Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil
Autor(a) principal: | |
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Data de Publicação: | 2009 |
Outros Autores: | , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/31123 http://dx.doi.org/10.1186/1758-5996-1-22 |
Resumo: | According to Brazilian National Data Survey diabetes is the fifth cause for hospitalization and is one of the ten major causes of mortality in this country.Aimsto stratify the estimated cardiovascular risk (eCVR) in a population of type 2 diabetics (T2DM) according to the Framingham prediction equations as well as to determine the association between eCVR with metabolic and clinical control of the disease.MethodsFrom 2000 to 2001 a cross-sectional multicenter study was conducted in 13 public out-patients diabetes/endocrinology clinics from 8 Brazilian cities. the 10-year risk of developing coronary heart disease (CHD) was estimated by the prediction equations described by Wilson et al (Circulation 1998). LDL equations were preferably used; when patients missed LDL data we used total cholesterol equations instead.ResultsData from 1382 patients (59.0% female) were analyzed. Median and inter-quartile range (IQ) of age and duration of diabetes were 57.4 (51-65) and 8.8 (3-13) years, respectively without differences according to the gender. Forty-two percent of these patients were overweight and 35.4% were obese (the prevalence of higher BMI and obesity in this T2DM group was significantly higher in women than in men; p < 0.001). the overall estimated eCVR in T2DM patients was 21.4 (13.5-31.3). the eCVR was high (> 20%) in 738 (53.4%), intermediate in 202 (14.6%) and low in 442 (32%) patients. Men [25.1(15.4-37.3)] showed a higher eCVR than women [18.8 (12.4-27.9) p < 0.001]. the most common risk factor was high LDL-cholesterol (80.8%), most frequently found in women than in men (p = 0.01). the median of risk factors present was three (2-4) without gender differences. Overall we observed that 60 (4.3%) of our patients had none, 154(11.1%) one, 310 (22.4%) two, 385 (27.9%) three, 300 (21.7%) four, 149 (10.5%) five and six, (2%) six risk factors. A higher eCVR was noted in overweight or obese patients (p = 0.01 for both groups). No association was found between eCVR with age or a specific type of diabetes treatment. A correlation was found between eCVR and duration of diabetes (p < 0.001), BMI (p < 0.001), creatinine (p < 0.001) and triglycerides levels (p < 0.001) but it was not found with HbA1c, fasting blood glucose and postprandial glucose. A higher eCVR was observed in patients with retinopathy (p < 0.001) and a tendency in patients with microalbuminuria (p = 0.06). Conclusion: our study showed that in this group of Brazilian T2DM the eCVR was correlated with the lipid profile and it was higher in patients with microvascular chronic complications. No correlation was found with glycemic control parameters. These data could explain the failure of intensive glycemic control programs aiming to reduce cardiovascular events observed in some studies. |
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Gomes, Marilia B.Giannella-Neto, DanielFaria, ManuelTambascia, MarcosFonseca, Reine M.Rea, RosangelaMacedo, GeisaModesto-Filho, JoaoSchmid, HelenaBittencourt, Alcina V.Cavalcanti, SauloRassi, NelsonPedrosa, HermelindaDib, Sergio A. [UNIFESP]Universidade do Estado do Rio de Janeiro (UERJ)Universidade de São Paulo (USP)Univ Fed MaranhaoUniversidade Estadual de Campinas (UNICAMP)Ctr Estudos Diabet & Endocrinol Estado Bahia CEDEUniv Fed ParanaHosp Agamenon MagalhaesPosto Assistencia Med JaguribeSanta Casa Porto AlegreInst Assistencia & Previdencia Servidor Estado BaSanta Casa Belo HorizonteHosp Geral GoianiaSecretaria Municipal Saude BrasiliaUniversidade Federal de São Paulo (UNIFESP)2016-01-24T13:52:00Z2016-01-24T13:52:00Z2009-01-01Diabetology & Metabolic Syndrome. London: Biomed Central Ltd, v. 1, 7 p., 2009.1758-5996http://repositorio.unifesp.br/handle/11600/31123http://dx.doi.org/10.1186/1758-5996-1-22WOS000207918200022.pdf10.1186/1758-5996-1-22WOS:000207918200022According to Brazilian National Data Survey diabetes is the fifth cause for hospitalization and is one of the ten major causes of mortality in this country.Aimsto stratify the estimated cardiovascular risk (eCVR) in a population of type 2 diabetics (T2DM) according to the Framingham prediction equations as well as to determine the association between eCVR with metabolic and clinical control of the disease.MethodsFrom 2000 to 2001 a cross-sectional multicenter study was conducted in 13 public out-patients diabetes/endocrinology clinics from 8 Brazilian cities. the 10-year risk of developing coronary heart disease (CHD) was estimated by the prediction equations described by Wilson et al (Circulation 1998). LDL equations were