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首页> 外文期刊>Diabetes, obesity & metabolism >Cardiovascular risk in the young type 1 diabetes population with a low 10-year, but high lifetime risk of cardiovascular disease
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Cardiovascular risk in the young type 1 diabetes population with a low 10-year, but high lifetime risk of cardiovascular disease

机译：10岁年龄段较低但终生罹患心血管疾病的风险较高的年轻1型糖尿病人群的心血管风险

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Diabetes mellitus is associated with excess cardiovascular mortality that is evident in all age groups, but is most pronounced in young people with type 1 diabetes. Cardiovascular risk estimation models generally estimate the probability of future events over a 10-year time horizon. Due to the dependency on age, children and adolescents with type 1 diabetes would be considered at low short-term risk but high life-time risk of developing a cardiovascular event. Guidelines recommend screening particularly for microvascular complications including nephropathy and retinopathy beginning around puberty. Identification of early microvascular abnormalities in children and adolescents not only predict later development of long-term microvascular complications and further end-organ damage but are associated with an increased risk for future macrovascular events. This may be because of the fact that the same glycaemic mechanisms responsible for the occurrence of microvascular disease may also apply to the development of atherosclerosis. Alternatively, interventions that reduce the development of microvascular end-organ damage may also delay the development of associated macrovascular disease. Screening for subclinical atherosclerosis, especially in the coronary and carotid vessels, has been advocated as a means of detecting early atherosclerotic disease in asymptomatic individuals with the aim of potentially reclassifying cardiovascular risk and guiding therapeutic interventions. Currently there is no randomized clinical trial evidence that additional screening using non-invasive imaging techniques alters cardiovascular disease outcomes. We do not know the best approach or combination of approaches to assess risk and reduce cardiovascular disease burden in type 1 diabetes mellitus. All screening interventions carry harms as well as benefits and until further evidence becomes available additional screening using non-invasive imaging tests for the detection of subclinical atherosclerosis cannot be currently recommended for patients with type 1 diabetes.
机译：在所有年龄组中，糖尿病都与过度的心血管疾病死亡率相关，但在1型糖尿病的年轻人中最为明显。心血管风险估计模型通常会估计10年时间范围内未来事件的可能性。由于年龄的影响，患有1型糖尿病的儿童和青少年的短期风险较低，但终生罹患心血管事件的风险较高。指南建议特别从青春期开始筛查微血管并发症，包括肾病和视网膜病。儿童和青少年早期微血管异常的鉴定不仅预示了长期微血管并发症的后期发展以及进一步的终末器官损害，而且与未来发生大血管事件的风险增加有关。这可能是由于以下事实：导致微血管疾病发生的相同血糖机制也可能适用于动脉粥样硬化的发展。或者，减少微血管终末器官损害发展的干预措施也可能延迟相关大血管疾病的发展。提倡筛查亚临床的动脉粥样硬化，尤其是在冠状动脉和颈动脉中，作为检测无症状个体早期动脉粥样硬化疾病的一种手段，目的在于对心血管疾病的风险进行重新分类并指导治疗干预。目前，尚无随机临床试验证据表明使用无创成像技术进行额外筛查会改变心血管疾病的预后。我们不知道评估1型糖尿病风险和减少心血管疾病负担的最佳方法或方法的组合。所有筛查干预措施都会带来危害和好处，直到获得进一步的证据为止，目前尚不建议对1型糖尿病患者使用非侵入性影像学检查来进行亚临床动脉粥样硬化的进一步筛查。

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