摘要
目的 调查北京地区某老年糖尿病男性人群代谢异常患病情况,探讨其与全因死亡及心血管死亡的关系.方法 对681例从1997年6月至1999年6月开始于解放军总医院接受年度健康体检的老年糖尿病男性（65～99岁）作为基线人群进行10年随访研究.Cox比例风险模型用于多因素分析,累积生存率估计采用Kaplan-Meier法,生存率比较采用Log-rank检验.结果 681例老年糖尿病男性患者,随访10年间因各种原因死亡208例,其中心脑血管疾病死亡70例,占总死亡人数的33.7%,仅次于恶性肿瘤的38.5%.Cox风险比例模型多因素分析结果显示与老年男性全因死亡独立相关的危险因素有年龄[相对危险度（RR）=1.099,95%CI 1.076～1.123]、脉压差（RR=1.009,95%CI 1.001～1.017）、餐后血糖（RR=1.115,95%CI 1.075～1.157）、甘油三酯（RR=0.683,95%CI 0.539～0.865）及高密度脂蛋白胆固醇（RR=0.444,95%CI 0.257～0.766）;与心脑血管疾病死亡率独立相关的危险因素有年龄（RR=1.112,95%CI 1.070～1.155）、餐后血糖（RR=1.278,95%CI 1.170～1.396）及收缩压（RR=1.013,95%CI 1.002～1.024）.糖尿病合并高血压、代谢综合征心脑血管疾病死亡累积生存率显著低（P＜0.05）.结论 心脑血管疾病死亡是老年糖尿病男性主要的死亡原因.年龄增长、餐后血糖水平升高是全因死亡及心脑血管疾病死亡的危险因素,脉压差增大及甘油三酯、高密度脂蛋白胆固醇水平降低增加全因死亡风险.糖尿病合并高血压、代谢综合征心脑血管死亡风险显著增加.
Objective To explore the relationship between metabolic diseases and death from all causes and cardiovascular diseases （CVD） in elderly male diabetics. Methods A total of 681 elderly male diabetics were recruited from June 1997 to June 1999 and followed up for 10 years. All underwent regular check-ups in PLA General Hospital each year. The Cox proportional hazards model was applied to the multivariate survival analysis for all-cause and CVD mortality. And the cumulative survival rates were calculated by Kaplan-Meier method and log-rank test was used to compare the survival rates. Results During a 10-year follow-up, 208 subjects died, including 70 deaths from CVD. Multivariate Cox regression analysis showed that age [relative risk （RR） = 1. 099, 95% confidence interval （C I）1. 076- 1. 123], pulse pressure（RR = 1. 009, 95% CI 1. 001 - 1. 017 ）, elevated postprandial glucose level （ RR = 1. 115, 95% CI 1. 075 - 1. 157 ） and lower triglyceride （ RR = 0. 683, 95% CI O. 539 - 0. 865 ） and high-density lipoprotein cholesterol（RR = 0. 444, 95 % CI O. 257 - 0. 766） increased the risks of all-cause mortality while age（RR = 1.112, 95% CI 1. 070 - 1. 155 ）, elevated postprandial glucose level （RR = 1. 278, 95% CI 1. 170 - 1. 396） and systolic blood pressure （RR = 1. 013, 95% CI 1. 002 - 1. 024） increased the risks of CVD mortality. The cumulative survival rates from CVD mortality in diabetics with metabolic syndrome were significantly lower compared with those with diabetes only （P 〈 0. 01 ）. Conclusion CVD remains a main cause of death for Chinese elderly male diabetics. Advanced age and elevated postprandial glucose level are risk factors of all-cause and CVD mortality. Diabetes mellitus with concurrent hypertension or metabolic syndrome is associated with an increased risk of CVD death.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第8期591-595,共5页
National Medical Journal of China
关键词
老年人
糖尿病
2型
代谢疾病
死亡
危险因素
Aged
Diabetes mellitus,type 2
Metabolic diseases
Death
Risk factors
