Abstract：
Type 2 diabetes mellitus (T2DM) is a risk factor for cardiac and renal complications; its effect on cardiorenal syndromes is unknown.
In a French nationwide cohort of 5,123,193 patients hospitalized in 2012 with ≥5 years of follow-up, we assessed the effect of T2DM on cardiorenal syndrome (CRS) (using cardiorenal, renocardiac, and simultaneous subtypes) incidence and outcomes using 1:1 propensity matching.
Among 4,605,236 adults without cardiorenal syndrome, 380,581 (8.5%) with T2DM were matched to 380,581 adults without T2DM. During follow-up, CRS occurred in 104,788 patients: simultaneous n = 25,225 (24.0%); cardiorenal n = 51,745 (49.4%); renocardiac n = 27,818 (26.5%). T2DM doubled the risk of incident CRS (1.30% versus 0.65%/year; adjusted hazard ratio (HR) for any cardiorenal syndrome: 2.14 [95% confidence interval 2.10;2.19]; renocardiac: 2.43 [2.34;2.53]; cardiorenal: 2.09 [2.03;2.15]; simultaneous: 1.94 [1.86;2.03]. Among the 26,396 adults with CRS in 2012, 11,355 (43.0%) had T2DM and were younger than non-diabetic adults (77.4 ± 9.5 versus 82.3 ± 10.0); 8,314 patients with T2DM were matched to 8,314 patients without. T2DM increased risk of: end-stage kidney disease, adjusted HR 1.50 [1.39;1.62]; myocardial infarction 1.35 [1.19;1.53]; cardiovascular death 1.20 [1.13;1.27]; heart failure 1.17 [1.12;1.21]; and all-cause death 1.09 [1.06;1.13], but not ischemic stroke.
Patients with T2DM represent almost half of patients with CRS and are younger than their non-diabetic counterparts. T2DM doubles the risk of CRS and increases the risk of death, cardiovascular outcome, and end-stage kidney disease but not ischemic stroke after CRS.
In a French nationwide cohort of 5,123,193 patients hospitalized in 2012 with ≥5 years of follow-up, we assessed the effect of T2DM on cardiorenal syndrome (CRS) (using cardiorenal, renocardiac, and simultaneous subtypes) incidence and outcomes using 1:1 propensity matching.
Among 4,605,236 adults without cardiorenal syndrome, 380,581 (8.5%) with T2DM were matched to 380,581 adults without T2DM. During follow-up, CRS occurred in 104,788 patients: simultaneous n = 25,225 (24.0%); cardiorenal n = 51,745 (49.4%); renocardiac n = 27,818 (26.5%). T2DM doubled the risk of incident CRS (1.30% versus 0.65%/year; adjusted hazard ratio (HR) for any cardiorenal syndrome: 2.14 [95% confidence interval 2.10;2.19]; renocardiac: 2.43 [2.34;2.53]; cardiorenal: 2.09 [2.03;2.15]; simultaneous: 1.94 [1.86;2.03]. Among the 26,396 adults with CRS in 2012, 11,355 (43.0%) had T2DM and were younger than non-diabetic adults (77.4 ± 9.5 versus 82.3 ± 10.0); 8,314 patients with T2DM were matched to 8,314 patients without. T2DM increased risk of: end-stage kidney disease, adjusted HR 1.50 [1.39;1.62]; myocardial infarction 1.35 [1.19;1.53]; cardiovascular death 1.20 [1.13;1.27]; heart failure 1.17 [1.12;1.21]; and all-cause death 1.09 [1.06;1.13], but not ischemic stroke.
Patients with T2DM represent almost half of patients with CRS and are younger than their non-diabetic counterparts. T2DM doubles the risk of CRS and increases the risk of death, cardiovascular outcome, and end-stage kidney disease but not ischemic stroke after CRS.
摘要：
目的：。2型糖尿病（T2DM）是心脏和肾脏并发症的危险因素；其对心肾综合征的影响尚不清楚。
方法：。在法国全国范围内的5,123,193名2012年住院患者中，随访时间≥5年，我们评估了T2DM对心肾综合征（CRS）的影响（使用心肾，肾性心脏,和同时亚型)使用1：1倾向匹配的发病率和结果。
结果：。在4,605,236名没有心肾综合征的成年人中，380,581例(8.5%)T2DM患者与380,581例无T2DM患者相匹配。随访期间,104,788例患者发生CRS：同时n=25,225（24.0％）；心肾n=51,745（49.4％）；肾心脏n=27,818（26.5％）。T2DM使CRS事件的风险增加了一倍(1.30%对0.65%/年;任何心肾综合征的调整风险比(HR):2.14[95%置信区间2.10;2.19];肾心:2.43[2.34;2.53];心肾:2.09[2.03;2.15];同时:1.94[1.86;2.03]。在2012年的26,396名患有CRS的成年人中，有11,355名（43.0％）患有T2DM，并且比非糖尿病成年人年轻（77.4±9.5对82.3±10.0）;8,314名T2DM患者与8,314名没有糖尿病的患者相匹配。T2DM增加以下风险：终末期肾病，调整后的HR1.50[1.39;1.62]；心肌梗死1.35[1.19;1.53]；心血管死亡1.20[1.13;1.27]；心力衰竭1.17[1.12;1.21]；和全因死亡1.09[1.06;1.13]，但不是缺血性中风.
结论：。T2DM患者几乎占CRS患者的一半，并且比非糖尿病患者年轻。T2DM使CRS的风险加倍，并增加死亡风险，心血管结果，和终末期肾病，但非CRS后缺血性卒中。
方法：。在法国全国范围内的5,123,193名2012年住院患者中，随访时间≥5年，我们评估了T2DM对心肾综合征（CRS）的影响（使用心肾，肾性心脏,和同时亚型)使用1：1倾向匹配的发病率和结果。
结果：。在4,605,236名没有心肾综合征的成年人中，380,581例(8.5%)T2DM患者与380,581例无T2DM患者相匹配。随访期间,104,788例患者发生CRS：同时n=25,225（24.0％）；心肾n=51,745（49.4％）；肾心脏n=27,818（26.5％）。T2DM使CRS事件的风险增加了一倍(1.30%对0.65%/年;任何心肾综合征的调整风险比(HR):2.14[95%置信区间2.10;2.19];肾心:2.43[2.34;2.53];心肾:2.09[2.03;2.15];同时:1.94[1.86;2.03]。在2012年的26,396名患有CRS的成年人中，有11,355名（43.0％）患有T2DM，并且比非糖尿病成年人年轻（77.4±9.5对82.3±10.0）;8,314名T2DM患者与8,314名没有糖尿病的患者相匹配。T2DM增加以下风险：终末期肾病，调整后的HR1.50[1.39;1.62]；心肌梗死1.35[1.19;1.53]；心血管死亡1.20[1.13;1.27]；心力衰竭1.17[1.12;1.21]；和全因死亡1.09[1.06;1.13]，但不是缺血性中风.
结论：。T2DM患者几乎占CRS患者的一半，并且比非糖尿病患者年轻。T2DM使CRS的风险加倍，并增加死亡风险，心血管结果，和终末期肾病，但非CRS后缺血性卒中。
