Is there glycemic threshold for mortality risk?
Is there glycemic threshold for mortality risk?
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DOI：
10.2337/diacare.22.5.696
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发表时间：
1999-05-01
期刊：
影响因子：
16.2
通讯作者：
Eschwege, E
中科院分区：
文献类型：
--
作者：
Balkau, B;Bertrais, S;Eschwege, E
目的-确定是否存在空腹和2小时血糖的阈值，超过该阈值，死于各种原因和冠心病(CHD)的风险增加。研究设计和方法-我们研究了巴黎前瞻性研究中7,018名年龄在44-55岁的男性的23年死亡数据，这些人在基线检查中没有糖尿病。结果：所有死因与空腹和2 h血糖浓度均呈J型关系，观察死亡率最低的区间分别为空腹血糖5.5 mm ol/L和2 h血糖5.0 mm o l/L。在这一人群中，冠心病死亡率较低：对于空腹血糖，危险比最好用正线性关系来模拟；对于2-h血糖，危险比最好地用J型曲线来模拟，观察到的最低死亡率在以6.0 mmol/l为中心的区间内。结论：在巴黎前瞻性研究中，没有明确的空腹或2-h血糖浓度使死亡率急剧上升的阈值；在血糖分布的较高水平，死亡风险随着空腹和2-h葡萄糖浓度的增加而递增。
OBJECTIVE - To determine whether there are thresholds for fasting and for 2-h glucose above which the risk of death from all causes and from coronary heart disease (CHD) increases.RESEARCH DESIGN AND METHODS - We studied 23-year mortality data from the Paris Prospective Study of the 7,018 men, aged 44-55 years, who were not known as diabetic at the baseline examination. The effect of glucose concentrations on mortality was studied using the observed relative risks and an age-adjusted Cox proportional hazards model.RESULTS - For all causes of death, there were J-shaped relationships with both fasting and 2-h glucose concentrations, and the lowest observed death rates were in the intervals centered on 5.5 mmol/l for fasting glucose and 5.0 mmol/l for 2-h glucose. The death rates for CHD were low in this population: for fasting glucose, the hazards ratio was best modeled by a positive linear relationship; for 2-h glucose, it was modeled by a J-shaped curve and the lowest observed death rate was in the interval centered on 6.0 mmol/l.CONCLUSIONS - In the Paris Prospective Study, there were no clear thresholds for fasting or 2-h glucose concentrations above which mortality sharply increased; in the upper levels of the glucose distributions, the risk of death progressively increased with increasing fasting and 2-h glucose concentrations.