preferably used; when patients missed LDL data we used total cholesterol equations instead.ResultsData from 1382 patients (59.0% female) were analyzed. Median and inter-quartile range (IQ) of age and duration of diabetes were 57.4 (51-65) and 8.8 (3-13) years, respectively without differences according to the gender. Forty-two percent of these patients were overweight and 35.4% were obese (the prevalence of higher BMI and obesity in this T2DM group was significantly higher in women than in men; p < 0.001). the overall estimated eCVR in T2DM patients was 21.4 (13.5-31.3). the eCVR was high (> 20%) in 738 (53.4%), intermediate in 202 (14.6%) and low in 442 (32%) patients. Men [25.1(15.4-37.3)] showed a higher eCVR than women [18.8 (12.4-27.9) p < 0.001]. the most common risk factor was high LDL-cholesterol (80.8%), most frequently found in women than in men (p = 0.01). the median of risk factors present was three (2-4) without gender differences. Overall we observed that 60 (4.3%) of our patients had none, 154(11.1%) one, 310 (22.4%) two, 385 (27.9%) three, 300 (21.7%) four, 149 (10.5%) five and six, (2%) six risk factors. A higher eCVR was noted in overweight or obese patients (p = 0.01 for both groups). No association was found between eCVR with age or a specific type of diabetes treatment. A correlation was found between eCVR and duration of diabetes (p < 0.001), BMI (p < 0.001), creatinine (p < 0.001) and triglycerides levels (p < 0.001) but it was not found with HbA1c, fasting blood glucose and postprandial glucose. A higher eCVR was observed in patients with retinopathy (p < 0.001) and a tendency in patients with microalbuminuria (p = 0.06). Conclusion: our study showed that in this group of Brazilian T2DM the eCVR was correlated with the lipid profile and it was higher in patients with microvascular chronic complications. No correlation was found with glycemic control parameters. These data could explain the failure of intensive glycemic control programs aiming to reduce cardiovascular events observed in some studies.Univ Estado Rio de Janeiro, Diabet Unit, Rio de Janeiro, BrazilUniv São Paulo Scholl Med, Hosp Clin, Lab Clin & Expt Gatroenterol LIM07, São Paulo, BrazilUniv Fed Maranhao, Div Endocrinol, Sao Luis, BrazilUniv Estadual Campinas, Div Endocrinol, Campinas, BrazilCtr Estudos Diabet & Endocrinol Estado Bahia CEDE, Salvador, BA, BrazilUniv Fed Parana, Div Endocrinol, BR-80060000 Curitiba, Parana, BrazilHosp Agamenon Magalhaes, Div Endocrinol, Recife, PE, BrazilPosto Assistencia Med Jaguribe, Joao Pessoa, Paraiba, BrazilSanta Casa Porto Alegre, Div Endocrinol, Porto Alegre, RS, BrazilInst Assistencia & Previdencia Servidor Estado Ba, Div Endocrinol, Salvador, BA, BrazilSanta Casa Belo Horizonte, Diabet Unit, Belo Horizonte, MG, BrazilHosp Geral Goiania, Div Endocrinol, Goiania, Go, BrazilSecretaria Municipal Saude Brasilia, Brasilia, DF, BrazilUniversidade Federal de São Paulo, Div Endocrinol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Endocrinol, São Paulo, BrazilWeb of Science7engBiomed Central LtdDiabetology & Metabolic SyndromeEstimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALWOS000207918200022.pdfapplication/pdf379371${dspace.ui.url}/bitstream/11600/31123/1/WOS000207918200022.pdf713a6e5b9eb4b21d5bdcee2a601cfd25MD51open accessTEXTWOS000207918200022.pdf.txtWOS000207918200022.pdf.txtExtracted texttext/plain32292${dspace.ui.url}/bitstream/11600/31123/2/WOS000207918200022.pdf.txt84cd2c3efcd67ba2f72b65923f4b1086MD52open access11600/311232023-01-27 22:45:17.639open accessoai:repositorio.unifesp.br:11600/31123Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-01-28T01:45:17Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil |
title |
Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil |
spellingShingle |
Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil Gomes, Marilia B. |
title_short |
Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil |
title_full |
Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil |
title_fullStr |
Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil |
title_full_unstemmed |
Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil |
title_sort |
Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil |
author |
Gomes, Marilia B. |
author_facet |
Gomes, Marilia B. Giannella-Neto, Daniel Faria, Manuel Tambascia, Marcos Fonseca, Reine M. Rea, Rosangela Macedo, Geisa Modesto-Filho, Joao Schmid, Helena Bittencourt, Alcina V. Cavalcanti, Saulo Rassi, Nelson Pedrosa, Hermelinda Dib, Sergio A. [UNIFESP] |
author_role |
author |
author2 |
Giannella-Neto, Daniel Faria, Manuel Tambascia, Marcos Fonseca, Reine M. Rea, Rosangela Macedo, Geisa Modesto-Filho, Joao Schmid, Helena Bittencourt, Alcina V. Cavalcanti, Saulo Rassi, Nelson Pedrosa, Hermelinda Dib, Sergio A. [UNIFESP] |
author2_role |
