估计的葡萄糖处置率和心血管--代谢综合征的死亡风险:一个基于人口的研究
Zheng Zhang1, Chao Fu1, Yiyi Chai1
1Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, No. 148, Baojian Road, Harbin, Heilongjiang Province, 150086, China.
较低的估计葡萄糖处置率 (eGDR) 预测心血管--代谢综合征 (CKM) 患者的死亡率较高. 这一发现对于识别高风险个体和指导CKM综合征的早期干预至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 心血管--代谢 (CKM) 综合征涉及相互关联的代谢,和心脏功能障碍,增加死亡风险.
- 胰岛素抵抗 (IR) 是CKM综合征发展的关键因素,但其与eGDR死亡率的联系尚未完全理解.
研究的目的:
- 调查估计的葡萄糖处置率 (eGDR) 与CKM综合征患者的全因和因特定死亡率之间的关联.
- 在不同葡萄糖代谢状态中,将eGDR与其他IR标记物 (TyG,HOMA-IR) 的预测性能进行比较.
主要方法:
- 利用了国家健康和营养检查调查 (NHANES 1999-2018) 对CKM综合征患者的数据.
- 采用考克斯回归和受限立方线 (RCS) 分析来研究eGDR与死亡率的关系.
- 根据葡萄糖代谢状态进行分层分析,并使用ROC曲线进行性能比较.
主要成果:
- 较低的eGDR与所有原因和特定原因死亡率的增加显著相关 (P <0.05).
- RCS分析揭示了eGDR与全因/糖尿病特定死亡率之间的非线性关系,以及与心血管死亡率的线性关系.
- eGDR显示出优于TyG和HOMA-IR的预测性能,特别是在正常血糖调节和糖尿病前期组中.
结论:
- 降低eGDR是CKM综合征死亡率的独立预测因素.
- 根据结果和葡萄糖状况,eGDR与死亡率的关系有所不同,观察到非线性模式.
- 作为风险分层和早期干预在CKM综合征管理中的生物标志物,eGDR显示出前景.
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