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Association of carotid atherosclerosis markers with all-cause and cardiovascular disease-specific mortality in persons with type 2 diabetes: a causal mediation analysis with glucose variation.
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- Author(s): Lin CC;Lin CC;Lin CC; Li CI; Li CI; Li CI; Liu CS; Liu CS; Liu CS; Lin CH; Lin CH; Lin CH; Yang SY; Yang SY; Li TC; Li TC; Li TC
- Source:
Acta diabetologica [Acta Diabetol] 2024 May; Vol. 61 (5), pp. 657-669. Date of Electronic Publication: 2024 Feb 23.- Publication Type:
Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: Springer Verlag Country of Publication: Germany NLM ID: 9200299 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-5233 (Electronic) Linking ISSN: 09405429 NLM ISO Abbreviation: Acta Diabetol Subsets: MEDLINE
- Publication Information: Publication: Berlin : Springer Verlag
Original Publication: Berlin : Springer International, c1991- - Subject Terms: Diabetes Mellitus, Type 2*/complications ; Diabetes Mellitus, Type 2*/mortality ; Carotid Artery Diseases*/mortality ; Blood Glucose*/metabolism ; Blood Glucose*/analysis ; Carotid Intima-Media Thickness* ; Cardiovascular Diseases*/mortality ; Cardiovascular Diseases*/etiology ; Mediation Analysis*; Humans ; Male ; Female ; Middle Aged ; Retrospective Studies ; Aged ; Biomarkers/blood ; Risk Factors ; Proportional Hazards Models
- Abstract: Aims: Glucose variation (GV) is independently associated with mortality in patients with diabetes. However, no study has examined the effects of carotid atherosclerosis markers on mortality after considering GV. Our purpose is to investigate the independent effects of carotid atherosclerosis markers in persons with type 2 diabetes (T2DM) after considering GV and the mediation effects of carotid atherosclerosis markers on associations between GV with cardiovascular disease (CVD) mortality.
Materials and Methods: This study is a retrospective cohort study including 3628 persons with T2DM who were admitted to a medical center between January 01, 2001 and October 31, 2021. GV was defined as a coefficient of variation (CV) of repeated measurements within a year before the index date (date of first IMT assessment). Carotid atherosclerosis markers included intima-media thickness (IMT), plaque, and stenosis. The outcomes consisted of all-cause and expanded cardiovascular disease (CVD) mortality. Cox proportional hazards models were applied.
Results: Among the participants, 286 (7.9%) had IMT ≥ 2 mm, 2834 (78.1%) had carotid plaque, and 464 (12.8%) had carotid stenosis ≥ 50%. When GV was considered, IMT, carotid plaque, and carotid stenosis were significant factors for all-cause mortality (except IMT considering HbA1c-CV) and expanded CVD mortality. IMT was a significant mediator in the associations of fasting plasma glucose (FPG)-CV with all-cause and expanded CVD mortality (2 and 3.19%, respectively), and carotid stenosis was a significant mediator in the association between FPG-CV and expanded CVD mortality (3.83%).
Conclusions: Our statistical evaluations show suggests that carotid atherosclerosis markers are important predictors of CVD mortality in persons with T2DM if GV is considered. In addition, IMT and carotid stenosis were significant mediators in the association between GV and mortality.
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- Contributed Indexing: Keywords: Intima-media thickness; Mortality; Type 2 diabetes
- Accession Number: 0 (Blood Glucose)
0 (Biomarkers) - Publication Date: Date Created: 20240223 Date Completed: 20240427 Latest Revision: 20240427
- Publication Date: 20240428
- Accession Number: 10.1007/s00592-024-02243-y
- Accession Number: 38393346
- Source:
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