Aims: To investigate associations between glycaemic control and normal body mass index (BMI) and the long-term risk of 3-point major adverse cardiovascular events (3P-MACE) in patients with type 2 diabetes (T2D).
Materials and methods: Adults with T2D and ≥1 glycated haemoglobin (HbA1c) and BMI record between 1 January 2007 and 31 October 2016 were included from the regional health information system of Yinzhou district, Ningbo, China. The index population comprised patients with HbA1c records ≥3 months after the initial T2D diagnosis and BMI records after the initial T2D diagnosis. Of these, patients with ≥1 BMI record after the index date were included in the sustained population. Analyses were conducted using Cox proportional hazards models.
Results: The index population included 5757 patients (median follow-up 6.8 years; 1188 [20.6%] experienced 3P-MACE). In this population, the 3P-MACE risk was significantly reduced in patients with glycaemic control and normal BMI (18.5-23.9 kg/m2) versus neither glycaemic control nor normal BMI using HbA1c cutoffs of <7.0% (adjusted hazard ratio [aHR] 0.73; 95% CI 0.62-0.86; p < 0.001) and ≤6.5% (aHR 0.76; 95% CI 0.64-0.90; p = 0.001). In the sustained population (n = 5513), the risk of 3P-MACE was significantly reduced in patients with sustained glycaemic control and normal BMI versus neither sustained glycaemic control nor normal BMI using HbA1c cutoffs of <7.0% (aHR 0.67; 95% CI 0.49-0.91; p = 0.012) and ≤6.5% (aHR 0.69; 95% CI 0.50-0.94; p = 0.020).
Conclusions: Index and sustained glycaemic control and normal BMI were associated with significant risk reduction in 3P-MACE among Chinese patients with T2D.
Keywords: cardiovascular events; glycaemic control; macrovascular disease; real world study; type 2 diabetes; weight management.
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