Hyperglycaemia is associated with all-cause and cardiovascular mortality in the Hoorn population:: the Hoorn Study
Hyperglycaemia is associated with all-cause and cardiovascular mortality in the Hoorn population:: the Hoorn Study
复制标题
DOI：
10.1007/s001250051249
复制
发表时间：
1999-08-01
期刊：
影响因子：
8.2
通讯作者：
Heine, RJ
中科院分区：
文献类型：
--
作者：
de Vegt, F;Dekker, JM;Heine, RJ
目标/假设。血糖程度已被证明与糖尿病受试者的全因死亡率和心血管死亡率相关。这种关联是否也存在于普通人群中仍然存在争议。我们在 2363 名无已知糖尿病的老年（50-75 岁）受试者的人群队列中研究了空腹血糖、负荷后 2 小时血糖和 HbA(1c) 的预测价值。方法。全因死亡率和心血管死亡率的相对风险 (RR) 通过 Cox 比例风险模型进行估计，并根据年龄和性别进行调整？另外还针对已知的心血管危险因素。结果。在 8 年的随访期间，185 名受试者死亡； 98 心血管原因。空腹血糖只能预测糖尿病范围，但风险在大约 6.1 mmol/l 时开始增加。即使在非糖尿病范围内，负荷后血糖和 HbA(1c) 值也与风险增加相关（线性趋势 p < 0.05）。这些增加的风险主要但不完全归因于已知的心血管危险因素。排除新诊断的糖尿病或既往患有心血管疾病的受试者 (n = 551) 后，负荷后血糖增加 5.8mmol/l（对应于人群分布的两个标准差）与较高的年龄调整和性别调整全因风险 (RR 2.24) 和心血管死亡率 (RR 3.40) (p < 0.05) 相关。在对已知的心血管危险因素进行额外调整后，这些相对风险仅仍然具有统计学意义，分别为 2.20 和 3.00 (p < 0.05)。结论/解释。高血糖变量，尤其是负荷后 2 小时葡萄糖浓度和较小程度的 HbA(1c) 值，表明在没有已知糖尿病的一般人群中存在全因死亡和心血管死亡的风险。
Aims/hypothesis. The degree of glycaemia has been shown to be associated with all-cause and cardiovascular mortality in diabetic subjects. Whether this association also exists in the general population is still controversial. We studied the predictive value of fasting plasma glucose, 2-hour post-load glucose and HbA(1c) in a population-based cohort of 2363 older (50-75 years) subjects, without known diabetes.Methods. Relative risks (RR) of all-cause and cardiovascular mortality were estimated by Cox proportional hazards model, adjusting for age and sex? and additionally for known cardiovascular risk factors.Results. During 8 years of follow-up, 185 subjects died; 98 of cardiovascular causes. Fasting plasma glucose was only predictive in the diabetic range, although the risks started to increase at about 6.1 mmol/l. Postload glucose and HbA(1c) values were, even within the non-diabetic range, associated with an increased risk (p for linear trend < 0.05). These increased risks were mostly but not completely, attributable to known cardiovascular risk factors. After exclusion of subjects with newly diagnosed diabetes or with pre-existent cardiovascular disease (n = 551), a 5.8mmol/l increase of post-load glucose (corresponding to two standard deviations of the population distribution) was associated with a higher age-adjusted and sex-adjusted risk of all-cause (RR 2.24) and cardiovascular mortality (RR 3.40) (p < 0.05), After additional adjustment for known cardiovascular risk factors, these relative risks mere still statistically significant, with values of 2.20 and 3.00 respectively (p < 0.05).Conclusions/interpretations. High glycaemic variables, especially 2-h post-load glucose concentrations and to a lesser extent HbA(1c) values, indicate a risk of all-cause and cardiovascular mortality in a general population without known diabetes.