Affiliation:
1. Department of Endocrinology Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences Beijing China
2. Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences Beijing China
3. Endocrinology and Metabolism, SBMS, Faculty of Medicine University of Queensland Brisbane Australia
4. School of Resource and Environmental Sciences Wuhan University Wuhan China
5. School of Public Health Wuhan University Wuhan China
6. Remin Hospital, Wuhan University Wuhan China
7. International Institute of Spatial Lifecourse Health (ISLE) Wuhan University Wuhan China
Abstract
AbstractAimThe 2019 ESC/EASD guidelines categorize cardiovascular disease risk (CVD) in patients with diabetes mellitus (DM). Assessing CVD risk is necessary to identify individuals at very high risk of CVD, enabling tailored and precise intervention for this high‐risk population. This study aims to evaluate the severity of a very high risk for CVD stratification among patients with type 2 DM (T2DM) across different regions in China.MethodsWe conducted a cross‐sectional screening study from 1 January 2020 to 30 December 2022. Disease duration, body mass index (BMI), targeted organ damage, such as atherosclerotic heart disease, proteinuria, impaired renal function, left ventricular hypertrophy, retinopathy and known CVD risk factors, were collected from diabetic patients by professionally trained physicians. The risk of CV in patients with DM was categorized into two groups: very high risk and others, according to the 2019 ESC/EASD guidelines.ResultsIn total, 1 870 720 participants from 1669 hospitals in 30 provinces of China, excluding Tibet, Taiwan, Hong Kong and Macao, were enrolled from 2020 to 2022, among whom 67.50% of patients with T2DM were at very high risk for CVD. The proportions of very high‐risk T2DM were higher in Northeast China (75.82%), Central China (73.65%) and Southwest China (72.66%), while the lowest prevalence of very high‐risk T2DM was found in Southern China (60.15%). The multivariate binary logistic regression analyses suggested that the category of very high risk for CVD is associated with age [odds ratio (OR) = 1.04; 95% confidence interval (CI): 1.04‐1.04; p < .0001], BMI (OR = 1.07; 95% CI: 1.07‐1.07; p < .0001), duration of DM (OR = 1.05; 95% CI: 1.05‐1.05; p < .0001), hypertension (OR = 3.75; 95% CI: 3.72‐3.78; p < .0001), dyslipidaemia (OR = 5.22; 95% CI: 5.18‐5.27; p < .0001) and smoking (OR = 2.92; 95% CI: 2.89‐2.95; p < .0001).ConclusionsThis study represented the largest observational study of CVD risk assessment in patients with T2DM in China. The CVD risk situation of patients with diabetes in China is critical, and comprehensive control and management of CVD risk factors, such as hypertension, BMI and dyslipidaemia, in patients with DM need to be strengthened in patients with T2DM in China.