Abstract 694: The Impact of Glucose-Lowering Therapy and Lifestyle-Related Factors on Vascular Disease Risk Reduction in Younger and Older Adults: National Trend and New Evidence from Big Data
Objective: To examine the independent and interaction impacts of glucose-lowering therapy and lifestyle-related factors (obesity and hypercholesterolemia) on vascular disease risk reduction in patients with type 2 diabetes mellitus (T2DM).
Methods: Data from 1999 to 2012 National Health and Nutrition Examination Surveys in participants aged≥30 years old (n=29064) were analyzed. T2DM was classified by self-reported physician diagnosis and those who were under glucose-lowering therapy. Coronary heart disease (CHD), stroke, and hypercholesterolemia (H-TC) were classified by self-reported physician diagnosis. Obesity was defined by BMI≥30 (weight(kg)/height squared(m2)).
Results: The prevalence of T2DM significantly increased from 8% in 1999 to 12.3% in 2012 in subjects aged <65 (p<.001), and from 19.8% to 26.1% in subjects aged≥65 (p<.0001). In logistic regression analysis, after adjustment for age, sex, race, education, obesity and H-TC, T2DM patients with glucose-lowering therapy had significantly lower risk of CHD (OR=0.76, 95%CI: 0.60-0.97, p=0.025) than those without glucose-lowering therapy. A further stratification analysis indicated a significant combined and dose-response effect of glucose-lowering therapy and body weight on the risk of CHD. Obese patients without glucose-lowering therapy had the highest prevalence rate of CHD, and non-obese patients with glucose-lowering therapy had the lowest rate in patients aged<65 (17.7% vs. 10.9%, a 38% reduction, p=0.035), and in those aged≥65 (37.0% vs. 28.0%, a 24% reduction, p=0.029). A significant effect of glucose-lowering therapy with non H-TC on CHD was also observed. A similar protective effect of glucose-lowering therapy with non-obesity and non H-TC on stroke was observed as well, although this association did not reach statistically significant.
Conclusion: using a 14-year nationally representative data, the study provides new evidence that a drug-lifestyle interaction effect of glucose-lowering therapy and diet-related factors plays a significant role in CHD risk reduction in patients with T2DM, and this effect could be even greater in younger adults than that in the older.
Author Disclosures: L. Liu: None.
- © 2015 by American Heart Association, Inc.