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T2DM perifer artärsid. Riskfaktorer. NDR. Diab Care

I Diabetes Care i november 2023 publicerades ett arbete av Avdic et al om risk för perifer arteriell sjukdom vid typ 2-diabetes.
 
Studien visar tydligt att klassiska riskfaktorer gällande hjärta och kärl 
 
• HbA1c ≥53 mmol/mol,
• systoliskt blodtryck ≥140 mmHg,
• LDL >2.5 mmol/L, rökning och
• eGFR <60 mL/min/1.73 m2
 
spelar stor roll för risken att utveckla perifer artärsjukdom,
drygt 6 ggr skillnad
 
Läs artikeln
 

Risk Factors for and Risk of Peripheral Artery Disease in Swedish Individuals With Type 2 Diabetes: A Nationwide Register-Based Study 

Tarik Avdic 

Rikard Isaksson; 

Soffia Gudbjörnsdottir; 

Zacharias Mandalenakis; 

Stefan Franzén; 

Naveed Sattar  

Joshua A. Beckman; 

Darren K. McGuire 

Björn Eliasson 

 

OBJECTIVE

To investigate to what extent having control of peripheral artery disease (PAD) risk factors is associated with the risk of incident PAD in individuals with type 2 diabetes.

RESEARCH DESIGN AND METHODS

A total of 148,096 individuals with type 2 diabetes in the Swedish National Diabetes Register between 2005 and 2009 were included and matched with 320,066 control subjects on the basis of age, sex, and county. A few control subjects who developed type 2 diabetes after recruitment, during wash-in (<0.2%), were not censored but instead matched with two new control subjects.

Individuals with type 2 diabetes were evaluated according to the number of PAD risk factors beyond recommended guideline levels at baseline, including LDL cholesterol, blood pressure, smoking, glycated hemoglobin, and estimated glomerular filtration rate. Incident PAD events were ascertained from 2006 to 2019.

RESULTS

A graded association was observed between the number of PAD risk factors not at target and incident PAD in individuals with type 2 diabetes.

The adjusted hazard ratio for PAD was 1.41 (95% CI 1.23–1.63) for those with type 2 diabetes with all PAD risk factors within target compared with control subjects matched for sex, age, and county but not risk factor status, in contrast with 9.28 (95% CI 3.62–23.79) for those with all five PAD risk factors not at target.

CONCLUSIONS

A graded association was observed between increasing number of PAD risk factors not at target and incident PAD in individuals with type 2 diabetes.

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