Target Values of Cardiovascular Risk Factors Are Not Associated with All-Cause Mortality in Patients with Type 2 Diabetes Mellitus

被引:2
作者
Pacilli, Antonio [1 ]
Lamacchia, Olga [2 ]
Fontana, Andrea [3 ]
Copetti, Massimiliano [3 ]
Cignarelli, Mauro [2 ]
Trischitta, Vincenzo [4 ,5 ]
De Cosmo, Salvatore [1 ]
机构
[1] IRCCS Casa Sollievo Sofferenza, Dept Med Sci, Unit Internal Med, San Giovanni Rotondo, Italy
[2] Univ Foggia, Dept Surg & Med Sci, Unit Endocrinol & Metab Dis, Foggia, FG, Italy
[3] IRCCS Casa Sollievo Sofferenza, Unit Biostat, San Giovanni Rotondo, Italy
[4] IRCCS Casa Sollievo Sofferenza, Res Unit Diabet & Endocrine Dis, San Giovanni Rotondo, Italy
[5] Univ Roma La Sapienza, Dept Expt Med, I-00185 Rome, Italy
关键词
GLUCOSE CONTROL; BLOOD-PRESSURE; FOLLOW-UP; METAANALYSIS; CHOLESTEROL; PEOPLE; DISEASE; EVENTS; COMPLICATIONS; PREVENTION;
D O I
10.1371/journal.pone.0124536
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background To investigate prospectively the relationship between target values of glycated hemoglobin, blood pressure and LDL-cholesterol, as considered in a combined fashion, and all-cause mortality in patients with type 2 diabetes mellitus. Methods Two cohorts of patients with type 2 diabetes mellitus, the Gargano Mortality Study (n=810) and the Foggia Mortality Study (n=929), were investigated. A weighted target risk score was built as a weight linear combination of the recommended targets reached by each patient. Results In the Gargano Mortality Study and in the Foggia Mortality Study (mean follow up=7.4 and 5.5 years, respectively), 161 (19.9%) and 220 (23.7%) patients died, with an age and sex adjusted annual incidence rate of 2.1 and 2.8 per 100 person-years, respectively. In both study samples the weighted target risk score tended to be linearly associated with all-cause mortality (HR for one point increment=1.30, 95% CI: 1.11-1.53, p=0.001, and HR=1.08, 95% CI: 0.95-1.24, p=0.243, respectively). When the two cohorts were pooled and analyzed together, a clear association between weighted target risk score and all-cause mortality was observed (HR for one point increment=1.17, 95% CI: 1.05-1.30, p=0.004). This counter-intuitive association was no longer observable in a model including age, sex, body mass index, smoking habit, estimated glomerular filtration rate, albuminuria and anti-diabetic, anti-hypertensive and anti-dyslipidemic treatment as covariates (HR for one point increment=0.99, 95% CI: 0.87-1.12, p=0.852). Conclusions In a real life clinical set of patients with type 2 diabetes mellitus, the combination of recommended target values of established cardiovascular risk factors is not associated with allcause mortality.
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