严重的黎明现象预测了2型糖尿病患者所有原因死亡的长期风险
Jinghao Cai1, Peng Peng2, Jingyi Lu1
1Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Diabetes/metabolism research and reviews
|May 20, 2024
概括
严重的黎明现象 (DP),在2型糖尿病中早晨葡萄糖升高,与全因死亡率的增加有关. 持续的葡萄糖监测有助于评估DP,强调其在糖尿病管理中的重要性,以获得更好的长期结果.
科学领域:
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
- 临床研究 临床研究
背景情况:
- 黎明现象 (DP) 涉及到血糖在早晨提升,而没有先前的低血糖症.
- 持续血糖监测 (CGM) 提供了对DP的精确评估.
- 需要进一步调查DP与2型糖尿病死亡率之间的关联.
研究的目的:
- 调查黎明现象 (DP) 的程度与2型糖尿病患者因任何原因死亡的风险之间的关系.
- 确定由CGM评估的DP是否是死亡率的独立预测因素.
主要方法:
- 对5542名患有2型糖尿病的成年住院患者进行前性分析.
- DP大小 (ΔG) 被定义为从夜间最低点到早餐前的CGM葡萄糖增加.
- 分为四个 ΔG 组的分层和可克斯比例危险回归用于死亡风险分析.
主要成果:
- 观察到 ΔG 与全因死亡风险之间存在非线性关系 (p=0.002).
- 一个 ΔG>5.55 mmol/L 与所有原因死亡率的30%高风险相关,与 ΔG 1.12-3.33 mmol/L 相比.
- 在对HbA1c进行调整后,这种关联仍然显著.
结论:
- 升高的黎明现象大小 (ΔG) 与2型糖尿病全因死亡率的增加显著相关.
- 严重的PD需要在葡萄糖管理策略中更加关注.
- 管理严重的PD可能有助于减少糖尿病患者的长期不良结果.
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