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Long-term effects intensive medical therapy on the development and progression of subclinical atherosclerosis and the metabolic syndrome in Chinese patients with type 2 diabetes mellitus

View Article: PubMed Central - PubMed

ABSTRACT

Background:: Few studies have investigated the progression of subclinical atherosclerosis and metabolic syndrome (MetS) in Chinese patients with type 2 diabetes mellitus (T2DM). This study was to compare the long-term effects of intensive medical therapy on the development and progression of subclinical atherosclerosis and MetS in Chinese T2DM patients with that of a conventional treatment regimen.

Methods:: A total of 316 T2DM patients were randomized to receive conventional pharmacological treatment or intensive medical therapy, consisting of diet and exercise counseling, from 2002 to 2014 at our hospital in Changsha, China. Clinical indicators of subclinical atherosclerosis and MetS were evaluated over the 12-year follow-up period. A χ2 analysis or t tests was used to compare the data between the 2 groups. Risk factors for subclinical atherosclerosis were identified using Cox proportional hazard models.

Results:: The incidence of subclinical atherosclerosis increased in both groups over time, and did not differ significantly between the 2 groups at the end of the study. However, after 6 years of treatment, the risk of subclinical atherosclerosis was significantly lower in the intensive medical therapy group, based on intima-media thickness (IMT) measurements, compared with that in the conventional treatment (44.2% vs. 69.7%; P < 0.01). Age, creatinine, and IMT of the common iliac artery were significantly associated with subclinical atherosclerosis. Although the indicators of MetS did not differ significantly at the end of study, the success rate for the management of MetS in the intensive medical therapy group was significantly higher than that in the conventional treatment group in 2006, 2008, 2010, and 2012.

Conclusions:: The incidence of atherosclerosis in the intensive medical therapy group was significantly lower than that in the conventional treatment group from 2006 to 2010 (P < 0.05), and the incidence of MetS in the intensive medical therapy group was significantly higher than that in the conventional treatment group from 2006 to 2012. Kaplan–Meier estimations showed that the risk of subclinical atherosclerosis in the intensive medical therapy group was significantly lower than that in the conventional treatment group (P < 0.001), whereas the risk of MetS was not significantly different between the treatment groups (P > 0.05).

No MeSH data available.


Flow chart depicting patient recruitment and selection, the number of patients who withdrew from the study, and the number of patients who were lost to follow-up.
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Figure 1: Flow chart depicting patient recruitment and selection, the number of patients who withdrew from the study, and the number of patients who were lost to follow-up.

Mentions: After screening a total of 489 patients with T2DM, 316 patients were enrolled in our study, with a baseline sample of 155 patients in the intensive medical therapy group and 161 patients in the conventional treatment group. One patient withdrew from the study owing to cerebral infarction, and another withdrew because of bladder cancer. A total of 70 patients were lost to follow-up, leaving a total of 246 patients (77.8%) who completed the study (Fig. 1). Although no significant differences were observed in patient characteristics at baseline, significantly greater percentages of smokers, alcohol users, and patients with a family history of MetS and higher levels of FPG, 2hPG, and LDL were observed in the conventional treatment group at the end of the study period, compared to those in the intensive medical therapy group in 2014 (Table 1).


Long-term effects intensive medical therapy on the development and progression of subclinical atherosclerosis and the metabolic syndrome in Chinese patients with type 2 diabetes mellitus
Flow chart depicting patient recruitment and selection, the number of patients who withdrew from the study, and the number of patients who were lost to follow-up.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120899&req=5

Figure 1: Flow chart depicting patient recruitment and selection, the number of patients who withdrew from the study, and the number of patients who were lost to follow-up.
Mentions: After screening a total of 489 patients with T2DM, 316 patients were enrolled in our study, with a baseline sample of 155 patients in the intensive medical therapy group and 161 patients in the conventional treatment group. One patient withdrew from the study owing to cerebral infarction, and another withdrew because of bladder cancer. A total of 70 patients were lost to follow-up, leaving a total of 246 patients (77.8%) who completed the study (Fig. 1). Although no significant differences were observed in patient characteristics at baseline, significantly greater percentages of smokers, alcohol users, and patients with a family history of MetS and higher levels of FPG, 2hPG, and LDL were observed in the conventional treatment group at the end of the study period, compared to those in the intensive medical therapy group in 2014 (Table 1).

View Article: PubMed Central - PubMed

ABSTRACT

Background:: Few studies have investigated the progression of subclinical atherosclerosis and metabolic syndrome (MetS) in Chinese patients with type 2 diabetes mellitus (T2DM). This study was to compare the long-term effects of intensive medical therapy on the development and progression of subclinical atherosclerosis and MetS in Chinese T2DM patients with that of a conventional treatment regimen.

Methods:: A total of 316 T2DM patients were randomized to receive conventional pharmacological treatment or intensive medical therapy, consisting of diet and exercise counseling, from 2002 to 2014 at our hospital in Changsha, China. Clinical indicators of subclinical atherosclerosis and MetS were evaluated over the 12-year follow-up period. A χ2 analysis or t tests was used to compare the data between the 2 groups. Risk factors for subclinical atherosclerosis were identified using Cox proportional hazard models.

Results:: The incidence of subclinical atherosclerosis increased in both groups over time, and did not differ significantly between the 2 groups at the end of the study. However, after 6 years of treatment, the risk of subclinical atherosclerosis was significantly lower in the intensive medical therapy group, based on intima-media thickness (IMT) measurements, compared with that in the conventional treatment (44.2% vs. 69.7%; P < 0.01). Age, creatinine, and IMT of the common iliac artery were significantly associated with subclinical atherosclerosis. Although the indicators of MetS did not differ significantly at the end of study, the success rate for the management of MetS in the intensive medical therapy group was significantly higher than that in the conventional treatment group in 2006, 2008, 2010, and 2012.

Conclusions:: The incidence of atherosclerosis in the intensive medical therapy group was significantly lower than that in the conventional treatment group from 2006 to 2010 (P < 0.05), and the incidence of MetS in the intensive medical therapy group was significantly higher than that in the conventional treatment group from 2006 to 2012. Kaplan–Meier estimations showed that the risk of subclinical atherosclerosis in the intensive medical therapy group was significantly lower than that in the conventional treatment group (P < 0.001), whereas the risk of MetS was not significantly different between the treatment groups (P > 0.05).

No MeSH data available.