Subclinical stales of glucose intolerance and risk of death in the US
Subclinical stales of glucose intolerance and risk of death in the US
复制标题
DOI：
10.2337/diacare.24.3.447
复制
发表时间：
2001-03-01
期刊：
影响因子：
16.2
通讯作者：
Brancati, FL
中科院分区：
文献类型：
--
作者：
Saydah, SH;Eberhardt, MS;Brancati, FL
目的-虽然临床上明显的2型糖尿病是一个很好的死亡原因，但对葡萄糖耐受不良的亚临床状态知之甚少。研究设计和方法-数据来自第二次全国健康和营养调查死亡率研究，一项前瞻性研究的成年人，进行了分析。这项分析集中在一个全国性的代表性样本，3,174名年龄在30-75岁之间的成年人，他们在基线时接受了口服葡萄糖耐量试验（1976-1980），并随访至1992年死亡。结果-使用1985年世界卫生组织标准，成人被分类为先前诊断为糖尿病（n = 248），未确诊的糖尿病（n = 183）、糖耐量受损（IGT）（n = 480）或正常糖耐量（n = 2，263）。对于这些组，到70岁的累积全因死亡率分别为41、34、27和20%（P < 0.001）。与糖耐量正常者相比，确诊糖尿病的成人全因死亡率的多变量校正RR最高（RR2.11，95% CI 1.56-2.84），其次为未确诊糖尿病（1.77，1.13-2.75）和IGT（1.42，1.08-1.87; P < 0.001）。在心血管疾病死亡率方面也观察到类似的风险模式。结论-在美国，与异常葡萄糖耐量相关的死亡率梯度从IGT成人的40%高风险到临床上明显的糖尿病成人的110%高风险。这些关联独立于已确定的心血管疾病风险因素。
OBJECTIVE - Although clinically evident type 2 diabetes is a it ell-established cause of mortality, less is known about subclinical states of glucose intolerance. RESEARCHDESIGN AND METHODS - Data from the Second National Health and Nutrition Examination Survey Mortality Study, a prospective study of adults, were analyzed. This analysis focused on a nationally representative sample of 3,174 adults aged 30-75 years who underwent an oral glucose tolerance rest at baseline (1976-1980) and who were followed up for death through 1992.RESULTS - Using 1985 World Health Organization criteria, adults were classified as having previously diagnosed diabetes (n = 248), undiagnosed diabetes (n = 183), impaired glucose tolerance (IGT) (n = 480), or normal glucose tolerance (n = 2,263). For these groups, cumulative all-cause mortality through age 70 was 41, 34, 27, and 20%, respectively (P < 0.001). Compared with those with normal glucose tolerance, the multivariate adjusted RR of all-cause mortality was greatest for adults with diagnosed diabetes (RR2.11, 95% CI 1.56-2.84), followed by those with undiagnosed diabetes (1.77, 1.13-2.75) and those with IGT(1.42, 1.08-1.87; P < 0.001). A similar pattern of risk was observed For cardiovascular disease mortality.CONCLUSIONS - In the U.S., there was a gradient of mortality associated with abnormal glucose tolerance ranging from a 40% greater risk in adults with IGT to a 110% greater risk in adults with clinically evident diabetes. These associations were independent of established cardiovascular disease risk factors.