Screening for diabetes using an oral glucose tolerance test within a western multi-ethnic population identifies modifiable cardiovascular risk: the ADDITION-Leicester study

被引：47

作者：

Webb, D. R. ^{[1
]}

Gray, L. J. ^{[2
]}

Khunti, K. ^{[2
]}

Srinivasan, B. ^{[1
]}

Taub, N. ^{[2
]}

Campbell, S. ^{[3
]}

Barnett, J. ^{[3
]}

Farooqi, A. ^{[2
]}

Echouffo-Tcheugui, J. B. ^{[4
]}

Griffin, S. J. ^{[4
]}

Wareham, N. J. ^{[4
]}

Davies, M. J. ^{[1
]}

机构：

[1] Leicester Royal Infirm, Dept Cardiovasc Sci, Vasc Res Grp, Leicester LE1 5WW, Leics, England

[2] Univ Leicester, Dept Hlth Sci, Leicester, Leics, England

[3] Leicester Royal Infirm, Dept Endocrinol & Diabet, Leicester LE1 5WW, Leics, England

[4] Addenbrookes Hosp, MRC, Epidemiol Unit, Inst Metab Sci, Cambridge, England

来源：

DIABETOLOGIA | 2011年 / 54卷 / 09期

关键词：

ADDITION-Leicester; Cardiovascular disease; Multi-ethnic; Screening; South Asian; Type; 2; diabetes; CORONARY-HEART-DISEASE; MULTIFACTORIAL INTERVENTION; PRIMARY PREVENTION; GENERAL-PRACTICE; FOLLOW-UP; TYPE-2; PEOPLE; PREVALENCE; MORTALITY; MELLITUS;

D O I：

10.1007/s00125-011-2189-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The aim of this study was to determine the frequency of undiagnosed glucose abnormalities and the burden of cardiovascular disease (CVD) risk among south Asians and white Europeans attending a systematic screening programme for type 2 diabetes (ADDITION-Leicester) and to estimate the achievable risk reduction in individuals identified with glucose disorders. Random samples of individuals (n = 66,320) from 20 general practices were invited for a 75 g OGTT and CVD risk assessment. Ten-year CVD risk among screen-detected people with diabetes or impaired glucose regulation (IGR) (impaired fasting glycaemia and/or impaired glucose tolerance [IGT]) was computed using the Framingham-based ETHRISK engine and achievable risk reduction was predicted using relative reductions for treatments extracted from published trials. A total of 6,041 participants (48% male, 22% south Asian) aged 40-75 years inclusive were included. Undiagnosed glucose disorders occurred more frequently in south Asians than white Europeans; age and sex adjusted odds ratios were 1.74 (95% CI 1.42-2.13) and 2.30 (95% CI 1.68-3.16) for IGT and diabetes respectively. Prevalence of any undetected glucose disorder was 17.5% in the whole cohort. Adjusted 10-year risk was similar in screen-detected people with IGR and diabetes (18.3% vs 21.6%), and was higher in south Asians across the glucose spectrum. Absolute CVD risk reductions of up to 13% in those with screen-detected type 2 diabetes and 6% in IGR are achievable using existing cardioprotective therapies. Population screening with an OGTT identifies a significant burden of modifiable CVD risk, especially within south Asian groups. Strategies enticing this population to consider screening programmes are urgently needed as significant risk reduction is possible once a glucose abnormality is identified. ClinicalTrials.gov NCT00318032 The project is funded for support and treatment costs by NHS Department of Health Support for Science and project grants.

引用

页码：2237 / 2246

页数：10

共 52 条

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[52] Rationale and design of the ADDITION-Leicester study, a systematic screening programme and Randomised Controlled Trial of multi-factorial cardiovascular risk intervention in people with Type 2 Diabetes Mellitus detected by screening [J].

Webb, D. R. ;

Khunti, K. ;

Srinivasan, B. ;

Gray, L. J. ;

Taub, N. ;

Campbell, S. ;

Barnett, J. ;

Henson, J. ;

Hiles, S. ;

Farooqi, A. ;

Griffin, S. J. ;

Wareham, N. J. ;

Davies, M. J. .

TRIALS, 2010, 11

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