2025-12-15 横浜市立大学
図1 各受診群における心血管疾患(虚血性心疾患および脳卒中)の累積発症率
青い点線(早期受診群)は、赤い実線(非受診群)に比べて、経過とともに心血管疾患の発症率が低く推移している
<関連情報>
- https://www.yokohama-cu.ac.jp/res-portal/news/20251215goto.html
- https://www.yokohama-cu.ac.jp/res-portal/news/gjok7g00000030db-att/20251215goto.pdf
- https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(25)01035-6/fulltext
新規糖尿病スクリーニングを受けた人の心血管疾患リスクに対する早期医療訪問の影響:大規模保険データベースを用いた標的試験のエミュレーション Effect of early healthcare visits on cardiovascular disease risk in people with newly screened diabetes: emulating a target trial using a large insurance database
Kiyomitsu Fukaguchi ∙ Tomohiro Shinozaki ∙ Zui C. Narita ∙ Atsushi Goto
Diabetes Research and Clinical Practice Published:November 23, 2025
DOI:https://doi.org/10.1016/j.diabres.2025.113020
Highlights
- Target trial emulation on 148,288 Japanese adults with newly screened diabetes and no prior CVD.
- Early visits within 1 year of screening were associated with a 27% lower 10-year CVD risk.
- 10-year absolute risk difference was -3.4 % (risk ratio 0.73) for early vs no visits.
- The association was consistent across age, sex, baseline glycemia, and medication subgroups.
- Findings support policies facilitating prompt follow-up after diabetes screening.
Abstract
Aims
To determine whether healthcare visits within one year after diabetes identification lower 10-year cardiovascular disease (CVD) risk compared with no visits.
Methods
We emulated a target trial in the nationwide JMDC Claims Database (>12 million Japanese beneficiaries). Adults aged 40–74 years with newly identified diabetes (HbA1c ≥ 6.5 % [48 mmol/mol] or fasting glucose ≥126 mg/dL) during annual health checkups between 1 January 2005 and 31 March 2021 and no prior history of CVD were assigned to an early-visit group (≥1 outpatient visit within one year) or a no-visit group. Weighted pooled logistic regression estimated 10-year risk differences and risk ratios for a composite CVD outcome.
Results
Among 148,288 participants (mean age 53 years; 77 % men; 421,466 person-years), 1,741 CVD events occurred. Early visits were associated with a lower 10-year composite CVD risk compared to no visits (risk difference –3.4 percentage points [95 % CI –6.2 to –1.4]; risk ratio 0.73 [95 % CI 0.59 to 0.87]). Subgroup analyses confirmed consistent results across various characteristics.
Conclusions
Early healthcare visits within one year of diabetes identification were associated with a lower 10-year CVD risk. Health systems should facilitate early follow-up after screening to translate early detection into cardiovascular benefit.
