التفاصيل البيبلوغرافية
| العنوان: |
Association Between Severe Hypoglycemia, Adverse Macrovascular Events, and Inflammation in the Edinburgh Type 2 Diabetes Study. |
| المؤلفون: |
Bedenis, Rachel, Price, Anna H., Robertson, Christine M., Morling, Jo R., Frier, Brian M., Strachan, Mark W. J., Price, Jackie F. |
| المصدر: |
Diabetes Care; Dec2014, Vol. 37 Issue 12, p3301-3308, 8p, 4 Charts |
| مصطلحات موضوعية: |
HYPOGLYCEMIA, TYPE 2 diabetes, DIABETES, INFLAMMATION, C-reactive protein |
| مستخلص: |
OBJECTIVE To determine whether a history of severe hypoglycemia was associated with an increased risk of subsequent macrovascular events in people with type 2 diabetes and to explore possible mediation of this association by inflammation. RESEARCH DESIGN AND METHODS A cohort of 1,066 adults aged 60-75 years with type 2 diabetes was evaluated prospectively. Baseline history of severe hypoglycemia and plasma levels of the inflammatory markers C-reactive protein, brinogen, interleukin-6, and tumor necrosis factor-a were recorded. Their association with incident macrovascular events after 4 years was explored. RESULTS At baseline, 87 participants (8.2%) reported one or more episodes of severe hypoglycemia within the preceding year, and at follow-up 99 participants (9.3%) had suffered a new macrovascular event. Hypoglycemia was associated with increased odds of macrovascular events (odds ratio [OR] 2.11 [95% CI 1.06, 4.21], P = 0.035), including coronary heart events (OR 2.44 [95% CI 1.13, 5.26], P = 0.023), largely due to increased myocardial infarction (OR 4.02 [95% CI 1.54, 10.48], P = 0.004). Hypoglycemia was also associated with increased levels of inflammatory markers, including a general inflammation factor derived using principal-components analysis (P = 0.030, after adjustment for cardiometabolic risk factors). However, the significant association between hypoglycemia and macrovascular events persisted after adjustment for inflammatory markers. CONCLUSIONS The odds of suffering a macrovascular event were higher in patients with type 2 diabetes who had a history of severe hypoglycemia. There was no evidence that a proinflammatory state had a major role in mediating this association. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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