Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance - The Australian diabetes, obesity, and lifestyle study (AusDiab)
Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance - The Australian diabetes, obesity, and lifestyle study (AusDiab)
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DOI：
10.1161/circulationaha.106.685628
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发表时间：
2007-07-10
期刊：
影响因子：
37.8
通讯作者：
Shaw, Jonathan E.
中科院分区：
文献类型：
--
作者：
Barr, Elizabeth L. M.;Zimmet, Paul Z.;Shaw, Jonathan E.
背景-糖尿病增加心血管疾病（CVD）和全因死亡率的风险。轻度血糖升高与死亡率之间的关系尚不清楚。这项研究调查了空腹血糖和糖耐量受损以及糖尿病是否会增加全因和心血管疾病死亡率的风险。方法和结果：1999年至2000年，对澳大利亚糖尿病、肥胖和生活方式研究（AusDiab）的10428名参与者的糖耐量状况进行了测定。中位随访5.2年后，298例死亡（88例心血管疾病死亡）。与糖耐量正常组相比，已知糖尿病和新诊断糖尿病的校正全因死亡率危险比（HRs）和95%可信区间（CIs）分别为2.3（1.6 ~ 3.2）和1.3（0.9 ~ 2.0）。空腹血糖受损（HR 1.6, 95% CI 1.0 ~ 2.4）和糖耐量受损（HR 1.5, 95% CI 1.1 ~ 2.0）患者的死亡风险也增加。65%死于心血管疾病的患者有已知的糖尿病、新诊断的糖尿病、空腹血糖受损或基线时葡萄糖耐量受损。已知糖尿病（HR 2.6, 95% CI 1.4 - 4.7）和空腹血糖受损（HR 2.5, 95% CI 1.2 - 5.1）是年龄、性别和其他传统CVD危险因素校正后CVD死亡率的独立预测因子，但糖耐量受损不是（HR 1.2, 95% CI 0.7 - 2.2）。结论：本研究强调了糖代谢异常与死亡率之间的密切联系，并表明这种情况导致了普通人群中大量的CVD死亡。在所有类型的糖代谢异常的人群中，心血管疾病的预防都是必要的。
Background - Diabetes mellitus increases the risk of cardiovascular disease ( CVD) and all-cause mortality. The relationship between milder elevations of blood glucose and mortality is less clear. This study investigated whether impaired fasting glucose and impaired glucose tolerance, as well as diabetes mellitus, increase the risk of all-cause and CVD mortality.Methods and Results - In 1999 to 2000, glucose tolerance status was determined in 10 428 participants of the Australian Diabetes, Obesity, and Lifestyle Study ( AusDiab). After a median follow-up of 5.2 years, 298 deaths occurred ( 88 CVD deaths). Compared with those with normal glucose tolerance, the adjusted all-cause mortality hazard ratios ( HRs) and 95% confidence intervals ( CIs) for known diabetes mellitus and newly diagnosed diabetes mellitus were 2.3 ( 1.6 to 3.2) and 1.3 ( 0.9 to 2.0), respectively. The risk of death was also increased in those with impaired fasting glucose ( HR 1.6, 95% CI 1.0 to 2.4) and impaired glucose tolerance ( HR 1.5, 95% CI 1.1 to 2.0). Sixty-five percent of all those who died of CVD had known diabetes mellitus, newly diagnosed diabetes mellitus, impaired fasting glucose, or impaired glucose tolerance at baseline. Known diabetes mellitus ( HR 2.6, 95% CI 1.4 to 4.7) and impaired fasting glucose ( HR 2.5, 95% CI 1.2 to 5.1) were independent predictors for CVD mortality after adjustment for age, sex, and other traditional CVD risk factors, but impaired glucose tolerance was not ( HR 1.2, 95% CI 0.7 to 2.2).Conclusions - This study emphasizes the strong association between abnormal glucose metabolism and mortality, and it suggests that this condition contributes to a large number of CVD deaths in the general population. CVD prevention may be warranted in people with all categories of abnormal glucose metabolism.