Effects of diabetes and level of glycemia on all-cause and cardiovascular mortality - The San Antonio Heart Study
Effects of diabetes and level of glycemia on all-cause and cardiovascular mortality - The San Antonio Heart Study
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DOI：
10.2337/diacare.21.7.1167
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发表时间：
1998-07-01
期刊：
影响因子：
16.2
通讯作者：
Stern, MP
中科院分区：
文献类型：
--
作者：
Wei, M;Gaskill, SP;Stern, MP
尽管高血糖水平明显是糖尿病患者微血管并发症的危险因素，但其在大血管并发症中的作用仍存在争议。我们对4,875名受试者（65%为墨西哥裔美国人）进行了7-8年的随访，以研究糖尿病和高血糖对全因和心血管疾病（CVD）死亡率的影响。研究设计和方法--考克斯比例风险模型用于估计全因和心血管死亡率的相对危险度（RR）。（男性RR [95%CI] = 2.1 [1.3-3.5];女性RR [95%CI]= 3.2 [1.9-5.4 ]）和CVD死亡率增加（男性RR [95%CI]= 3.2 [1.4-7.1];女性RR [95%CI]= 8.5 [2.8-25.2]）。在糖尿病受试者中，四分位数4的患者的全因死亡风险是四分位数1和2的4.2倍（P < 0.001），心血管疾病死亡风险是四分位数1和2的4.7倍（P = 0.01）。在进一步校正其他潜在危险因素后，四分位数4的受试者的全因死亡风险和CVD死亡风险比四分位数1和2的受试者高4.9倍。此外，高血压，目前吸烟，胆固醇>6.2 mmol/l是显着的预测CVD死亡率使用考克斯models.CONCLUSIONs-We的结论是，糖尿病是一个预测的全因和CVD死亡率在一般人群中，高血糖症和常见的CVD危险因素是重要的预测全因和CVD死亡率在糖尿病受试者。
OBJECTIVE-Although the level of hyperglycemia is clearly a risk factor for microvascular complications in diabetic patients, its role in macrovascular complications remains controversial. We followed 4,875 subjects (65% Mexican-American) for 7-8 years to investigate the effects of diabetes and hyperglycemia on all-cause and cardiovascular disease (CVD) mortality. These end points were also analyzed according to quartiles of baseline fasting plasma glucose among diabetic participants.RESEARCH DESIGN AND METHODS-The Cox proportional hazards model was used to estimate the relative risks (RRs) for all-cause and CVD mortality.RESULTS-Diabetes was significantly associated with increased all-cause mortality (RR [95% CI] = 2.1 [1.3-3.5] in men; 3.2 [1.9-5.4 ] in women) and increased CVD mortality (3.2 [1.4-7.1] in men; 8.5 [2.8-25.2] in women). Among diabetic subjects, those in quartile 4 had a 4.2-fold greater risk of all-cause mortality (P < 0.001) and a 4.7-fold greater risk of CVD mortality (P = 0.01) than those in quartiles 1 and 2 combined. After further adjustment for other potential risk factors, subjects in quartile 4 had a 4.9-fold greater risk of all-cause mortality and a 4.9-foId greater risk of CVD mortality than those in quartiles 1 and 2. In addition, hypertension, current smoking, and cholesterol >6.2 mmol/l were significant predictors of CVD mortality using Cox models.CONCLUSIONS-We conclude that diabetes is a predictor of both all-cause and CVD mortality in the general population and that both hyperglycemia and common CVD risk factors are important predictors of all-cause and CVD mortality in diabetic subjects.