Diabetes, Metabolic Syndrome and Obesity (Oct 2021)

Assessment of Cardiovascular Risk Factors and Their Interactions in the Risk of Coronary Heart Disease in Patients with Type 2 Diabetes with Different Weight Levels, 2013–2018

  • Wang C,
  • Ye D,
  • Xie Z,
  • Huang X,
  • Wang Z,
  • Shangguan H,
  • Zhu W,
  • Wang S

Journal volume & issue
Vol. Volume 14
pp. 4253 – 4262

Abstract

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Chenchen Wang,1,2 Demei Ye,1 Zuoling Xie,1,2 Xi Huang,1 Zheng Wang,2 Haiyan Shangguan,2,3 Wenwen Zhu,2 Shaohua Wang1 1Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, 210009, People’s Republic of China; 2School of Medicine, Southeast University, Nanjing, 210009, People’s Republic of China; 3Nanjing Central Hospital, Nanjing, 210008, People’s Republic of ChinaCorrespondence: Shaohua WangDepartment of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, 210009, People’s Republic of ChinaTel +86 25 83262810Fax +86 25 83285132Email [email protected]: In addition to hyperglycemia and hyperlipidemia, obesity and hypertension are important cardiovascular risk factors for coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM). This study aims to explore the interaction of these risk factors.Patients and Methods: Data of hospitalized patients with T2DM from 2013 to 2018 were collected. A multivariate logistic regression model was established. Patients with normal weight and blood pressure were recruited as controls. The interaction on the risk of CHD was evaluated by relative excess risk due to interaction (RERI).Results: Among the 30,693 patients with T2DM, 7202 (23.5%) had CHD. In the low weight group, the prevalence of CHD in patients with hypertension was nearly four times higher than that in patients without hypertension (42.7% vs 11.3%, P < 0.01). The OR value of hypertension alone on CHD increased from 1.29 (95% CI 1.06– 1.56) in the body mass index (BMI) 30.0– 34.9 kg/m2 group to 1.35 (95% CI 1.11– 1.62) in the BMI ≤ 18.5 kg/m2 group. Additive interaction was observed between hypertension and BMI in CHD risk, especially in the low weight group (RERI:2.2, 95% CI 0.9– 3.5). BMI and CHD risk showed a smile curve relationship. The attributive proportion in the low weight group was higher than that in the severe obesity group, that is, 0.52 (95% CI 0.35– 0.69) vs 0.18 (95% CI − 0.59 to 0.95).Conclusion: Maintaining normal weight and avoiding low weight are particularly important for patients with co-occurring diabetes and hypertension to prevent the risk of CHD.Keywords: type 2 diabetes, cardiovascular, hypertension, body mass index, interaction

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