Diabetes Care：糖尿病到底增加心血管疾病和患癌死亡风险多少？

2016-08-12 MedSci MedSci原创

大量西班牙研究人员调查后发现，由于糖尿病会增加民众出现心血管疾病、癌症和其他疾病的风险，由此会使民众过早死亡的风险显著增加。研究人员通过对超过55000名民众调查分析后发现,糖尿病患者患肝癌、结直肠癌、肺癌、肝肾疾病、心血管疾病如心梗和卒中等风险增加，因此糖尿病患者过早死亡的风险增加。这项研究结果发表在Diabetes Care。既往研究表明,尽管近年来糖尿病患者总体死亡率降低,但糖尿病患者的

大量西班牙研究人员调查后发现，由于糖尿病会增加民众出现心血管疾病、癌症和其他疾病的风险，由此会使民众过早死亡的风险显著增加。

研究人员通过对超过55000名民众调查分析后发现,糖尿病患者患肝癌、结直肠癌、肺癌、肝肾疾病、心血管疾病如心梗和卒中等风险增加，因此糖尿病患者过早死亡的风险增加。这项研究结果发表在Diabetes Care。

既往研究表明,尽管近年来糖尿病患者总体死亡率降低,但糖尿病患者的预期寿命更短，肢体障碍伴随时间较久，生活质量降低。该研究的结果与既往研究结果相符合。

众多研究结果都已证明糖尿病和心血管死亡之间存在关联。但María Grau博士指出众多研究疏忽了癌症患者死亡率与糖尿病之间的关系。她认为该研究的重点在于发现糖尿病与癌症之间的关系，并对高风险人群进行癌症筛查，尤其是肝癌、结直肠癌等肿瘤，以便采取更有效的预防措施降低糖尿病患者罹患肿瘤及相关并发症的发生率。

研究人员指出，通过采取社会支持系统如戒烟令，可以提高民众的认知程度，并调整生活方式，降低出现并发症的几率。但是我们要做的还有很多，我们面临的挑战依然很严峻。

为了探究尿病和某种死亡原因之间的联系,研究人员对1991-2005年在7大地区进行的12个队列研究进行了数据分析，这些研究采用的研究方式相似。所有的参与者经由普通人群随机选择,年龄范围为35-79岁,没有心血管疾病临床表现或诊断。糖尿病患者血糖>125mg/dL。研究人员对他们进行了10年的随访调查，并记录下他们的就诊记录、生存状况和死亡原因。Grau博士指出,在西班牙,1型糖尿病的患病率不到1%,大多糖尿病患者为2型糖尿病。

一共有55292名参与者参与研究，其中15.6%患有糖尿病，研究人员发现，糖尿病患者较非糖尿病患者表现更为衰老，BMI、血脂、血压、血糖更高，较少吸烟。在10年的随访调查中，有1710名(3.8%)非糖尿病患者死亡，781名(9.1%)糖尿病患者死亡。其中分别有220名非糖尿病患者和85名糖尿病患者的死亡原因不列入研究范围内。

设计包括吸烟、BMI、收缩压、高密度脂蛋白、总胆固醇等的多元模型后发现，糖尿病显著增加民众心血管疾病和癌症的死亡风险，也增加民众非心血管疾病和癌症的死亡风险。研究人员采用CSH和PSH进行分析死亡率风险时发现，对男性而言，糖尿病增加患者心血管疾病死亡风险为CSH：2.03，PSH：1.99，女性为CSH：2.28，PSH：2.23，主要死亡原因为心衰和卒中。对男性而言，糖尿病增加患者肿瘤死亡风险为CSH：1.37，PSH：1.35，女性为CSH：1.68，PSH：1.66。导致糖尿病患者死亡的主要肿瘤类型为肝癌、结直肠癌、肺癌。对男性而言，糖尿病增加患者非心血管疾病和肿瘤的死亡风险为CSH：1.53，PSH：1.50，女性为CSH：1.89，PSH：1.84，主要死亡原因为感染、慢性阻塞性肺疾病、肝脏和肾脏疾病。

原始出处：

Jose Miguel Baena-Díez,et al, Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis,Diabetes Care,4,Aug,2016

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2016-12-21 木头人513

#Diabetes#

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2017-02-04 ms9608593228839890

#DIA#

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2016-09-20 1e10c84am36(暂无匿称)

文章很好，非常有益

86 0
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2016-09-12 舒心和人

用数据说话，让证据更有说服力，所以严格控制血糖，避免出现严重并发症

89 0
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channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160528/IMG5749A60FD120A3124.jpg, createdBy=65fe1709307, createdName=青荷, createdTime=Sun Aug 21 08:51:00 CST 2016, time=2016-08-21, status=1, ipAttribution=)]
2016-09-11 1e10c84am36(暂无匿称)

己拜读，受益匪浅

0 0
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channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160528/IMG5749A60FD120A3124.jpg, createdBy=65fe1709307, createdName=青荷, createdTime=Sun Aug 21 08:51:00 CST 2016, time=2016-08-21, status=1, ipAttribution=)]
2016-12-25 ms5439512287675881

#BET#

70 0
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2016-08-28 stead

学习到了

79 0
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2016-08-28 stead

学习到了

0 0
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2016-08-27 ylzr123

赞！文章有深度，值得收藏拜读。

75 0
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2016-08-21 青荷

好文章，继续学习

48 0