相关实验视频
在2型糖尿病患者中,生存率作为HbA (c) 的函数:一个回顾性队列研究
Craig J Currie1, John R Peters, Aodán Tynan
1Department of Medicine, School of Medicine, Cardiff University, Cardiff, UK. currie@cardiff.ac.uk
Lancet (London, England)
|January 30, 2010
概括
非常低和非常高的血糖水平 (HbA1c) 都会增加2型糖尿病患者的死亡风险. 目前的糖尿病指南可能需要修订,以包括最低HbA1c目标.
科学领域:
- 内分泌学 在内分泌学.
- 糖尿病研究 糖尿病研究
- 公共卫生 公共卫生
背景情况:
- 对2型糖尿病的干预研究引发了关于严格血糖控制的安全问题.
- 评估与糖化血红蛋白 (HbA1c) 水平相关的生存率对于患者的治疗结果至关重要.
研究的目的:
- 评估HbA1c水平与2型糖尿病患者全因死亡率之间的关联.
- 研究不同治疗方案 (口服药与胰岛素) 对死亡率的影响.
主要方法:
- 从1986年至2008年,对两大英国群体 (n=47,970) 的50岁以上2型糖尿病患者进行分析.
- 利用考克斯生存模型,调整关键的混因素,如年龄,性别,吸烟和心血管风险.
- 强化口服治疗患者与胰岛素治疗方案患者之间的死亡率比较.
主要成果:
- 在HbA1c和全因死亡率之间观察到U形关联,最低的危险比率约为7.5%.
- 与参考组相比,在最低 (HR 1.52) 和最高 (HR 1.79) 的HbA1c分值中发现了显著增加的死亡风险.
- 基于胰岛素的治疗方案与结合性口服药物相比,与更高的死亡风险 (HR 1.49) 有关.
结论:
- 低和高的平均HbA1c水平都与2型糖尿病的死亡率和心脏事件增加有关.
- 这些发现表明,可能需要修订糖尿病管理指南,以纳入最低HbA1c目标.
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