Prevalence of cardiovascular risk factors in patients with type 1 diabetes in end-stage renal disease: changes in the trend from 1999 to 2006.
OBJECTIVE
The aim of this study was to describe the prevalence of cardiovascular disease risk factors (CVDRFs) and the degree of control in a Spanish population of patients with type 1 diabetes (DM1) and end-stage renal disease (ESRD) as well as the changes observed in this setting over 8 years.


METHODS
Patients with DM1 and ESRD were evaluated from 1999 to 2006. Clinical variables, smoking habit, glycosylated hemoglobin (HbA(1c)) and lipids values, and drug treatment were evaluated. The cohort was divided into four biannual groups for analysis. HbA(1c) >7, LDL >100 mg/dl, blood pressure (BP) >140/90 mmHg, and tobacco use were considered as CVDRFs.


RESULTS
A total of 177 patients (65% male) with a mean age of 37.2+/-6.2 years were studied. They had 24.3+/-5.9 years of diabetes evolution. Mean HbA(1c) was 7.9+/-1.5% with 29.6% of patients having values less than 7%. Mean LDL was 109.3+/-40.4 mg/dl and 41.1% were below 100 mg/dl. Over the years these proportions increased significantly (P=.028 and .0015, respectively). Mean systolic and diastolic BP were 142.5+/-22.9 and 82.2+/-14.9 mmHg, respectively, with 53.8% of patients having BP <140/90 mmHg with no changes over the years (P=.11). The proportion of never smokers was 51.5%, reaching 65.5% in the last biannual period (P=.01). In the whole cohort, 89.3% had one or more CVDRFs. There was a statistically significant trend to a reduction in the number of CVDRFs over time (r=-.208, P=.005).


CONCLUSIONS
CVDRFs are highly prevalent in patients with DM1 and ESRD. The control of these CVDRFs is still insufficient; however, there has been a clear improvement in the control over the years.
Rueda
Sergio F
SF
Department of Endocrinology and Nutrition, Hospital Clínic Universitari, 08036 Barcelona, Spain.
Fernández
Cristian
C
Nicolau
Joana
J
Ricart
María J
MJ
Esmatjes
Enric
E
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000150:complications*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D006951:Hyperlipoproteinemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000209:etiology; D016014:Linear Models; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology
D006442:Glycated Hemoglobin; D008077:Lipoproteins, LDL; C517652:hemoglobin A1c protein, human