Coronary heart disease in patients with type 2 biabetes: The role of traditional, behavioral and atherogenic risk factors in a large multicenter study

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dc.authorid0000-0001-7566-5427
dc.authorid0000-0002-6866-2364
dc.authorid0000-0001-9989-6473
dc.authorid0000-0002-0601-6893
dc.authorid0000-0003-4867-3725
dc.authorid0000-0003-4510-6282
dc.authorid0000-0002-9637-6744
dc.authorid0000-0001-8613-1797
dc.contributor.authorTelci Çaklılı, Özge
dc.contributor.authorDemirci, İbrahim
dc.contributor.authorHaymana, Cem
dc.contributor.authorHacışahinoğulları, Hülya
dc.contributor.authorKılınç, Faruk
dc.contributor.authorKarakoç, Ayhan
dc.contributor.authorSarı, Ramazan
dc.contributor.authorTaşçı, İlker
dc.contributor.authorSalman, Serpil
dc.contributor.authorErsoy, Canan
dc.contributor.authorBayram, Fahri
dc.contributor.authorSatman, İlhan
dc.contributor.authorSönmez, Alper
dc.date.accessioned2026-08-25T17:16:19Z
dc.date.available2026-08-25T17:16:19Z
dc.date.issued2026
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.description.abstractBackground Type 2 diabetes mellitus (T2DM) substantially increases the risk of coronary artery disease (CAD) through insulin resistance, inflammation, and related complications. In this large, nationally representative multicenter study, we investigated behavioral and metabolic risk factors associated with CAD in T2DM. Materials and Methods This cross-sectional study was conducted across Türkiye, including 70 endocrine clinics in 36 cities. Adults with T2DM followed at the same center for at least one year were included. Sociodemographic, anthropometric, clinical, laboratory, and lifestyle data were recorded using a standardized web-based system. Results A total of 5707 patients with diabetes were recruited, of whom 4956 (86.8%) had T2DM (mean age 58.9 ± 10.0 years; 59.8% women). CAD status was available in 4750 patients, among whom 1061 (22.3%) had CAD. CAD was more frequent in men than women (30.4% vs 16.9%, P < .001). Patients with CAD were older (62.8 ± 8.6 vs 57.8 ± 10.2 years, P < .001) and had longer diabetes duration (16.1 ± 8.8 vs 12.2 ± 7.7 years, P < .001). Body mass index was lower (31.2 ± 5.8 vs 31.8 ± 6.8 kg/m2, P = .005), whereas waist circumference was higher (106.7 ± 13.7 vs 105.1 ± 14.1 cm, P = .004). Lower income was associated with CAD (23.4% vs 19.5%, P = .003), whereas smoking and exercise were not (P = .219 and P = .977). Hypertension was associated with CAD (28.2% vs 14.5%, P < .001). Systolic blood pressure was higher (126.1 ± 13.6 vs 124.3 ± 13.6 mmHg, P = .004), while diastolic pressure did not differ (P = .603). HbA1c was higher in the CAD group (8.27 ± 1.94 vs 7.84 ± 1.89%, P < .001), and hypoglycemia was more frequent (24.6% vs 20.8%, P = .002). In multivariable logistic regression, independent predictors of CAD were older age (OR 1.04, 95% CI 1.03-1.05, P < .001), male sex (OR 0.39, 95% CI 0.33-0.46, P < .001), current smoking (OR 1.37, 95% CI 1.12-1.66, P = .002), hypertension (OR 2.00, 95% CI 1.68-2.38, P < .001), microvascular complications (OR 1.48, 95% CI 1.26-1.74, P < .001), higher HbA1c (OR 1.12 per %, 95% CI 1.07-1.17, P < .001), longer diabetes duration (OR 1.04 per year, 95% CI 1.02-1.05, P < .001), and lower income (OR 0.74, 95% CI 0.62-0.88, P = .001). Exercise, diet, hypoglycemia, education, and body mass index were not independently associated with CAD (all P > .05). Conclusion In this large national cohort of T2DM patients, CAD was independently associated with classical cardiometabolic risk factors, microvascular complications, and lower income, whereas lifestyle factors were not independently associated after adjustment. These findings highlight dominant role of cumulative metabolic burden and vascular damage in determining CAD risk and emphasize the importance of early, sustained, risk factor–targeted management.
dc.identifier.citationTelci Çaklılı, Ö., Demirci, İ., Haymana, C., Hacışahinoğulları, H., Kılınç, F., Karakoç, A., Sarı, R., Taşçı, İ., Salman, S., Ersoy, C., Bayram, F., Satman, İ., & Sönmez, A. (2026). Coronary heart disease in patients with type 2 biabetes: The role of traditional, behavioral and atherogenic risk factors in a large multicenter study. European Journal of Endocrinology, 195(1), Oxford University Press. https://doi.org/10.1093/ejendo/lvag096.1799
dc.identifier.doi10.1093/ejendo/lvag096.1799
dc.identifier.issn0804-4643
dc.identifier.issn1479-683X
dc.identifier.issue1
dc.identifier.urihttps://doi.org/10.1093/ejendo/lvag096.1799
dc.identifier.urihttps://hdl.handle.net/20.500.13055/1607
dc.identifier.volume195
dc.identifier.wosWOS:001844691600001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorSalman, Serpil
dc.institutionauthorid0000-0003-4867-3725
dc.language.isoen
dc.publisherOxford University Press
dc.relation.ispartofEuropean Journal of Endocrinology
dc.relation.publicationcategoryKonferans Öğesi - Uluslararası - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleCoronary heart disease in patients with type 2 biabetes: The role of traditional, behavioral and atherogenic risk factors in a large multicenter study
dc.typeConference Object
dspace.entity.typePublication

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