Prospective Study of Fasting Blood Glucose and Intracerebral Hemorrhagic Risk.
Prospective Study of Fasting Blood Glucose and Intracerebral Hemorrhagic Risk.
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DOI：
10.1161/strokeaha.117.019189
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发表时间：
2018-01
期刊：
影响因子：
8.3
通讯作者：
Gao X
中科院分区：
文献类型：
--
作者：
Jin C;Li G;Rexrode KM;Gurol ME;Yuan X;Hui Y;Ruan C;Vaidya A;Wang Y;Wu S;Gao X
虽然糖尿病是缺血性中风的独立危险因素，但空腹血糖和脑出血之间的联系是有限的和不一致的。本研究的目的是研究长期空腹血糖浓度对随后的脑出血风险的潜在影响。这项前瞻性研究包括96,110名开滦研究的参与者，居住在唐山市开滦社区，中国，他们在基线(2006年)没有心血管疾病和癌症。最新的累积平均空腹血糖浓度被用作当前研究的主要暴露水平。经病历复查确认为2006年至2015年发生的脑出血事件。在817,531人年的随访中，我们确定了755例偶发脑出血病例。调整后的脑出血危险比及其95%可信区间(CI)：糖尿病和空腹血糖≥分别为1.59(95%CI，1.2 6~2.0 2)和1.31(95%CI，1.0 2~1.6 9)；空腹血糖为5.60~6.09 mmol/L，低血糖为2.04(95%CI：1.23~3.38)；与正常空腹血糖4.00~5.59 mmol/L比较，排除使用降糖药、阿司匹林、降压药或抗凝剂后，结果持续存在，且脑出血病例发生在随访的前两年。在这个以社区为基础的大型队列中，空腹血糖浓度低(≥6.1mmoL/L)和高空腹血糖浓度4.006.09mmoL/L相比，发生脑出血的风险更高。
Although diabetes mellitus is an established independent risk factor for ischemic stroke, the association between fasting blood glucose and intracerebral hemorrhage is limited and inconsistent. The objectives of the current study was to examine the potential impact of long-term fasting blood glucose concentration on subsequent risk of intracerebral hemorrhage. This prospective study included 96,110 participants of the Kailuan study, living in Kailuan community, Tangshan city, China, who were free of cardiovascular diseases and cancer at baseline(2006).Fasting blood glucose concentration was measured in 2006, 2008, 2010, and 2012. Updated cumulative average fasting blood glucose concentration was used as primary exposure of the current study. Incident intracerebral hemorrhage from 2006 to 2015 was confirmed by review of medical records. During 817,531 person-years of follow-up, we identified 755 incident intracerebral hemorrhage cases. The nadir risk of intracerebral hemorrhage was observed at fasting blood glucose concentration of 5.3 mmol/L. The adjusted hazard ratios and their 95% confidence intervals (CIs) of intracerebral hemorrhage were 1.59(95% CI, 1.26–2.02) for diabetes or fasting blood glucose ≥7.00 mmol/L, 1.31(95%CI, 1.02–1.69) for impaired fasting glucose (fasting blood glucose 6.10–6.99 mmol/L), 0.98(95% CI: 0.78–1.22) for fasting blood glucose 5.60–6.09 mmol/L, and 2.04 (95%CI, 1.23–3.38) for hypoglycemia (fasting blood glucose <4.00 mmol/L), comparing with normal fasting blood glucose 4.00–5.59 mmol/L. The results persisted after excluding individuals who used hypoglycemic, aspirin, antihypertensive agents, or anticoagulants, and those with intracerebral hemorrhagic cases occurred in the first two years of follow-up. In this large community-based cohort, low (<4.0 mmol/L) and high (≥6.1 mmol/L) fasting blood glucose concentrations were associated with higher risk of incident intracerebral hemorrhage, relative to fasting blood glucose concentrations of 4.00–6.09 mmol/L.