Development and Validation of a Total Coronary Heart Disease Risk Score in Type 2 Diabetes Mellitus

Yang, Xilin; So, Wing‐Yee; Kong, Alice Pik‐Shan; Ma, Rong; Ko, G. T. C.; Ho, Chung-Shun; Lam, Christopher Wai‐Kei; Cockram, Clive S.; Chan, Juliana C.N.; Tong, Peter C.Y.

doi:10.1016/j.amjcard.2007.10.019

Cited by 105 publications

(93 citation statements)

References 27 publications

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“…A Hong Kong study by Yang et al [40,41] and, among broader populations, the Framingham Offspring study [42] and the recent Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (AD-VANCE) study [38] all had similar findings to FIELD. Yang et al investigated a Chinese population with type 2 diabetes, using registry data and non-centralised outpatient laboratory measurements.…”

Section: Discussionsupporting

confidence: 53%

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Estimated glomerular filtration rate and albuminuria are independent predictors of cardiovascular events and death in type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study

et al. 2010

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Aims/hypothesis We investigated effects of renal function and albuminuria on cardiovascular outcomes in 9,795 lowrisk patients with diabetes in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. Methods Baseline and year 2 renal status were examined in relation to clinical and biochemical characteristics. Outcomes included total cardiovascular disease (CVD), cardiac and non-cardiac death over 5 years. Results Lower estimated GFR (eGFR) vs eGFR ≥90 ml min . CVD risk was further modified by renal status changes over the first 2 years. In multivariable analysis, 77% of the effect of eGFR and 81% of the effect of albumin:creatinine ratio were accounted for by other variables, principally low HDL-cholesterol and elevated blood pressure. Conclusions/interpretation Reduced eGFR and albuminuria are independent risk factors for cardiovascular events and mortality rates in a low-risk population of mainly European ancestry. While their independent contributions to CVD risk appear small when other risk factors are considered, they remain excellent surrogate markers in clinical practice because they capture risk related to a number of other characteristics. Therefore, both should be considered when assessing prognosis and treatment strategies in patients with diabetes, and both should be included in risk models.

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Section: Discussionsupporting

confidence: 53%

“…Each of . b Cardiovascular risk of eGFR groups, according to presence or not of baseline micro-and macroalbuminuria these studies relied on local measures of eGFR and albuminuria at each clinical site [38][39][40][41]; in contrast, our report used centrally measured laboratory values.…”

Section: Discussionmentioning

confidence: 99%

Estimated glomerular filtration rate and albuminuria are independent predictors of cardiovascular events and death in type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study

et al. 2010

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“…18 We also calculated the 5-year risk of CHD and stroke using the equations derived from the Hong Kong Diabetes Registry. 19,20 We then used 5-year CHD risk ⩾20% and 5-year stroke risk ⩾10% to identify high-risk subjects for future CV events in those without prior history of CHD or stroke.…”

Section: Definitions Of Complicationsmentioning

confidence: 99%

Borderline ankle–brachial index is associated with increased prevalence of micro- and macrovascular complications in type 2 diabetes: A cross-sectional analysis of 12,772 patients from the Joint Asia Diabetes Evaluation Program

Yan¹,

Zhang

Kong³

et al. 2015

Diabetes and Vascular Disease Research

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Borderline ankle-brachial index is increasingly recognised as a marker of cardiovascular risk. We evaluated the impact of borderline ankle-brachial index in 12,772 Chinese type 2 diabetes patients from the Joint Asia Diabetes Evaluation Program between 2007 and 2012. Cardiovascular risk factors, complications and health-related quality of life were compared between patients with normal ankle-brachial index (1.0-1.4), borderline ankle-brachial index (0.90-0.99) and peripheral arterial disease (ankle-brachial index < 0.9). The prevalence of peripheral arterial disease and borderline ankle-brachial index was 4.6% and 9.6%, respectively. Borderline ankle-brachial index patients were older, more likely to be smokers and hypertensive, had longer duration of diabetes, poorer kidney function and poorer health-related quality of life than patients with normal ankle-brachial index. After adjustment for traditional cardiovascular risk factors, borderline ankle-brachial index was an independent predictor of diabetes-related micro-and macrovascular complications including retinopathy (odd ratios: 1.19 (95% confidence interval: 1.04-1.37)), macroalbuminuria (1.31 (1.10-1.56)), chronic kidney disease (1.22 (1.00-1.50)) and stroke (1.31 (1.05-1.64)). These findings suggest that patients with diabetes and borderline ankle-brachial index are at increased cardiovascular risk and may benefit from more intensive management.

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“…In addition to cardiovascular disease [4][5][6] and renal disease [7][8] , type 1 and type 2 diabetes are also associated with a spectrum of cancers [9][10][11][12][13][14][15] , except for prostate cancer with reports showing conflicting results [16][17] . Since the first few reports on increased incidence of cancer in insulintreated patients, there are ongoing debates regarding the risk association of insulin use with cancer [18][19] .…”

Section: Introductionmentioning

confidence: 99%

Diabetes, insulin and cancer risk

Yang

Chan²

2012

WJD

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There is a consensus that both type 1 and type 2 diabetes are associated with a spectrum of cancers but the underlying mechanisms are largely unknown. On the other hand, there are ongoing debates about the risk association of insulin use with cancer. We have briefly reviewed recent related research on exploration of risk factors for cancer and pharmacoepidemiological investigations into drug use in diabetes on the risk of cancer, as well as the current understanding of metabolic pathways implicated in intermediary metabolism and cellular growth. Based on the novel findings from the Hong Kong Diabetes Registry and consistent experimental evidence, we argue that use of insulin to control hyperglycemia is unlikely to contribute to increased cancer risk and that dysregulations in the AMPactivated protein kinase pathway due to reduced insulin action and insulin resistance, the insulin-like growth factor-1 (IGF-1)-cholesterol synthesis pathway and renin-angiotensin system, presumably due to reduced insulin secretion and hyperglycemia, may play causal roles in the increased risk of cancer in diabetes. Further exploration into the possible causal relationships between abnormalities of these pathways and the risk of cancer in diabetes is warranted.

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Development and Validation of a Total Coronary Heart Disease Risk Score in Type 2 Diabetes Mellitus

Cited by 105 publications

References 27 publications

Estimated glomerular filtration rate and albuminuria are independent predictors of cardiovascular events and death in type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study

Estimated glomerular filtration rate and albuminuria are independent predictors of cardiovascular events and death in type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study

Borderline ankle–brachial index is associated with increased prevalence of micro- and macrovascular complications in type 2 diabetes: A cross-sectional analysis of 12,772 patients from the Joint Asia Diabetes Evaluation Program

Diabetes, insulin and cancer risk

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