Abstract：
BACKGROUND: Previous studies have shown that increasing body mass index (BMI) was associated with decreased hypoglycemia in type 2 diabetes, but it remains uncertain whether this finding could be applied to patients with and without cardiac autonomic neuropathy (CAN).
METHODS: The study included 7789 participants with type 2 diabetes from action to control cardiovascular risk in diabetes (ACCORD) trail. CAN was defined as SDNN < 8.2 ms and RMSSD < 8.0 ms. Obesity was defined as BMI ≥ 30 kg/m2. Outcomes were identified as severe hypoglycemia requiring any assistance (HAA) or requiring medical assistance (HMA). We assessed the association between obesity and severe hypoglycemia in type 2 diabetes with or without CAN using COX regression models adjusted for baseline characteristics.
RESULTS: Over a median follow-up of 4.7 years, a total of 893 participants developed HAA and 584 participants developed HMA. Compared with non-obesity, obesity was associated with lower risk of severe hypoglycemia (HAA: hazard ratio [HR] 0.51, 95% confidence interval [CI] 0.38-0.68, P < 0.001; HMA: HR 0.57, 95% CI 0.40-0.82, P = 0.002) in CAN present group, but not in CAN absent group (HAA: HR 0.98, 95% CI 0.83-1.16, P = 0.830; HMA: HR 0.97, 95% CI 0.79-1.19, P = 0.754). Similarly, increasing BMI was associated with reduced severe hypoglycemic events in participants with CAN, but not in participants without CAN.
CONCLUSIONS: CAN modifies the association between obesity and hypoglycemia in type 2 diabetes. Type 2 diabetic individuals with CAN who are under weight control should pay attention to hypoglycemic events.
BACKGROUND: http://www.
RESULTS: gov . Unique identifier: NCT00000620.
METHODS: The study included 7789 participants with type 2 diabetes from action to control cardiovascular risk in diabetes (ACCORD) trail. CAN was defined as SDNN < 8.2 ms and RMSSD < 8.0 ms. Obesity was defined as BMI ≥ 30 kg/m2. Outcomes were identified as severe hypoglycemia requiring any assistance (HAA) or requiring medical assistance (HMA). We assessed the association between obesity and severe hypoglycemia in type 2 diabetes with or without CAN using COX regression models adjusted for baseline characteristics.
RESULTS: Over a median follow-up of 4.7 years, a total of 893 participants developed HAA and 584 participants developed HMA. Compared with non-obesity, obesity was associated with lower risk of severe hypoglycemia (HAA: hazard ratio [HR] 0.51, 95% confidence interval [CI] 0.38-0.68, P < 0.001; HMA: HR 0.57, 95% CI 0.40-0.82, P = 0.002) in CAN present group, but not in CAN absent group (HAA: HR 0.98, 95% CI 0.83-1.16, P = 0.830; HMA: HR 0.97, 95% CI 0.79-1.19, P = 0.754). Similarly, increasing BMI was associated with reduced severe hypoglycemic events in participants with CAN, but not in participants without CAN.
CONCLUSIONS: CAN modifies the association between obesity and hypoglycemia in type 2 diabetes. Type 2 diabetic individuals with CAN who are under weight control should pay attention to hypoglycemic events.
BACKGROUND: http://www.
RESULTS: gov . Unique identifier: NCT00000620.
摘要：
背景：先前的研究表明，体重指数（BMI）的增加与2型糖尿病的低血糖减少有关，但目前尚不清楚这一发现是否适用于有或没有心脏自主神经病变(CAN)的患者.
方法：该研究纳入了7789名2型糖尿病患者，从控制糖尿病心血管风险（ACCORD）的行动。CAN定义为SDNN<8.2ms且RMSSD<8.0ms。肥胖定义为BMI≥30kg/m2。结果被确定为需要任何帮助(HAA)或需要医疗帮助(HMA)的严重低血糖。我们使用校正基线特征的COX回归模型评估了2型糖尿病伴或不伴CAN的肥胖与严重低血糖之间的相关性。
结果：经过4.7年的中位随访，共有893名参与者出现HAA,584名参与者出现HMA.与非肥胖相比，肥胖与严重低血糖风险较低相关(HAA:危险比[HR]0.51,95%置信区间[CI]0.38-0.68,P<0.001;HMA:HR0.57,95%CI0.40-0.82,P=0.002),但不存在CAN组（HAA：HR0.98，95％CI0.83-1.16，P=0.830；HMA：HR0.97，95％CI0.79-1.19，P=0.754）。同样，BMI升高与CAN患者严重低血糖事件减少相关,但不是没有CAN的参与者。
结论：CAN改变了2型糖尿病患者肥胖与低血糖之间的关系。体重控制下的2型糖尿病患者应注意低血糖事件。
背景：http://www.
结果：政府。唯一标识符：NCT00000620。
方法：该研究纳入了7789名2型糖尿病患者，从控制糖尿病心血管风险（ACCORD）的行动。CAN定义为SDNN<8.2ms且RMSSD<8.0ms。肥胖定义为BMI≥30kg/m2。结果被确定为需要任何帮助(HAA)或需要医疗帮助(HMA)的严重低血糖。我们使用校正基线特征的COX回归模型评估了2型糖尿病伴或不伴CAN的肥胖与严重低血糖之间的相关性。
结果：经过4.7年的中位随访，共有893名参与者出现HAA,584名参与者出现HMA.与非肥胖相比，肥胖与严重低血糖风险较低相关(HAA:危险比[HR]0.51,95%置信区间[CI]0.38-0.68,P<0.001;HMA:HR0.57,95%CI0.40-0.82,P=0.002),但不存在CAN组（HAA：HR0.98，95％CI0.83-1.16，P=0.830；HMA：HR0.97，95％CI0.79-1.19，P=0.754）。同样，BMI升高与CAN患者严重低血糖事件减少相关,但不是没有CAN的参与者。
结论：CAN改变了2型糖尿病患者肥胖与低血糖之间的关系。体重控制下的2型糖尿病患者应注意低血糖事件。
背景：http://www.
结果：政府。唯一标识符：NCT00000620。
