GHb level and subsequent mortality among adults in the U.S.
GHb level and subsequent mortality among adults in the U.S.
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DOI：
10.2337/dc09-0117
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发表时间：
2009-08
期刊：
影响因子：
16.2
通讯作者：
Gregg E
中科院分区：
文献类型：
--
作者：
Saydah S;Tao M;Imperatore G;Gregg E
在具有全国代表性的成人样本中，研究以糖化血红蛋白（GHb）衡量的高血糖与后续死亡率之间的关联。
我们纳入了年龄≥20岁的成年人，他们参与了第三次全国健康和营养检查调查（1988 - 1994年），并且拥有完整信息，包括通过自我报告确定的基线糖尿病状况以及测量的糖化血红蛋白（n = 19025），并随访至2000年底以确定死亡率。
在总体人群中，较高水平的糖化血红蛋白与全因死亡、心脏病死亡和癌症死亡的风险增加相关。在对潜在风险因素进行调整后，糖化血红蛋白≥8%的成年人与糖化血红蛋白<6%的成年人相比，全因死亡率的相对危险度（RH）为2.59（95%置信区间1.88 - 3.56），心脏病死亡率为3.38（1.98 - 5.77），癌症死亡率为2.64（1.17 - 5.97）。在已确诊糖尿病的成年人中，糖化血红蛋白≥8%与糖化血红蛋白<6%相比，全因死亡率（RH 1.68，95%置信区间1.03 - 2.74）和心脏病死亡率（2.48，1.09 - 5.64）更高，但癌症死亡率与糖化血红蛋白类别无关。在未确诊糖尿病的成年人中，全因死亡率、心脏病死亡率或癌症死亡率与糖化血红蛋白类别之间无显著关联。
这些结果强调了糖化血红蛋白水平在具有和未具有确诊糖尿病的全国代表性成人样本中对死亡风险的重要性，并表明在糖尿病成年人中，较高水平与死亡率增加相关。
To examine the association of hyperglycemia, as measured by GHb, with subsequent mortality in a nationally representative sample of adults. We included adults aged ≥20 years who participated in Third National Health and Nutrition Examination Survey (1988–1994) and had complete information, including baseline diabetes status by self-report and measured GHb (n = 19,025) and follow-up through the end of 2000 for mortality. In the overall population, higher levels of GHb were associated with increased risk of mortality from all causes, heart disease, and cancer. After adjustment for potential risk factors, the relative hazard (RH) for adults with GHb ≥8% compared with adults with GHb <6% was 2.59 (95% CI 1.88–3.56) for all-cause mortality, 3.38 (1.98–5.77) for heart disease mortality, and 2.64 (1.17–5.97) for cancer mortality. Among adults with diagnosed diabetes, having GHb ≥8% compared with GHb <6% was associated with higher all-cause mortality (RH 1.68, 95% CI 1.03–2.74) and heart disease mortality (2.48, 1.09–5.64), but there was no increased risk of cancer mortality by GHb category. Among adults without diagnosed diabetes, there was no significant association of all-cause, heart disease, or cancer mortality and GHb category. These results highlight the importance of GHb levels in mortality risk among a nationally representative sample of adults with and without diagnosed diabetes and indicate that higher levels are associated with increased mortality in adults with diabetes.
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