[ADA2015]中国研究：随访期间血糖变异越高，全因死亡风险越高
2015年第75届美国188bet在线平台网址 协会(ADA)科学年会在美国波士顿召开。上海市闵行区疾控中心团队的一项研究入选ADA2015年会普通壁报专场(GeneralPosterSession)。该研究发现中国2型188bet在线平台网址 患者中评估随访期间空腹血糖(PFG)变异与全因死亡率之间存在相关性。以下是研究摘要译文。
2015年第75届美国188bet在线平台网址 协会(ADA)科学年会在美国波士顿召开。上海市闵行区疾控中心团队的一项研究入选ADA2015年会普通壁报专场(GeneralPosterSession)。该研究发现中国2型188bet在线平台网址 患者中评估随访期间空腹血糖(PFG)变异与全因死亡率之间存在相关性。以下是研究摘要译文。
目的：与188bet在线平台网址 相关的远期并发症包括心血管和肾脏疾病，这些并发症是全球导致188bet在线平台网址 患者死亡的主要原因。188bet在线平台网址 患者在随访期间血糖变异的重要性尚不清楚。该研究旨在中国2型188bet在线平台网址 患者中评估随访期间空腹血糖(PFG)变异与全因死亡率之间的关联。
方法：在2007年1月~2007年12月间共纳入6847例2型188bet在线平台网址 患者。这些患者第一年至少有4次空腹血糖记录，每年进行常规随访，随访至2014年。通过空腹血糖标准差和变异系数(FPG-SD、FPG-CV)计算血糖变异，采用Cox比例风险回归模型评估在校正其他相关危险因素后血糖变异对全因死亡率的影响。
结果：在平均随访6.2年间，共有818例患者(占总人数11.941%)死亡，死亡率为19.43/1000人-年。平均FPG-SD为0.91mmol/L，平均FPG-CV为0.12，根据FPG-SD和FPG-CV水平各自分为从低到高四个分位。经多变量校正后，相比FPG-SD第一分位(<0.37mmol/L)，FPG-SD第二分位(0.37~0.66 mmol/L)、第三分位(0.66~1.15 mmol/L)、第四分位(>1.15mmol/L)的风险比分别为0.90 (0.74, 1.11)、1.00(0.84, 1.26)和1.39(1.15, 1.68)(p分别=0.001);相比FPG-CV第一分位(<0.05 mmol/L)，FPG-CV第二分位(0.56~0.10mmol/L)、第三分位(0.10 ~0.15mmol/L)、第四分位(>0.15mmol/L)的风险比分别为 0.89(0.73, 1.10)、1.06(0.87, 1.30)和1.36(1.12, 1.64)(p分别=0.002);即随着FPG-SD和FPG-CV的增加，全因死亡风险显著增加。
结论：高水平的血糖变异与全因死亡率增加相关，FPG-SD和FPG-CV可能是中国2型188bet在线平台网址 患者全因死亡的独立预测因素。
【研究摘要】
| Abstract Number: | 1715-P |
| Title: |
The Association between Visit-to-Visit Variability of Fasting Plasma Glucose and All-Cause Mortality in Chinese Type 2 Diabetic Patients |
| Authors: | YINAN LIU, BAODONG YAO, HONG FANG, YUJIE YAN, YANPING ZHAO, YUE CHEN, Shanghai, China, Ottawa, ON, Canada |
| Abstract: |
Diabetes is associated with long-term complications that include cardiovascular and kidney disease and is an important cause of mortality worldwide. The importance of visit-to-visit glycemic variability in diabetes remains unclear. This study aimed to assess the relationship between visit-to-visit variability in fasting plasma glucose (FPG) and all-cause mortality in Chinese type 2 diabetic patients. From Jan 2007 to Dec 2007, 6,847 type 2 diabetic patients with at least four records of FPG in the first year during regular follow-up were included in this analysis. They were followed through Nov 2014. The data were obtained from Electric Health Recording (EHR) of Shanghai Minhang District of China. Glycemic variation were calculated using standard deviation and coefficient of variation of FPG (FPG-SD and FPG-CV respectively), and Cox proportional hazards regression model was applied to estimate the effect on all-cause mortality adjusting for other related risk factors. 11.94% (n=818) of the cohort died during an average of 6.2 years follow-up, resulting in a mortality rate of 19.43 per 1000 person-years. The mean FPG-SD was 0.91 mmol/L. After multivariate adjustment, hazard ratios for the second (0.37 to 0.66 mmol/L), third (0.66 to 1.15 mmol/L) and fourth (>1.15 mmol/L) versus first FPG-SD quartile (<0.37 mmol/L) were 0.90 (0.74, 1.11), 1.00 (0.84, 1.26) and 1.39 (1.15, 1.68), respectively (p=0.001). The mean FPG-CV was 0.12. Multivariable hazard ratios for the second (0.56 to 0.10), third (0.10 to 0.15) and fourth (>0.15) versus first FPG-CV quartile (<0.05) were 0.89 (0.73, 1.10), 1.06 (0.87, 1.30) and 1.36 (1.12, 1.64) (p=0.002). High level of glycemic variability is associated with an increase of all-cause mortality, and both FPG-SD and FPG-CV may be independent predictors of all-cause mortality in Chinese type 2 diabetic patients.
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