Intermediate hyperglycaemia and 10-year mortality in resource-constrained settings: the PERU MIGRANT Study.
Intermediate hyperglycaemia and 10-year mortality in resource-constrained settings: the PERU MIGRANT Study.
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DOI：
10.1111/dme.14298
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发表时间：
2020-09
期刊：
影响因子：
--
通讯作者：
Bernabé-Ortiz A
中科院分区：
文献类型：
--
作者：
Lazo-Porras M;Ruiz-Alejos A;Miranda JJ;Carrillo-Larco RM;Gilman RH;Smeeth L;Bernabé-Ortiz A
为了确定由空腹血糖和HbA1c标准定义的中度高血糖是否与拉丁美洲国家10年队列人群的死亡率有关。秘鲁移民研究的分析是在三个不同的人口群体(农村、从农村到城市的移民和城市移民)中进行的。基线评估于2007/2008年进行，后续评估于2018年进行。结果是全原因死亡，暴露于中度高血糖，使用三种定义：(1)空腹血糖受损，根据美国糖尿病协会标准[空腹血糖5.6-6.9 mmol/L(100-125 mg/dl)]；(2)中度高血糖，根据美国糖尿病协会标准定义[糖化血红蛋白水平39-46 mmol/mol(5.7-6.4%)]；及(3)中度高血糖根据国际专家委员会标准定义[糖化血红蛋白水平42-46 mmol/mol(6.0-6.4%)]。使用COX比例风险模型估计粗略和调整后的危险比和95%的顺应性。在基线时，研究人群的平均年龄(SD)为47.8(11.9)岁，其中52.5%是女性。研究队列分为农村人口组207人(20.0%)、农村向城市流动人口组583人(59.7%)和城市人口组198人(20.3%)。根据美国糖尿病协会空腹血糖受损定义、国际专家委员会HbA1c定义和美国糖尿病协会HbA1c定义，中度高血糖患病率分别为6%、12.9%和38.5%，10年后死亡率为63/976(7%)。根据粗略模型中基于HbA1c的定义，中度高血糖与全因死亡率相关[根据美国糖尿病协会的风险比2.82(95%可信区间1.59-4.99)，根据国际专家委员会的风险比2.92(95%可信区间1.62-5.28)]，而美国糖尿病协会定义的空腹血糖受损不与[风险比0.84(95%可信区间0.26-2.68)]相关。然而，在调整后的模型中，只有美国糖尿病协会基于HbA1c的定义与全因死亡率相关[危险比1.91(95%CI 1.03-3.53)]，而国际专家委员会基于HbA1c的定义和美国糖尿病协会基于空腹血糖受损的定义没有[风险比分别为1.42(95%CI 0.75-2.68)和1.09(95%CI 0.33-3.63)]。根据美国糖尿病协会HbA1c标准定义的中度高血糖与秘鲁队列研究10年后死亡率升高有关。在这些秘鲁人中，HbA1c似乎是一个与死亡率相关的因素。中度高血糖是糖尿病的一个重要危险因素，但根据所用定义的不同，患有这种情况的人的比例不同。空腹血糖受损、糖耐量受损和/或HbA1c标准与死亡率的关联程度尚不清楚。使用基于糖化血红蛋白的美国糖尿病协会定义评估的中度高血糖与拉丁美洲国家10年队列中死亡率的增加有关。HbA1c似乎是与秘鲁人口死亡率相关的一项指标。
To determine whether intermediate hyperglycaemia, defined by fasting plasma glucose and HbA1c criteria, is associated with mortality in a 10‐year cohort of people in a Latin American country. Analysis of the PERU MIGRANT Study was conducted in three different population groups (rural, rural‐to‐urban migrant, and urban). The baseline assessment was conducted in 2007/2008, with follow‐up assessment in 2018. The outcome was all‐cause mortality, and the exposure was intermediate hyperglycaemia, using three definitions: (1) impaired fasting glucose, defined according to American Diabetes Association criteria [fasting plasma glucose 5.6–6.9 mmol/l (100–125 mg/dl)]; (2) intermediate hyperglycaemia defined according to American Diabetes Association criteria [HbA1c levels 39–46 mmol/mol (5.7–6.4%)]; and (3) intermediate hyperglycaemia defined according to the International Expert Committee criteria [HbA1c levels 42–46 mmol/mol (6.0–6.4%)]. Crude and adjusted hazard ratios and 95% CIs were estimated using Cox proportional hazard models. At baseline, the mean (sd) age of the study population was 47.8 (11.9) years and 52.5% of the cohort were women. The study cohort was divided into population groups as follows: 207 people (20.0%) in the rural population group, 583 (59.7%) in the rural‐to‐urban migrant group and 198 (20.3%) in the urban population