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首页> 外文期刊>North American Journal of Medical Sciences >Estimation of 10-Year Risk of Coronary Heart Disease in Nepalese Patients with Type 2 Diabetes: Framingham Versus United Kingdom Prospective Diabetes Study
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Estimation of 10-Year Risk of Coronary Heart Disease in Nepalese Patients with Type 2 Diabetes: Framingham Versus United Kingdom Prospective Diabetes Study

机译：尼泊尔2型糖尿病患者10年冠心病风险的估计：弗雷明汉与英国前瞻性糖尿病研究

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Background:Predicting future coronary heart disease (CHD) risk with the help of a validated risk prediction function helps clinicians identify diabetic patients at high risk and provide them with appropriate preventive medicine.Aim:The aim of this study is to estimate and compare 10-year CHD risks of Nepalese diabetic patients using two most common risk prediction functions: The Framingham risk equation and United Kingdom Prospective Diabetes Study (UKPDS) risk engine that are yet to be validated for Nepalese population.Patients and Methods:We conducted a hospital-based, cross-sectional study on 524 patients with type 2 diabetes. Baseline and biochemical variables of individual patients were recorded and CHD risks were estimated by the Framingham and UKPDS risk prediction functions. Estimated risks were categorized as low, medium, and high. The estimated CHD risks were compared using kappa statistics, Pearson's bivariate correlation, Bland-Altman plots, and multiple regression analysis.Results:The mean 10-year CHD risks estimated by the Framingham and UKPDS risk functions were 17.7 ± 12.1 and 16.8 ± 15 (bias: 0.88, P > 0.05), respectively, and were always higher in males and older age groups (P < 0.001). The two risk functions showed moderate convergent validity in predicting CHD risks, but differed in stratifying them and explaining the patients' risk profile. The Framingham equation predicted higher risk for patients usually below 70 years and showed better association with their current risk profile than the UKPDS risk engine.Conclusions:Based on the predicted risk, Nepalese diabetic patients, particularly those associated with increased numbers of risk factors, bear higher risk of future CHDs. Since this study is a cross-sectional one and uses externally validated risk functions, Nepalese clinicians should use them with caution, and preferably in combination with other guidelines, while making important medical decisions in preventive therapy of CHD.
机译：背景：借助经过验证的风险预测功能预测未来冠心病（CHD）的风险可帮助临床医生识别高风险的糖尿病患者并为他们提供适当的预防药物。目的：本研究的目的是评估和比较10-尼泊尔糖尿病患者的一年CHD风险使用两种最常见的风险预测函数：Framingham风险方程式和英国前瞻性糖尿病研究（UKPDS）风险引擎，尚未针对尼泊尔人群进行验证。患者和方法：我们进行了一项基于医院的研究524例2型糖尿病患者的横断面研究。记录每个患者的基线和生化变量，并通过Framingham和UKPDS风险预测功能估算冠心病风险。估计风险分为低，中和高。使用Kappa统计数据，Pearson的二元相关性，Bland-Altman图和多元回归分析比较了估计的冠心病风险。结果：Framingham和UKPDS风险函数估计的10年冠心病平均风险为17.7±12.1和16.8±15（偏倚：0.88，P> 0.05），并且在男性和老年人群中总是更高（P <0.001）。这两种风险函数在预测冠心病风险方面显示出适度的收敛效度，但是在对它们进行分层和解释患者风险概况方面有所不同。 Framingham方程预测通常低于70岁的患者的风险更高，并且与UKPDS风险引擎相比显示出与当前风险状况的相关性更好。结论：根据预测的风险，尼泊尔糖尿病患者，尤其是与危险因素数量增加相关的糖尿病患者承担未来冠心病的风险更高。由于这项研究是一项横断面研究，并且使用了外部验证的风险功能，因此尼泊尔临床医生应谨慎使用这些功能，最好与其他指南结合使用，同时在预防冠心病的重要医疗决策上。

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