Heart：2型糖尿病患者心血管和肾脏预后的预测模型

2021-04-10 Nebula MedSci原创

Nebula-Qin

复旦大学附属中山医院医生/ 住院医师

多种2型糖尿病患者心血管和肾脏预后的预测模型孰优孰劣？

全球糖尿病的发病率持续上升：目前全球约有4.63亿糖尿病患者，其中9.3%的患者年龄在20-79岁。糖尿病是导致肾衰竭的首要原因，约25%的糖尿病成人患者存在中至重度的慢性肾病。2019年，约11.3%的全球死亡可归因于糖尿病。

为了提供一份临床实践指南(BMJ快速推荐)，考虑使用钠葡萄糖共转运体-2抑制剂和胰高血糖素样肽-1受体激动剂治疗成人2型糖尿病，该研究总结了关于这些患者心血管和肾脏预后的有效危险模型的表现。

研究流程

研究人员系统地检索了2020年1月前的文献数据，以筛选评估非卧床成人2型糖尿病患者全因和心血管死亡率、心力衰竭(HF)住院、终末期肾病(ESKD)、心肌梗死(MI)和缺血性卒中风险模型的观察性研究，并进行了相应的汇总分析。

各种预后汇总分析结果

总体上，共筛选了22589篇文章，其中15篇关于7种风险模型的观察性研究被证明符合要求被纳入本次分析。这7种风险模型均有1个以上的验证队列，在这些模型中，2型糖尿病并发症风险方程(RECODe)在初步研究中具有最好的校准性，且对以下结果的混合判别能力最高：全因死亡率(C-统计 0.75，95% CI 0.70-0.80；高确定性)、心血管死亡率(0.79，95%CI 0.75-0.84；低确定性)、ESKD(0.73，95%CI 0.52-0.94；低确定性)、MI(0.72，95%CI 0.69-0.74；中度确定性)和卒中(0.71，95%CI 0.68-0.74；中度确定性)。然而，该模型并不能预测心力衰竭住院的风险。

总之，在现有的风险预测模型中，RECODe在初步验证研究中具有令人满意的校正效果，可接受的区分度优于其他模型，但在大多数初步研究中存在较高的偏倚风险。

原始出处：

Buchan Tayler A,Malik Abdullah,Chan Cynthia et al. Predictive models for cardiovascular and kidney outcomes in patients with type 2 diabetes: systematic review and meta-analyses. Heart, 2021, https://doi.org/10.1136/heartjnl-2021-319243

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2021-06-24 12192b1am98暂无昵称

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2021-06-19 ms3000001194153612

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2021-06-10 12295c59m59暂无昵称

学习了

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2021-04-12 维他命

#预测模型#

74 0
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12 06:56:48 CST 2021, time=2021-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563442, encodeId=344215634426a, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Apr 12 06:56:48 CST 2021, time=2021-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=955820, encodeId=2e62955820b9, content=有用！, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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2021-04-12 zhaojie88

#ART#

60 0
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2021-04-12 aids213

#2型糖尿病患者#

92 0
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2021-04-12 xue8604

#糖尿病患者#

106 0
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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/LkRGPiaiaPpvicy108WCl3K5S9LqWFjKQlpA7iaRo5QQ6aM5pmLJenLGh9Sq1TB7WOFrpvSTbO0OoMlpmGoTgTVU8w/132, createdBy=8e1c2328105, createdName=pingping456, createdTime=Sun Apr 11 06:56:34 CST 2021, time=2021-04-11, status=1, ipAttribution=)]
2021-04-12 zhzhxiang

#肾脏预后#

102 0
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encodeId=953814e5058a9, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Mon Apr 12 06:56:48 CST 2021, time=2021-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1555576, encodeId=116c15555e672, content=<a href='/topic/show?id=0d7282e398f' target=_blank style='color:#2F92EE;'>#肾脏预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82739, encryptionId=0d7282e398f, topicName=肾脏预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21ca14623751, createdName=zhzhxiang, createdTime=Mon Apr 12 06:56:48 CST 2021, time=2021-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563442, encodeId=344215634426a, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Apr 12 06:56:48 CST 2021, time=2021-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=955820, encodeId=2e62955820b9, content=有用！, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/LkRGPiaiaPpvicy108WCl3K5S9LqWFjKQlpA7iaRo5QQ6aM5pmLJenLGh9Sq1TB7WOFrpvSTbO0OoMlpmGoTgTVU8w/132, createdBy=8e1c2328105, createdName=pingping456, createdTime=Sun Apr 11 06:56:34 CST 2021, time=2021-04-11, status=1, ipAttribution=)]
2021-04-12 slcumt

#HEART#

66 0
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encodeId=953814e5058a9, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Mon Apr 12 06:56:48 CST 2021, time=2021-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1555576, encodeId=116c15555e672, content=<a href='/topic/show?id=0d7282e398f' target=_blank style='color:#2F92EE;'>#肾脏预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82739, encryptionId=0d7282e398f, topicName=肾脏预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21ca14623751, createdName=zhzhxiang, createdTime=Mon Apr 12 06:56:48 CST 2021, time=2021-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563442, encodeId=344215634426a, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Apr 12 06:56:48 CST 2021, time=2021-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=955820, encodeId=2e62955820b9, content=有用！, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/LkRGPiaiaPpvicy108WCl3K5S9LqWFjKQlpA7iaRo5QQ6aM5pmLJenLGh9Sq1TB7WOFrpvSTbO0OoMlpmGoTgTVU8w/132, createdBy=8e1c2328105, createdName=pingping456, createdTime=Sun Apr 11 06:56:34 CST 2021, time=2021-04-11, status=1, ipAttribution=)]
2021-04-11 pingping456

有用！

102 0

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