group. The prevalence of intermediate hyperglycaemia was: 6%, 12.9% and 38.5% according to the American Diabetes Association impaired fasting glucose definition, the International Expert Committee HbA1c‐based definition and the American Diabetes Association HbA1c‐based definition, respectively, and the mortality rate after 10 years was 63/976 (7%). Intermediate hyperglycaemia was associated with all‐cause mortality using the HbA1c‐based definitions in the crude models [hazard ratios 2.82 (95% CI 1.59–4.99) according to the American Diabetes Association and 2.92 (95% CI 1.62–5.28) according to the International Expert Committee], whereas American Diabetes Association‐defined impaired fasting glucose was not [hazard ratio 0.84 (95% CI 0.26–2.68)]. In the adjusted model, however, only the American Diabetes Association HbA1c‐based definition was associated with all‐cause mortality [hazard ratio 1.91 (95% CI 1.03–3.53)], whereas the International Expert Committee HbA1c‐based and American Diabetes Association impaired fasting glucose‐based definitions were not [hazard ratios 1.42 (95% CI 0.75–2.68) and 1.09 (95% CI 0.33–3.63), respectively]. Intermediate hyperglycaemia defined using the American Diabetes Association HbA1c criteria was associated with an elevated mortality rate after 10 years in a cohort from Peru. HbA1c appears to be a factor associated with mortality in this Peruvian population. Intermediate hyperglycaemia is an important risk factor for diabetes, but the proportion of people with this condition varies according to the definition used. The extent to which impaired fasting glucose, impaired glucose tolerance and/or HbA1c criteria are associated with mortality remains unclear. Intermediate hyperglycaemia assessed using the HbA1c‐based American Diabetes Association definition was associated with increased mortality rate in a 10‐year cohort from a Latin American country. HbA1c appeared to be a measurement associated with mortality in this Peruvian population.
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DOI：
10.1136/bmj.i5953
发表时间：
2016-11-23
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Huang Y;Cai X;Mai W;Li M;Hu Y
通讯作者：
Hu Y
影响因子：
9.8
作者：
Mao, Xianyun;Bigham, Abigail W.;Parra, Esteban J.
通讯作者：
Parra, Esteban J.
影响因子：
44.5
作者：
Schmidt, Maria Ines;Bracco, Paula A.;Duncan, Bruce B.
通讯作者：
Duncan, Bruce B.
DOI：
10.1016/s2214-109x(18)30386-3
发表时间：
2018-11
期刊：
The Lancet. Global health
影响因子：
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作者：
Kruk ME;Gage AD;Arsenault C;Jordan K;Leslie HH;Roder-DeWan S;Adeyi O;Barker P;Daelmans B;Doubova SV;English M;García-Elorrio E;Guanais F;Gureje O;Hirschhorn LR;Jiang L;Kelley E;Lemango ET;Liljestrand J;Malata A;Marchant T;Matsoso MP;Meara JG;Mohanan M;Ndiaye Y;Norheim OF;Reddy KS;Rowe AK;Salomon JA;Thapa G;Twum-Danso NAY;Pate M
通讯作者：
Pate M
影响因子：
5.1
作者：
Lazo-Porras, Maria;Bernabe-Ortiz, Antonio;Jaime Miranda, J.
通讯作者：
Jaime Miranda, J.