Risk factors for cardiovascular disease and mortality events in adults with type 2 diabetes — a 10-year follow-up: Tehran Lipid and Glucose Study

摘要

Background: To identify risk factors for cardiovascular disease (CVD) and mortality events in patients with type 2 diabetes and to calculate their population attributable fraction among a representative Iranian population. Methods: A total of 1198 patients with type 2 diabetes (504 men and 694 women), aged ≥30 years, without prevalent CVD, with a median follow-up of 10 years were included in current study. To examine the association between risk factors and their outcomes, multivariate sex-adjusted Cox proportional hazard regression models were used. Results: During the study, 281 and 172 participants experienced CVD and all-cause mortality events, respectively. Regarding CVD events, fasting plasma glucose (FPG) level of 7.22–<10 mmol/L [hazard ratio (HR): 1.46, 95% CI 1.12–1.96], FPG level ≥10 mmol/L (HR 2.04, 1.53–2.72), hypertension (HR 1.65, 1.28–2.13), hypercholesterolaemia (HR 1.96, 1.40–2.75) and high waist to hip ratio (HR 1.30, 0.99–1.70; p = 0.051) were significant predictors, and corresponding population attributable fractions were 9.76, 17.84, 23.26, 41.63 and 14.76%, respectively. Considering all-cause mortality events, hypertension (HR 1.70, 1.23–2.36), FPG level ≥10 mmol/L (HR 2.31, 1.55–3.20) and smoking (HR 1.45, 1.03–2.04) were significant predictors, and corresponding population attributable fractions were 25.81, 20.88 and 11.18%, respectively. Meanwhile, being overweight or obese was associated with lower all-cause and CVD mortality events. Conclusions: Among modifiable risk factors in patients with type 2 diabetes, hypercholesterolaemia and central adiposity for CVD, smoking for mortality events and hypertension and poor glycaemic control for both outcomes need to be paid most attention by healthcare professionals.