江苏省两城市35岁及以上2型糖尿病患者缺血性心血管病10年发病风险评估

Evaluation of 10-year risk for ischemic cardiovascular disease in type 2 diabetes aged 35 years old and above in two cities of Jiangsu Province

目的评估江苏省两城市35岁及以上2型糖尿病(T2DM)患者缺血性心血管病(ICVD)10年发病风险。方法2013年12月至2014年1月,采用整群随机抽样的方法,将江苏省常熟市、淮安市清河区和淮安区纳入国家基本公共卫生服务管理的15624例35岁及以上T2DM患者纳为研究对象,通过面对面问卷调查、体格和生化指标测量,获取研究对象的ICVD危险因素暴露情况,采用改良的《国人ICVD10年发病危险评估表》对其发病风险进行评估。结果研究对象年龄为(62.2±9.7)岁,其中男性6137例(39.3%)。ICVD危险因素中,高收缩压检出率最高(74.8%,11685例),其次为高总胆固醇(70.7%,11051例)。T2DM患者的ICVD10年发病风险预测得分为(10.4±3.3)分,ICVD10年发病绝对危险度[P50(P25~P75)]为15.6%(6.8%~32.7%)。T2DM患者中ICVD10年发病风险极高危者2602例(16.7%),高危者3714例(23.8%),中危者3746例(24.0%)。ICVD总危险评分中贡献较大的危险因素分别为年龄(49.1%)、高血压(17.7%)和糖尿病(15.5%)。男性T2DM患者中吸烟(11.0%)是除年龄(47.4%)和高血压(20.5%)以外贡献最大的危险因素。结论江苏省两城市35岁及以上T2DM患者ICVD10年发病风险较高,尤其是老年、女性、高血压及男性吸烟患者。

Objective To evaluate the risk of 10-year risk of ischemic cardiovascular disease (ICVD) in patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu province. Methods From December 2013 to January 2014, a total of 15 624 patients with type 2 diabetes aged 35 years old and above, who received national basic public health service in Changshu county of Suzhou city, Huai′an and Qinghe districts of Huai′an city, Jiangsu province, were recruited by cluster sampling method. Face-to-face questionnaire survey, anthropometric and laboratory measurements were conducted to collect exposures to ICVD risk factors. Improved Ten Year Risk Assessment Table of ICVD in Chinese was used to assess the risk score and the absolute risk of developing ICVD. Results The participants were (62.2±9.7) years old, of which 6 137 were men (39.3%). Among the participants, the highest rate of exposure to ICVD risk factors was high systolic blood pressure (74.8%, n=11 685), followed by high total cholesterol (70.7%, n= 11 051).The score of 10-year risk for ICVD was (10.4±3.3) and the median (P25-P75) value of absolute risk was 15.6% (6.8%-32.7%). 16.7% (n=2 602) participants were under extremely high risk of 10-year risk for ICVD, 23.8% (n=3 714) under high-risk and 24.0% (n=3 746) under middle-risk. Among the total risk score of ICVD, age (49.1%), hypertension (17.7%) and diabetes (15.5%) accounted for relatively high proportion, however, smoking (11.0%) was the most important risk factor except for age (47.4%) and systolic blood pressure (20.5%) in male participants. Conclusion Patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu Province have a high risk of developing ICVD for 10 years, especially in elderly, female, hypertension patients and male smokers.