: A 10-year follow-up study |
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| المؤلفون: | Garofolo, Monia, Gualdani, Elisa, Giannarelli, Rosa, Aragona, Michele, Campi, Fabrizio, Lucchesi, Daniela, Daniele, Giuseppe, Miccoli, Roberto, Francesconi, Paolo, Del Prato, Stefano, Penno, Giuseppe |
| المساهمون: | Garofolo, Monia, Gualdani, Elisa, Giannarelli, Rosa, Aragona, Michele, Campi, Fabrizio, Lucchesi, Daniela, Daniele, Giuseppe, Miccoli, Roberto, Francesconi, Paolo, Del Prato, Stefano, Penno, Giuseppe |
| سنة النشر: | 2019 |
| المجموعة: | ARPI - Archivio della Ricerca dell'Università di Pisa |
| مصطلحات موضوعية: | All-cause mortality, Cardiovascular disease, Diabetic kidney disease, Diabetic retinopathy, Microvascular burden, Microvascular complication, Peripheral diabetic polyneuropathy, Type 1 diabetes mellitus |
| الوصف: | Background: Microvascular complications (MC) have been claimed to increase the risk for cardiovascular disease in diabetic subjects. However, the effect of MC burden on the risk of major vascular outcomes and all-cause mortality in type 1 diabetes is still poorly explored. We evaluated the relationship between microvascular complications burden and incidence of major cardiovascular events and all-cause mortality in subjects with type 1 diabetes. Methods: We recruited 774 participants with type 1 diabetes in a single-center observational study over a follow-up of 10.8 ± 2.5 years. Hazard ratios (HR) for cardiovascular outcomes and all-cause death associated with microvascular complications were determined by unadjusted and adjusted Cox regression analysis. Results: Out of 774 individuals, 54.9% had no-MC, 32.3% 1 MC, 9.7% 2 MC and 3.1% 3 MC. A total of 54 deaths (7.0%) occurred. Death rate increased from no-MC 2.1% (Ref) to 1 MC 7.2% (HR 3.54 [95% CI 1.59-7.87]), 2 MC 14.7% (HR 6.41 [95% CI 2.65-15.49]) and 3 MC 66.7% (HR 41.73 [95% CI 18.42-94.57], p < 0.0001). After adjustments, HRs were: 1 MC 2.05 (95% CI 0.88-4.76), 2 MC 1.98 (95% CI 0.75-5.21), 3 MC 7.02 (95% CI 2.44-20.20, p = 0.002). Forty-nine subjects (6.7%) had at least one cardiovascular event, and cumulative incidence went from no-MC 2.2% (Ref) to 1 MC 5.0%; (HR 2.27 [95% CI 0.96-5.38]), 2 MC 26.8% (HR 12.88 [95% CI 5.82-28.50]) and 3 MC 40.9% (HR 29.34 [95% CI 11.59-74.25], p < 0.0001). Upon adjustments, HRs were: 1 MC 1.59 (95% CI 0.65-3.88), 2 MC 4.33 (95% CI 1.75-10.74), 3 MC 9.31 (95% CI 3.18-27.25, p < 0.0001). Thirty-five individuals (4.8%) had at least one coronary event, which cumulative incidence increased with MC burden (p < 0.0001). Conclusions: In type 1 diabetes, microvascular complications burden increases in an independent dose-dependent manner the risk of major cardiovascular outcomes and all-cause mortality. The presence and number of microvascular complications should be considered in stratifying overall cardiovascular ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/31733651; info:eu-repo/semantics/altIdentifier/wos/WOS:000497734800004; volume:18; issue:1; journal:CARDIOVASCULAR DIABETOLOGY; http://hdl.handle.net/11568/1017892Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85075114771; http://www.cardiab.com/homeTest/ |
| DOI: | 10.1186/s12933-019-0961-7 |
| الإتاحة: | https://doi.org/10.1186/s12933-019-0961-7Test http://hdl.handle.net/11568/1017892Test http://www.cardiab.com/homeTest/ |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.AE3EAC5C |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s12933-019-0961-7 |
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