Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particularly in women: Lessons from the San Luigi Gonzaga Diabetes Study
Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particularly in women: Lessons from the San Luigi Gonzaga Diabetes Study
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DOI：
10.1210/jc.2005-1005
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发表时间：
2006-03-01
影响因子：
5.8
通讯作者：
Trovati, M
中科院分区：
文献类型：
--
作者：
Cavalot, F;Petrelli, A;Trovati, M
目的：餐后血糖对糖尿病并发症的影响是一个备受争议的问题。我们的目的是评估空腹和餐后血糖对2型糖尿病心血管事件的预测作用以及性别的影响。方法：在529个人口中（284名男性和245名女性）连续2型糖尿病患者参加我们的糖尿病诊所，我们评估了关系，校正了心血管危险因素和治疗类型，5年随访期间心血管事件与血红蛋白A1 c（HbA 1c）和血糖基线值之间的关系：1）隔夜空腹后，2）早餐后，3）午餐后，4）晚餐前。结果：我们记录了77名受试者的心血管事件：284名男性中的54名（19%）和245名女性中的23名（9.4%）。单因素分析显示，男性心血管事件与年龄增加、糖尿病病程延长、HbA 1c和纤维蛋白原升高相关，女性心血管事件与收缩压、白蛋白排泄率、HbA 1c和所有血糖值升高相关。吸烟在发生事件的受试者中更常见。当所有血糖值和HbA 1c同时引入模型时，只有午餐后血糖预测心血管事件，女性第三个三分位数与第一个和第二个三分位数的风险比（5.54;置信区间，1.45-21.20）大于男性（2.12;置信区间，1.04-4.32; P
Objective: The influence of postprandial blood glucose on diabetes complications is intensively debated. We aimed to evaluate the predictive role of both fasting and postprandial blood glucose on cardiovascular events in type 2 diabetes and the influence of gender.Methods: In a population of 529 (284 men and 245 women) consecutive type 2 diabetic patients attending our diabetes clinic, we evaluated the relationships, corrected for cardiovascular risk factors and type of treatment, between cardiovascular events in a 5-yr follow-up and baseline values of hemoglobin A1c (HbA1c) and blood glucose measured: 1) after an overnight fast, 2) after breakfast, 3) after lunch, and 4) before dinner. Continuous variables were categorized into tertiles.Results: We recorded cardiovascular events in 77 subjects: 54 of 284 men (19%) and 23 of 245 women (9.4%). Univariate analysis indicated that cardiovascular events were associated with increasing age, longer diabetes duration, and higher HbA1c and fibrinogen in men, and higher systolic blood pressure, albumin excretion rate, HbA1c, and all blood glucose values in women. Smoking was more frequent in subjects with events. When all blood glucose values and HbA1c were introduced simultaneously in the models, only blood glucose after lunch predicted cardiovascular events, with hazard ratio of the third tertile vs. the first and the second tertiles greater in women (5.54; confidence interval, 1.45-21.20) than in men (2.12; confidence interval, 1.04-4.32; P