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NEJM:糖尿病患者的超额死亡率

2015-10-29 崔倩 译 MedSci原创

2型糖尿患者的全因死亡、心血管疾病引起的死亡及各级血糖控制和肾脏并发症之间的过剩风险目前还是未知的。在这个基于注册表的研究中,研究人员根据2型糖尿病人群中血糖控制和肾脏并发症来评估这些风险。该研究包括的患者为1998年1月1日后注册在瑞典国家糖尿病注册的患者。对于每一个患者,都会随机从普通人群中挑取1个对照,随机根据年龄,性别,和县进行匹配。所有参加者随访至2011年12月31日,被记录在瑞典特定

2型糖尿患者的全因死亡、心血管疾病引起的死亡及各级血糖控制和肾脏并发症之间的多余风险目前还是未知的。在这个基于注册表的研究中,研究人员根据2型糖尿病人群中血糖控制和肾脏并发症来评估这些风险。

该研究包括的患者为1998年1月1日后在瑞典国家糖尿病注册的患者。对于每一个患者,都会随机从普通人群中挑取1个对照(随机根据年龄、性别、和县进行匹配)。所有参加者随访至2011年12月31日,被记录在瑞典特定死因死亡注册中。

糖尿病组平均随访时间为4.6年,对照组为4.8年。总体而言,糖尿病患者中77117/435369(17.7%)例患者死亡,对照组中306097/2117483(14.5%)例患者死亡(调整后的危险比,1.15;95%可信区间[Cl],1.14至1.16)。糖尿病患者和对照参与者的心血管死亡的发生率分别为7.9% vs 6.1%(调整后的危险比,1.14;95%Cl,1.13至1.15)。全因死亡和心血管死亡的过剩风险随着年龄小、更糟糕的血糖控制、和更严重的肾脏并发症的而增加。与对照参与者相比,55岁以下且糖化血红蛋白水平在6.9%或以下(每摩尔非糖化血红蛋白≤52mmol)的糖尿病患者的任何原因死亡的危险比为1.92(95%Cl,1.75至2.11);在年龄大于75岁或以上的患者中相应的危险比为0.95(95%Cl,0.94至0.96)。在正常白蛋白尿的患者中,与对照组相比,那些年龄超过55岁的且糖化血红蛋白水平在6.9%或更低的患者的死亡风险比为1.60(95%Cl,1.40至1.82);在年龄大于75岁或以上的患者中相应的危险比为0.76(95%Cl,0.75至0.78),65至75岁的患者死亡风险也显著降低(危险比为0.87;95% Cl,0.84至0.91)。

2型糖尿病人的死亡率与普通人群的相比,差别很大,从庞大的患者群体的大量超额风险到降低死亡风险,都取决于年龄、血糖控制和肾脏并发症。

原始出处:

Mauro Tancredi,Annika Rosengren,Ann-Marie Svensson,et al.Excess Mortality among Persons with Type 2 Diabetes,NEJM,2015.10.29

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    2015-11-02 nizongzan

    什么都不敢吃

    0

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    2015-11-02 nizongzan

    可怕

    0

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    2015-11-02 nizongzan

    希望快点功课

    0

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    2015-11-01 王新春

    好文章!

    0

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