糖尿病前表型和全因或心血管死亡率:来自人口研究的证据
1Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
概括
较多的糖尿病前期诊断标准,包括禁食血葡萄糖 (FPG) 和糖化血红蛋白A1C (HbA1C),与死亡风险增加相关. 这一发现强调了全面的糖尿病前期评估对于预测不良健康结果的重要性.
科学领域:
- 内分泌学和新陈代谢学
- 心血管疾病流行病学
- 公共卫生和预防医学
背景情况:
- 糖尿病前期的诊断采用多个标准:禁食血葡萄糖 (FPG),糖化血红蛋白A1C (HbA1C) 和2小时后载荷血葡萄糖 (2h PG).
- 具有多个糖尿病前诊断标准对死亡风险的预后价值仍然不完全理解.
研究的目的:
- 调查糖尿病前诊断标准的数量与随后的全因和心血管疾病 (CVD) 死亡率之间的关联.
- 评估更多的糖尿病前期缺陷是否预测死亡风险更高.
主要方法:
- 来自2005-2016年国家健康和营养检查调查的4511名糖尿病前期成人数据的分析.
- 利用卡普兰-梅尔曲线,考克斯比例危险回归和分层分析来根据一个,两个或三个糖尿病前期标准比较死亡率.
- 调整为多变量回归模型中的潜在混因素.
主要成果:
- 很大一部分人符合多个糖尿病前期的标准:60.78%符合一个标准,29.60%符合两个标准,9.62%符合三个标准.
- 符合两项或三项糖尿病前期标准的个体显示,与符合一个标准的人相比,所有原因死亡率 (分别为1.341和1.369) 和心血管疾病死亡率 (分别为1.836和2.037) 的多变量调整危险比率显著增加.
- 多重糖尿病前期标准与心血管疾病死亡率之间的关联在男性中尤为明显.
结论:
- 满足糖尿病前期诊断标准的数量与所有原因和心血管疾病死亡率的风险增加直接相关.
- 识别患有多种糖尿病前期缺陷的个体可能有助于对心血管事件和整体死亡率的风险分层.
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