Importance of Lipid Levels in Elderly Diabetic Individuals : Baseline Characteristics and 1-Year Survey of Cardiovascular Events

元データ 2008-01-20 社団法人日本循環器学会

概要

Background The respective incidences of ischemic heart and cerebrovascular disease (IHD, CVD) are high in diabetic individuals. Complications of dyslipidemia increase the risk, but direct evidence is limited, so a cohort prospective study (Japan-CDM) was conducted. Methods and Results The study group comprised 4,014 subjects with type 2 diabetes (1,936 women, 2,078 men; mean age 67.4±9.5 years) who were divided into dyslipidemic patients (79.1%) with or without medication (medicated, 50.9%; not medicated, 28.2%) and normo-lipidemic patients (20.9%). The incidence of IHD, CVD, arteriosclerosis obliterans (ASO), congestive heart failure (CHF) and death was assessed. IHD and CVD occurred in 0.82 and 0.67%, respectively, during the first year following registration. CHF, ASO and sudden death occurred in 0.27%, 0.12% and 0.12%, respectively. There was a significant statistical difference in the relation of elevated levels of high-density lipoprotein-cholesterol to lower rates of IHD and CVD. IHD and CVD in males were dependent on the level of low-density lipoprotein-cholesterol (LDL-C): 0.45%, 1.56%, 1.78%, 1.91% and 2.34% were observed in less than 2.11, 2.11-2.62, 2.63-3.15, 3.16-3.67, and more than 3.68 mol/L of LDL-C. In the lowest LDL-C group, death other than from vascular diseases was increased. Age, sex (male) and complicated hypertension increased the risk of events. Patients who were prescribed antihyperlipidemic agents suffered less events than patients who were not being treated, which suggests direct effects of therapy. Conclusion Strict lipid control may be effective for reducing the incidence of vascular events in Japanese diabetic individuals.

著者

YAMADA Nobuhiro Department of Internal Medicine, University of Tsukuba
SONE Hirohito Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba
KUBOTA Kiyoshi Department of Pharmacoepidemiology, Faculty of Medicine, University of Tokyo
Watanabe Hiroshi Department of Cardiology, Niigata City General Hospital
Kawashima Seinosuke Division Of Cardiovascular And Respiratory Medicine Kobe University Graduate School Of Medicine
OHRUI Takashi Department of Geriatric and Respiratory Medicine, Tohoku University School of Medicine
HAYASHI Toshio Department of Geriatrics, Nagoya University Graduate School of Medicine
Iguchi Akihisa Department of Geriatrics, Nagoya University Graduate School of Medicine
Satoh Hiroshi Division Of Cardiology Internal Medicine Iii Hamamatsu University School Of Medicine
Kawashima Seinosuke Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University
Itoh Hideki Tokyo Metropolitan Geriatric Hospital
Nomura Hideki Department Of Geriatrics Nagoya Kita Hospital
Nomura Hideki Department Of Cell Physiology Nagoya University Graduate School Of Medicine
Hayashi Toshio Department Of Gerontology Nagoya University Graduate School Of Medicine
Hayashi Toshio Department Of Geriatrics Nagoya University School Of Medicine
Yokote Koutaro Division Of Diabetes Metabolism And Endocrinology Department Of Internal Medicine Chiba University H
Iguchi Akihisa Department Of Gerontology Nagoya University Graduate School Of Medicine
Iguchi Akihisa Department Of Geriatrics Medicine In Growth And Aging Program In Health And Community Medicine Nagoy
Sone Hirohito Department Of Endocrinology & Metabolism Department Of Sports Medicine University Of Tsukuba
UMEGAKI Hiroyuki Department of Geriatrics, Nagoya University Graduate School of Medicine
Hattori Yoshiyuki Department Of Biological Science Graduate School Of Science Hiroshima University
Hattori Yoshiyuki Department Of Endocrinology And Metabolism Dokkyo University School Of Medicine
Yoshizumi Masashi Department of Cardiovascular Physiology, Hiroshima University Graduate School of Biomedical Sciences
Yamada Nobuhiro Department Of Internal Medicine Endocrinology And Metabolism Graduate School Of Comprehensive Human
Yamada Nobuhiro Department Of Chemistry And Chemical Engineering Yamagata University
Hayashi Toshio Department Of Geriatrics Nagoya University Graduate School Of Medicine
Sone Hirohito Department Of Nutrition Ochanomizu University
Kubota Kiyoshi Department Of Pharamacoepidemiology University Of Tokyo Faculty Of Medicine
Watanabe Hiroshi Clinical Pharmacology And Therapeutics Hamamatsu University School Of Medicine
Umegaki Hiroyuki Department Of Geriatrics Nagoya University Graduate School Of Medicine
Ohrui Takashi Department Of Geriatric Medicine Tohoku University School Of Medicine
Ohrui Takashi Department Of Geriatric And Respiratory Medicine Tohoku University Graduate School Of Medicine
Yoshizumi Masashi Department Of Cardiovascular Physiology Hiroshima University Graduate School Of Biomedical Sciences
Watanabe Hiroshi Department Of Clinical Pharmacology & Therapeutics Hamamatsu University School Of Medicine
Hayashi Toshio Department Of Bioldgy College Of General Education University Of Tokyo Komaba
Watanabe Hiroshi Department Of Applied Chemistry And Bioengineering Graduate School Of Engineering Osaka City Univers
Satoh Hiroshi Department Of Nutrition Ochanomizu University
Hattori Yoshiyuki Department of Endocrinology and Metabolism, Dokkyo University School of Medicine

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