2型糖尿病者增殖性视网膜病与VADT实验中冠状动脉钙含量相关联

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2型糖尿病者增殖性视网膜病与退伍军人糖尿病实验(VADT)中冠状动脉钙含量相关联
Proliferative Diabetic Retinopathy in Type 2 Diabetes is Related to Coronary Artery Calcium in the Veterans Affairs Diabetes Trial (VADT)
ABSTRACT
摘要

Objective: Increasing evidence suggests that macrovascular disease and retinopathy (RET) may be more closely linked than previously believed. We determined the relationship between RET and coronary atherosclerosis as measured by CT detectable coronary artery calcium (CAC).
目的：越来越多的证据表明大血管病变与视网膜病（RET）的关联比原先认为的还要密切。我们通过CT检测了冠状动脉中钙含量从而了解了视网膜病（RET）和冠状动脉硬化之间的关系。

Research Design and Methods: The cross-sectional association between CAC and RET was assessed on a VADT sub-sample of 204 subjects with a mean duration of type 2 diabetes of 12.3 ± 8.3 years.
实验设计与方法：用CAC与RET之间具有代表性的关联来评估VADT中204名受检者发现2型糖尿病患者的中位生存时间是12.3 ± 8.3年。

Results: RET was correlated with CAC (r=0.19, p=0.006). Median CAC increased across RET categories: 197 in those with no RET, 229 with microaneurysms only, 364 with mild non-proliferative diabetic RET (NPDR), 300 with moderate to severe NPDR, and 981 in those with proliferative diabetic RET (PDR). Stepwise multivariable linear regression analysis was performed to find a parsimonious subset of relevant risk factors to include along with PDR in predicting CAC. After adjustment for either this subset of standard factors (p = 0.047) or a more extensive panel of risk factors (p = 0.035), PDR was significantly associated with CAC. Moreover, using logistic regression, individuals with PDR were approximately 6 fold more likely to have CAC > 400 compared to those with no PDR, even after adjustment for other CVD risk factors.
结果：RET与CAC相关(r=0.19, p=0.006). 随着RET的分类CAC增加：197名CAC没有RET,229名患者仅有微动脉瘤，364名患者有轻微的非增殖性糖尿病RET(NPDR),300名患者有中到重度的NPDR，981名患者伴有增殖性糖尿病RET(PDR).多变量线性回归逐步分析发现在预见CAC时包括PDR在内的一个相关危险因素。调整了这个危险因素(p = 0.047)或者一个更广范围的危险因素(p = 0.035)后发现PDR与CAC密切相关。而且利用逻辑回归发现，即便调整了其他CVD危险因素后，有PDR的患者其CAC> 400的可能性是那些没有PDR的患者的6倍多。

Conclusions: These data indicate an important relationship between RET and extent of coronary atherosclerosis (CAC), and suggest the potential to identify and treat shared risk factors for these common micro- and macrovascular complications.
结论：这些数据表明了RET与冠状动脉硬化（CAC）程度之间有重要的关联，也表明识别和治疗普通微血管和大血管并发症的共有危险因素的潜能。