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英国前瞻性糖尿病研究(UKPDS)作为一项临床试验,也为我们阐明2型糖尿病心血管并发症自然病程提供了纵向资料。UKPDS的研究人员利用临床、流行病学、统计学和经济学方法,建立数学模型,以确定2型糖尿病心血管疾病(心绞痛、心肌梗死、卒中、周围血管疾病)及死亡的预测因子(危险因子)。UKPDS进一步明确了年龄、高血糖、高血压、血脂紊乱和吸烟是上述风险的危险因子,并且创制了UKPDS风险分析软件(UKPDS Risk Engine)和UKPDS预后分析模型(UKPDS Outcome Model)。例如,采用UKPDS风险分析软件2.0,分析一名62岁白人男性患者,该患者患2型糖尿病11年,A1C为8.3%,收缩压为145mmHg,总胆固醇为5.8mmol/L,HDL-C为1.1mmol/L,无吸烟史,结果表明,该患者10年内患冠心病的几率为33%。这些模型还可以帮助临床医生、试验人员、保健专家、指南制定者及卫生经济学家估计患者在改善生活质量后相关风险和/或死亡的预后情况。
UK Prospective Diabetes Study (UKPDS) as a clinical trial also provides longitudinal information on the natural history of cardiovascular complications in type 2 diabetes. UKPDS researchers used mathematical, clinical, epidemiological, statistical, and economic methods to establish models of predictors of cardiovascular disease (angina pectoris, myocardial infarction, stroke, peripheral vascular disease) and death (risk factors ). UKPDS further identified age, hyperglycemia, hypertension, dyslipidemia and smoking as risk factors for these risks and has created the UKPDS Risk Engine and UKPDS Outcome Model. For example, using a UKPDS risk analysis software 2.0, a 62-year-old Caucasian male patient with diabetes type 11 for 11 years had A1C of 8.3%, systolic blood pressure of 145 mmHg, total cholesterol of 5.8 mmol / L and HDL-C of 1.1 mmol / L, no smoking history, the results show that 10 years the risk of suffering from coronary heart disease was 33%. These models can also help clinicians, experimenters, health professionals, guideline developers, and health economists to assess patients’ prognosis of the associated risks and / or death after improving quality of life.