Incident cardiovascular disease by clustering of favourable risk factors in type 1 diabetes: the EURODIAB Prospective Complications Study - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Diabetologia Année : 2022

Incident cardiovascular disease by clustering of favourable risk factors in type 1 diabetes: the EURODIAB Prospective Complications Study

Soraya Soulimane
  • Fonction : Auteur
Yakima D. Vogtschmidt
  • Fonction : Auteur
Monika Toeller
  • Fonction : Auteur
John Harry S. Fuller
  • Fonction : Auteur
Sabita S. Soedamah-Muthu
  • Fonction : Auteur correspondant
  • PersonId : 1163936

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Résumé

Aims: The aim of this prospective study was to examine CVD risk reduction in type 1 diabetes (1) for people with favourable cardiovascular health metrics and (2) by clustering of these metrics. Methods: Data from 2313 participants from the EURODIAB Prospective Complications Study were analysed. All had type 1 diabetes (51% men, mean ± SD age 32 ± 9 years). Seven cardiovascular health metrics were studied—smoking, BMI, physical activity, a diet score, total cholesterol/HDL-cholesterol ratio, combined systolic and diastolic BP and HbA1c—divided into favourable/less favourable categories. Cox proportional hazards models were used to calculate HRs (95% CIs) of incident CVD for each metric. Clusters were made by scoring each individual by the number of favourable metrics. Results: A total of 163 people developed incident CVD during a mean ± SD follow-up of 7.2 ± 1.3 years. Participants with more favourable HbA1c levels of <57 mmol/mol (<7.4%) had a 37% significantly lower CVD risk than those with a less favourable HbA1c (HR [95% CI] 0.63 [0.44, 0.91]), and participants with a more favourable BP (systolic BP <112 mmHg and diastolic BP <70 mmHg) had a 44% significantly lower CVD risk than participants in the less favourable BP group (HR [95% CI] 0.56 [0.34, 0.92]). There was a dose–response relation with a lower HR observed with greater clustering of more favourable metrics: people with four or more favourable metrics had an HR of 0.37 (95% CI 0.18, 0.76), adjusted for sex and age at diabetes diagnosis, compared with those with no favourable metrics. Conclusions/interpretation: Low HbA1c and low BP were protective cardiovascular health metrics in our study of people with type 1 diabetes. Targeting all cardiovascular health metrics could be more effective in preventing CVD than targeting single metrics. Graphical abstract: [Figure not available: see fulltext.].
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hal-03775774 , version 1 (09-11-2022)

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Soraya Soulimane, Beverley J. Balkau, Yakima D. Vogtschmidt, Monika Toeller, John Harry S. Fuller, et al.. Incident cardiovascular disease by clustering of favourable risk factors in type 1 diabetes: the EURODIAB Prospective Complications Study. Diabetologia, 2022, 65 (7), pp.1169-1178. ⟨10.1007/s00125-022-05698-2⟩. ⟨hal-03775774⟩
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