Body mass index and the risk of total and cardiovascular mortality among patients with type 2 diabetes: a large prospective study in Ukraine
Body mass index and the risk of total and cardiovascular mortality among patients with type 2 diabetes: a large prospective study in Ukraine
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DOI：
10.1136/hrt.2008.150524
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发表时间：
2009-03-01
期刊：
影响因子：
5.7
通讯作者：
Hu, G.
中科院分区：
文献类型：
--
作者：
Khalangot, M.;Tronko, M.;Hu, G.
背景资料：一些前瞻性研究评估了2型糖尿病患者的体重指数（BMI）与心血管死亡率之间的关系，但结果存在争议。目的：探讨不同BMI分布与糖尿病患者总死亡率和心血管死亡率之间的关系。这项研究共纳入了30534名乌克兰男性和58909名来自全国人口糖尿病登记的2型糖尿病女性。在平均2.7年的随访中，记录了7804例死亡，其中3320例死于心血管疾病。在对年龄、吸烟和饮酒进行调整后，（< 23、23-24.9、25-29.9（参照组）、30-34.9和>= 35 kg/m2）的糖尿病男性的平均体重为1.57（95% CI 1.42 - 1.74），1.16（1.05至1.28）、1.0、1.01（0.91至1.12）和1.24心血管死亡率分别为1.67（95% CI 1.42 ~ 1.95）、1.30（1.12 ~ 1.51）、1.0、1.13（0.96 ~ 1.34）和1.54（1.16 ~ 2.05）。女性糖尿病患者的风险比为1.34（95% CI 1.22 - 1.47），1.00（0.91至1.10）、1.0、1.04（0.97至1.12）和1.27总死亡率为1.14 ~ 1.41，心血管死亡率为1.36（95%CI 1.18 ~ 1.57）、1.06（0.92 ~ 1.21）、1.0、1.12（1.01 ~ 1.25）和1.35（1.15 ~ 1.59）。收缩压，总胆固醇，心血管疾病史，糖尿病治疗和糖尿病持续时间的额外调整影响results.Conclusions：这项研究表明，在糖尿病男性和女性之间的BMI和总的和心血管疾病的死亡率之间的U形关联。
Background: Several prospective studies have evaluated the association between body mass index (BMI) and cardiovascular mortality among patients with type 2 diabetes; however, the results are controversial.Objective: To investigate the association of different BMI distributions with total and cardiovascular mortality among diabetic patients.Methods: A total of 30 534 Ukrainian men and 58 909 women with type 2 diabetes from the nationwide population-based diabetes register were included in this study.Results: During a mean follow-up of 2.7 years, 7804 deaths were recorded, of which 3320 were due to cardiovascular disease. After adjustment for age, smoking and alcohol drinking, the hazard ratios across the five BMI categories (< 23, 23-24.9, 25-29.9 (reference group), 30-34.9 and >= 35 kg/m(2)) among diabetic men were 1.57 (95% CI 1.42 to 1.74), 1.16 (1.05 to 1.28), 1.0, 1.01 (0.91 to 1.12) and 1.24 (1.02 to 1.50) for total mortality, and 1.67 (95% CI 1.42 to 1.95), 1.30 (1.12 to 1.51), 1.0, 1.13 (0.96 to 1.34) and 1.54 (1.16 to 2.05) for cardiovascular mortality, respectively. The respective hazard ratios among diabetic women were 1.34 (95% CI 1.22 to 1.47), 1.00 (0.91 to 1.10), 1.0, 1.04 (0.97 to 1.12) and 1.27 (1.14 to 1.41) for total mortality, and 1.36 (95% CI 1.18 to 1.57), 1.06 (0.92 to 1.21), 1.0, 1.12 (1.01 to 1.25) and 1.35 (1.15 to 1.59) for cardiovascular mortality. Additional adjustment for systolic blood pressure, total cholesterol, history of cardiovascular disease, diabetes treatments and duration of diabetes affected the results only slightly.Conclusions: This study indicated a U-shaped association between BMI and total and cardiovascular mortality among diabetic men and women.