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J Diabetes Complications: 血糖变异性可预测血液透析成人糖尿病患者的全因死亡率

2020-03-16 网络 网络

血糖变异性是一项新的血糖控制指标,其已经成为一种能够更准确地获取不良结局发生的病理过程的测量手段。迄今为止,尚无相关研究探讨透析糖尿病患者血糖变异性与死亡率之间的关系。近期一项发表在Journal o

血糖变异性是一项新的血糖控制指标,其已经成为一种能够更准确地获取不良结局发生的病理过程的测量手段。迄今为止,尚无相关研究探讨透析糖尿病患者血糖变异性与死亡率之间的关系。近期一项发表在Journal of Diabetes and its Complications中国人群的研究显示接受血液透析的成人糖尿病患者中,血糖变异性最大者全因死亡风险要高于变异性较小者。

研究概要


来自浙江嘉兴学院附属第一医院的研究者使用连续血糖监测评估血液透析治疗的1,240例成人糖尿病患者(平均年龄64.3岁;女性39.2%)连续2天(隔天透析)的基线血糖变异性。研究人员称,CGM设备中的生物传感器每3分钟测量一次血糖。研究人员利用这些数据确定了每位受试者的变异系数。变异系数大于52%的受试者血糖变异性最大,而变异系数31%或更小的受试者血糖变异性最小。研究人员检查了2.4年中位随访期间的患者记录,以评估死亡率。


主要结果


研究人员确定了整个研究队列中340例死亡患者,发现血糖变异性最大的受试者在随访期间死亡的可能性是血糖变异性最小的受试者的两倍(OR=2.0;95%CI,1.2~3.2)。研究人员指出,在充分校正的模型中,“最高变异系数四分位数仍是全因死亡率的统计学显著预测因子”。在随访期间,与血糖变异系数在31%~40%(OR=2.2;95%CI,1.3~3.7)和40%~52%(OR=1.7;95%CI,1-2.7)之间的患者相比,血糖变异性最大的患者在随访期间死亡的可能性更大。

研究者评述到:高血糖变异性与血液透析成人糖尿病患者患者全因死亡率风险增加独立相关,与血红蛋白、白蛋白、C反应蛋白、既往心血管疾病史、药物治疗或低血糖无关,进一步丰富了不断涌现的证据支持血糖变异性的预后价值。血糖变异性与死亡率的关联可能与血糖变异性对各种并发症(尤其是糖尿病大血管和微血管并发症)的进展有重要影响有关。

原始出处:
Shi C, et al. Glycemic variability and all-cause mortality in patients with diabetes receiving hemodialysis: A prospective cohort study.J Diabetes Complications. 2020;doi:10.1016/j.jdiacomp.2020.107549.

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    2020-08-17 xuyong536
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  8. 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createdName=12498dabm77暂无昵称, createdTime=Wed Mar 18 11:21:57 CST 2020, time=2020-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474895, encodeId=438414e489589, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Wed Mar 18 11:21:57 CST 2020, time=2020-03-18, status=1, ipAttribution=)]
    2020-03-18 habb
  9. 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