author author author author author author author author author author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade do Estado do Rio de Janeiro (UERJ) Universidade de São Paulo (USP) Univ Fed Maranhao Universidade Estadual de Campinas (UNICAMP) Ctr Estudos Diabet & Endocrinol Estado Bahia CEDE Univ Fed Parana Hosp Agamenon Magalhaes Posto Assistencia Med Jaguribe Santa Casa Porto Alegre Inst Assistencia & Previdencia Servidor Estado Ba Santa Casa Belo Horizonte Hosp Geral Goiania Secretaria Municipal Saude Brasilia Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Gomes, Marilia B. Giannella-Neto, Daniel Faria, Manuel Tambascia, Marcos Fonseca, Reine M. Rea, Rosangela Macedo, Geisa Modesto-Filho, Joao Schmid, Helena Bittencourt, Alcina V. Cavalcanti, Saulo Rassi, Nelson Pedrosa, Hermelinda Dib, Sergio A. [UNIFESP] |
description |
According to Brazilian National Data Survey diabetes is the fifth cause for hospitalization and is one of the ten major causes of mortality in this country.Aimsto stratify the estimated cardiovascular risk (eCVR) in a population of type 2 diabetics (T2DM) according to the Framingham prediction equations as well as to determine the association between eCVR with metabolic and clinical control of the disease.MethodsFrom 2000 to 2001 a cross-sectional multicenter study was conducted in 13 public out-patients diabetes/endocrinology clinics from 8 Brazilian cities. the 10-year risk of developing coronary heart disease (CHD) was estimated by the prediction equations described by Wilson et al (Circulation 1998). LDL equations were preferably used; when patients missed LDL data we used total cholesterol equations instead.ResultsData from 1382 patients (59.0% female) were analyzed. Median and inter-quartile range (IQ) of age and duration of diabetes were 57.4 (51-65) and 8.8 (3-13) years, respectively without differences according to the gender. Forty-two percent of these patients were overweight and 35.4% were obese (the prevalence of higher BMI and obesity in this T2DM group was significantly higher in women than in men; p < 0.001). the overall estimated eCVR in T2DM patients was 21.4 (13.5-31.3). the eCVR was high (> 20%) in 738 (53.4%), intermediate in 202 (14.6%) and low in 442 (32%) patients. Men [25.1(15.4-37.3)] showed a higher eCVR than women [18.8 (12.4-27.9) p < 0.001]. the most common risk factor was high LDL-cholesterol (80.8%), most frequently found in women than in men (p = 0.01). the median of risk factors present was three (2-4) without gender differences. Overall we observed that 60 (4.3%) of our patients had none, 154(11.1%) one, 310 (22.4%) two, 385 (27.9%) three, 300 (21.7%) four, 149 (10.5%) five and six, (2%) six risk factors. A higher eCVR was noted in overweight or obese patients (p = 0.01 for both groups). No association was found between eCVR with age or a specific type of diabetes treatment. A correlation was found between eCVR and duration of diabetes (p < 0.001), BMI (p < 0.001), creatinine (p < 0.001) and triglycerides levels (p < 0.001) but it was not found with HbA1c, fasting blood glucose and postprandial glucose. A higher eCVR was observed in patients with retinopathy (p < 0.001) and a tendency in patients with microalbuminuria (p = 0.06). Conclusion: our study showed that in this group of Brazilian T2DM the eCVR was correlated with the lipid profile and it was higher in patients with microvascular chronic complications. No correlation was found with glycemic control parameters. These data could explain the failure of intensive glycemic control programs aiming to reduce cardiovascular events observed in some studies. |
publishDate |
2009 |
dc.date.issued.fl_str_mv |
2009-01-01 |
dc.date.accessioned.fl_str_mv |
2016-01-24T13:52:00Z |
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2016-01-24T13:52:00Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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Diabetology & Metabolic Syndrome. London: Biomed Central Ltd, v. 1, 7 p., 2009. |
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http://repositorio.unifesp.br/handle/11600/31123 http://dx.doi.org/10.1186/1758-5996-1-22 |
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1758-5996 |
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WOS000207918200022.pdf |
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10.1186/1758-5996-1-22 |
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WOS:000207918200022 |
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Diabetology & Metabolic Syndrome. London: Biomed Central Ltd, v. 1, 7 p., 2009. 1758-5996 WOS000207918200022.pdf 10.1186/1758-5996-1-22 WOS:000207918200022 |
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http://repositorio.unifesp.br/handle/11600/31123 http://dx.doi.org/10.1186/1758-5996-1-22 |
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