2型糖尿病和10年人口死亡率的查 (ADDITION-剑桥):一个集群随机对照试验
Rebecca K Simmons1, Justin B Echouffo-Tcheugui, Stephen J Sharp
1MRC Epidemiology Unit, Cambridge, UK.
Lancet (London, England)
|October 9, 2012
概括
在高危人群中,对2型糖尿病的查并没有降低全因死亡率. 这项大型英国研究发现,在10年内,2型糖尿病查没有显著的益处.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 临床试验 临床试验
背景情况:
- 2型糖尿病的患病率正在上升,造成了公共卫生挑战.
- 基于人口的查和早期治疗是减轻这种负担的潜在策略.
- 关于2型糖尿病查计划的好处存在不确定性.
研究的目的:
- 评估基于人口的2型糖尿病逐步查计划对所有原因死亡率的影响.
- 评估查对心血管,癌症和糖尿病相关死亡率的影响.
主要方法:
- 一个务实的,集群随机试验,涉及英格兰东部33个一般实践.
- 包括20184名高危人群,年龄在40-69岁之间.
- 一个阶段性查过程涉及血糖和HbA1c测试,并进行确认性口服葡萄糖耐受性测试以诊断.
主要成果:
- 在超过184,000人年的随访中,与对照组相比,在查实践中没有观察到任何原因死亡率的显著降低 (HR1.06,95% CI 0.90-1.25).
- 心血管,癌症或糖尿病相关死亡率没有显著降低与查邀请有关.
- 3%的查人员被诊断患有2型糖尿病.
结论:
- 在英国的高风险人群中,对2型糖尿病的查并没有在十年内导致所有原因,心血管或糖尿病相关死亡率的减少.
- 查的潜在好处可能比预期的要小,或者仅限于患有可检测疾病的个人.
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