Capital Medical University, China
Title: A 48-month prospective study of the effects of multifactorial interventions on cardiovascular risk factors in patients with T2DM in an urban community: The Beijing Communities Diabetes Study 12
Shenyuan Yuan, Professor and Chief physician of Internal Medicine, Beijing Tongren Hospital, Capital Medical University. I graduated from Peking University Dept.of Medicine in 1955 and get MD&BS. I have been engaged in medical career for 62 years. I served as Director of Internal Medicine, Director of Digestive Science, and Director of Endocrinology in Beijing Tongren Hospital. I was the first head of the Beijing Diabetes Prevention and Treatment Office. I was Vice Chairman of Chinese Society on Microcirculation, Special member of European Society on Microcirculation, Director of Beijing Society of Digestion, CMA. I have won 21 awards, including the first Prize, the second prize and the third prize of Beijing Municipal Science and Technology Progress. 23 postgraduate students were trained under my guidance. In 1990, I enjoyed the Special Allowance of the State Council, and awarded as outstanding contribution expert in Beijing. Since 1996, I have carried out medical consultation work in communities for 22 years. I assisted in the establishment of Diabetes Prevention and Treatment Centers in Chaoyang district, Fengtai district, Mentougou district, Changping district, Daxing district and Yanqing district in Beijing. Now, I am principal leader of Beijing Community Diabetes Study (“BCDS”, 2008-2018) and the BRIDGES project from the International Diabetes Federation.
To assess whether multifactorial interventions have long-term effects on the risk of diabetes-related macrovascular complications in patients with type 2 diabetes mellitus living in urban communities of Beijing. A total of 2926 patients with type 2 diabetes from 15 community health centers were divided into a diabetes mellitus (DM) group (n=824), a hypertension (HTN) group (n=1267), and a cardiovascular disease (CVD) group (n=835). By applying Framingham risk scores (FRS), patients in the 3 groups were subdivided into low (FRS <10%), medium (FRS 10%-20%), and high (FRS >20%) Framingham risk strata. After 48 months, patients were followed-up to assess the long-term effects of the multifactorial interventions. At baseline, the patients’ mean neck circumference (NC) was significantly higher in the HTN and CVD groups than in the DM group (P<0.05). After 48 months of follow-up, the CVD and HTN groups both had higher blood pressures and lipid levels than the DM group (both P<0.01). Although there was no significant change in the FRS versus baseline in the low and medium Framingham risk strata, a significant reduction in FRS was noted in the high Framingham risk strata. In Cox multivariate analyses, the HTN and CVD groups had higher incidences of endpoint events than the DM group. This study has demonstrated for the first time a relationship between NC and CVD in diabetic patients. Multifactorial interventions for CVD risk factors over 48 months lowered the estimated 10-year risk for CVD events in diabetes. FRS score influences the incidence of CVD events in diabetic patients. Aggressive risk reduction should be focused on these individuals who had high FRS score.