CAPTURE 研究：13 个国家的 2 型糖尿病成人心血管疾病患病率的跨国、横断面研究。
CAPTURE: a multinational, cross-sectional study of cardiovascular disease prevalence in adults with type 2 diabetes across 13 countries.
机构信息
Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Hadassah Hebrew University Hospital, PO Box 12000, 91120, Jerusalem, Israel.
King Saud University, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia.
出版信息
Cardiovasc Diabetol. 2021 Jul 27;20(1):154. doi: 10.1186/s12933-021-01344-0.
BACKGROUND
There is a paucity of global data on cardiovascular disease (CVD) prevalence in people with type 2 diabetes (T2D). The primary objective of the CAPTURE study was to estimate the prevalence of established CVD and its management in adults with T2D across 13 countries from five continents. Additional objectives were to further characterize the study sample regarding demographics, clinical parameters and medication usage, with particular reference to blood glucose-lowering agents (GLAs: glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors) with demonstrated cardiovascular benefit in randomized intervention trials.
METHODS
Data were collected from adults with T2D managed in primary or specialist care in Australia, China, Japan, Czech Republic, France, Hungary, Italy, Argentina, Brazil, Mexico, Israel, Kingdom of Saudi Arabia, and Turkey in 2019, using standardized methodology. CVD prevalence, weighted by diabetes prevalence in each country, was estimated for the overall CAPTURE sample and participating countries. Country-specific odds ratios for CVD prevalence were further adjusted for relevant demographic and clinical parameters.
RESULTS
The overall CAPTURE sample included 9823 adults with T2D (n = 4502 from primary care; n = 5321 from specialist care). The overall CAPTURE sample had median (interquartile range) diabetes duration 10.7 years (5.6-17.9 years) and glycated hemoglobin 7.3% (6.6-8.4%) [56 mmol/mol (49-68 mmol/mol)]. Overall weighted CVD and atherosclerotic CVD prevalence estimates were 34.8% (95% confidence interval [CI] 32.7-36.8) and 31.8% (95% CI 29.7-33.8%), respectively. Age, gender, and clinical parameters accounted for some of the between-country variation in CVD prevalence. GLAs with demonstrated cardiovascular benefit were used by 21.9% of participants, which was similar in participants with and without CVD: 21.5% and 22.2%, respectively.
CONCLUSIONS
In 2019, approximately one in three adults with T2D in CAPTURE had diagnosed CVD. The low use of GLAs with demonstrated cardiovascular benefit even in participants with established CVD suggested that most were not managed according to contemporary diabetes and cardiology guidelines. Study registration NCT03786406 (registered on December 20, 2018), NCT03811288 (registered on January 18, 2019).
背景
全球范围内关于 2 型糖尿病（T2D）患者心血管疾病（CVD）患病率的数据有限。CAPTURE 研究的主要目的是估计五个大陆 13 个国家成年人中 T2D 患者的已确诊 CVD 及其管理的患病率。其他目标是进一步描述研究样本的人口统计学、临床参数和药物使用情况，特别是与在随机干预试验中具有心血管获益的降糖药物（GLAs：胰高血糖素样肽-1 受体激动剂和钠-葡萄糖协同转运蛋白 2 抑制剂）相关的情况。
方法
2019 年，在澳大利亚、中国、日本、捷克共和国、法国、匈牙利、意大利、阿根廷、巴西、墨西哥、以色列、沙特阿拉伯王国和土耳其，使用标准化方法从初级或专科护理的 T2D 成年人中收集数据。使用每个国家的糖尿病患病率进行加权，估计 CAPTURE 总体样本和参与国家的 CVD 患病率。进一步调整了与人口统计学和临床参数相关的国家特定 CVD 患病率的比值比。
结果
总体 CAPTURE 样本包括 9823 名 T2D 成年人（初级保健 4502 名，专科保健 5321 名）。总体 CAPTURE 样本的中位（四分位距）糖尿病病程为 10.7 年（5.6-17.9 年），糖化血红蛋白为 7.3%（6.6-8.4%）[56mmol/mol（49-68mmol/mol）]。总体加权 CVD 和动脉粥样硬化性 CVD 患病率估计值分别为 34.8%（95%置信区间 [CI]：32.7-36.8）和 31.8%（95% CI：29.7-33.8）。年龄、性别和临床参数解释了 CVD 患病率的部分国家间差异。具有心血管获益证据的 GLAs 在参与者中的使用率为 21.9%，在有 CVD 和无 CVD 的参与者中相似：分别为 21.5%和 22.2%。
结论
2019 年，在 CAPTURE 中约有三分之一的 T2D 成年人患有确诊的 CVD。即使在患有已确诊 CVD 的参与者中，具有心血管获益证据的 GLAs 的低使用率表明，大多数人并未根据当代糖尿病和心脏病学指南进行管理。研究注册 NCT03786406（2018 年 12 月 20 日注册），NCT03811288（2019 年 1 月 18 日注册）。
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