論文

査読有り 国際誌
2019年11月1日

Relationship Between Number of Multiple Risk Factors and Coronary Artery Disease Risk With and Without Diabetes Mellitus.

The Journal of clinical endocrinology and metabolism
  • Mayuko Yamada-Harada
  • ,
  • Kazuya Fujihara
  • ,
  • Taeko Osawa
  • ,
  • Masahiko Yamamoto
  • ,
  • Masanori Kaneko
  • ,
  • Masaru Kitazawa
  • ,
  • Yasuhiro Matsubayashi
  • ,
  • Takaho Yamada
  • ,
  • Nauta Yamanaka
  • ,
  • Hiroyasu Seida
  • ,
  • Wataru Ogawa
  • ,
  • Hirohito Sone

104
11
開始ページ
5084
終了ページ
5090
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1210/jc.2019-00168

PURPOSE: To determine the degree of control of multiple risk factors under real-world conditions for coronary artery disease (CAD) according to the presence or absence of diabetes mellitus (DM) and to determine whether reaching multifactorial targets for blood pressure (BP), low-density lipoprotein-cholesterol (LDL-C), HbA1c, and current smoking is associated with lower risks for CAD. METHODS: We investigated the effects on subsequent CAD of the number of controlled risk factors among BP, LDL-C, HbA1c, and current smoking in a prospective cohort study using a nationwide claims database of 220,894 individuals in Japan. Cox regression examined risks over a 4.8-year follow-up. RESULTS: The largest percentage of participants had two risk factors at target in patients with DM (39.6%) and subjects without DM (36.4%). Compared with those who had two targets achieved, the risks of CAD among those who had any one and no target achieved were two and four times greater, respectively, regardless of the presence of DM. The effect of composite control was sufficient to bring CAD risk in patients with DM below that for subjects without DM with any two targets achieved, whereas the risk of CAD in the DM group with all four risk factors uncontrolled was 9.4 times more than in the non-DM group who had achieved two targets. CONCLUSIONS: These findings show that composite control of modifiable risk factors has a large effect in patients with and without DM. The effect was sufficient to bring CAD risk in patients with DM below that in the non-DM group who had two targets achieved.

リンク情報
DOI
https://doi.org/10.1210/jc.2019-00168
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30994885

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