Advanced Cardiovascular‐Kidney‐Metabolic Risk and Risk‐Factor Control in Patients With Type 2 Diabetes Without Established Cardiovascular Disease
Hai Nguyen Ngoc Dang, The Trung Le, Anh Kiem Pham, Linh Duy Le, Nam Van Duc Nguyen, Thanh Thien Tran, Thinh Ba Le, Ny Ha Tuyet Le, Nam Van Le, Hau Phuc Tran, Hung Minh Vu, Duong Hung Tran, Bich Ngoc Hoang Thi, Huy Nhu Pham, Hieu Minh Le, Thang Chi Doan, Binh Anh Ho, Tien Anh Hoang, Minh Van Huynh, Thang Viet LuongABSTRACT
Background
Cardiovascular‐kidney‐metabolic (CKM) risk stratification may identify patients with type 2 diabetes mellitus (T2DM) who require more intensive primary prevention, but real‐world data from Vietnam are limited. We aimed to describe advanced CKM risk and risk‐factor control in Vietnamese patients with T2DM without established cardiovascular disease (CVD).
Methods
This multicenter cross‐sectional study enrolled 1436 adults with T2DM without CVD in Vietnam. Advanced CKM risk was defined as 10‐year total CVD risk ≥ 20% or eGFR < 60 mL/min/1.73 m 2 . Guideline‐based control of HbA1c, blood pressure, LDL‐C, triglycerides, and non‐HDL‐C was evaluated. Logistic regression assessed associations between advanced CKM risk and target achievement.
Results
Advanced CKM risk was identified in 551 patients (38.4%). Despite a relatively low prevalence of BMI ≥ 25 kg/m 2 (26.9%), hypertriglyceridemia was the most common metabolic abnormality, affecting 88.0% of participants. Risk‐factor control was generally low, with 33.3% achieving glycemic control, 33.5% blood pressure control, 18.8% LDL‐C control, 12.0% triglyceride control, and 21.1% non‐HDL‐C control. After adjustment, advanced CKM risk was associated with poorer blood pressure control (adjusted OR = 0.466, 95% CI = 0.359–0.603, p < 0.001) and triglyceride control (adjusted OR = 0.677, 95% CI = 0.473–0.969, p = 0.033), but not with achievement of HbA1c, LDL‐C, non‐HDL‐C, or combined lipid control.
Conclusions
Advanced CKM risk was common among Vietnamese patients with T2DM without established CVD and was consistently associated with poorer blood pressure control. CKM‐based risk assessment may identify high‐risk patients earlier and support guideline‐directed risk‐factor management. Frequent hypertriglyceridemia with relatively low obesity supports a CKM‐based strategy tailored to this metabolic risk pattern.