Diabetes mellitus: a risk factor for ischemic stroke in a large biracial population.
Diabetes mellitus: a risk factor for ischemic stroke in a large biracial population.
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DOI：
10.1161/strokeaha.113.001318
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发表时间：
2013-06
期刊：
影响因子：
8.3
通讯作者：
Kissela BM
中科院分区：
文献类型：
--
作者：
Khoury JC;Kleindorfer D;Alwell K;Moomaw CJ;Woo D;Adeoye O;Flaherty ML;Khatri P;Ferioli S;Broderick JP;Kissela BM
我们以前曾报道过，在黑人和白人糖尿病患者中，缺血性卒中的发病率均增加，尤其是在<55岁的患者中。随着过去十年糖尿病患病率的上升，我们在5年和10年后重新审视了糖尿病对同一人群（约130万）卒中发病率的影响。这是一项基于人口的研究。本分析纳入了1993年7月至1994年6月、1999年和2005年期间大辛辛那提/北方肯塔基州地区5个县≥20岁的非裔美国人和白色居民的首次缺血性卒中。根据2000年美国人群的性别、种族和年龄（如适用）调整发病率。1993/1994年、1999年和2005年首次缺血性卒中中报告的糖尿病史分别为493/1，709（28%）、522/1，778（29%）和544/1，680（33%）。非裔美国人中，有糖尿病与无糖尿病患者的卒中发生率风险比（95%CI）从1993/94年的5.6显著降低至2005年的3.2;白人的风险比在1993/94年和2005年保持稳定，为3.8。然而，风险比随年龄而变化，在20至65岁的人群中观察到的总体风险增加了5至14倍。糖尿病患者在所有年龄段，尤其是<65岁，无论种族如何，中风的风险都大大增加。1999年和2005年的发病率和风险比虽然与20世纪90年代中期的报告相似，但考虑到糖尿病和代谢综合征在美国和世界各地的流行，其意义越来越大。
We previously reported increased incidence of ischemic stroke among both blacks and whites with diabetes, especially in those <55 years old. With rising prevalence of diabetes in the last decade, we revisit the impact of diabetes on stroke incidence in the same population (~1.3 million) 5 and 10 years later. This is a population-based study. First ischemic strokes among African American and white residents of the 5-county Greater Cincinnati/Northern Kentucky region, ≥20 years old, for periods 7/1993 to 6/1994, 1999, and 2005, were included in this analysis. Incidence rates were adjusted for gender, race and age, as appropriate, to the 2000 US population. History of diabetes among first ischemic strokes was reported for 493/1,709 (28%) in 1993/94, 522/1,778 (29%) in 1999, and 544/1,680 (33%) in 2005. Risk ratios (95% CI) for rates of stroke in those with versus without diabetes for African Americans reduced significantly from 5.6 in 1993/94 to 3.2 in 2005; for whites the risk ratio remained stable at 3.8 in 1993/94 and 2005. However, risk ratios varied with age, with an overall 5- to 14-fold increased risk observed in those 20 to 65 years old. Those with diabetes remain at greatly increased risk for stroke at all ages, especially <65 years, regardless of race. The rates and risk ratios for 1999 and 2005, while similar to those previously reported for the mid-1990s, take on increased significance, given the epidemic of diabetes and metabolic syndrome throughout the US and the world.