摘要
目的探讨总代谢评分对北京社区老年2型糖尿病(T2DM)患者脑血管事件发生的预测作用。方法2008年北京社区糖尿病研究(BCDS)共纳入15个社区老年T2DM患者。在BCDS中,2132例老年T2DM患者随访有完整的筛查数据,包括血糖、血压、血脂,并赋予各指标代谢评分,将随访期间所有代谢评分汇总为总代谢评分(TMS)。根据患者的TMS,将患者分为4组:低评分(TMS≤28.0分)组、中评分(>28.0~32.5分)组、高评分(>32.5~37.5分)组和极高评分(TMS>37.5分)组。评估老年T2DM的TMS与脑血管事件发生关系。采用EpiData3.0软件建立BCDS专用数据库。使用SAS 9.1软件进行统计分析,采用Cox回归模型分析影响老年T2DM脑血管事件发生的危险因素。使用Kaplan-Meier生存分析方法计算随访期间脑血管事件的累积发生风险并进行log-rank检验。结果入组时,单因素方差分析结果显示,4组患者年龄差异无统计学意义(P>0.05);极高评分组患者的血压、空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA1c)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)水平均显著高于低评分组、中评分组及高评分组(均P<0.05),血尿酸水平明显低于其他3组(均P<0.05);极高评分组接受抗血小板聚集治疗的患者比例为51.09%(257/503),明显低于低评分组[62.41%(332/532)]。随访结束时,极高评分组患者的血压水平显著高于低评分组(均P<0.05);极高评分组中空腹血糖、餐后2 h血糖、HbA1c均显著高于低评分组、中评分组及高评分组(均P<0.05);极高评分组的LDL-C水平均显著高于低评分组、中评分组及高评分组(均P<0.05)。在8年的随访中,共发生78例脑血管事件,其中急性脑出血18例,伴有肢体活动障碍的急性脑梗死46例,短暂脑缺血发作14例。极高评分组脑血管事件发生率[5.8%(29/503)]显著高于低评分组[2.6%(14/532),P=0.031]。log-rank检验结果显示,极高评分组与低评分组脑血管事件累�
Objective To explore the predictive effect of the total metabolic scores for cerebrovascular events in elderly type 2-diabetes(T2DM)in Beijing community.Methods A total of 15 communities of elderly T2DM were enrolled in Beijing Community Diabetes Study(BCDS)from 2008.All 2132 elderly T2DM in BCDS had complete screening data during the follow-up,including blood glucose,blood pressure,lipid profiles,which each index assigned metabolic score,and all metabolic scores during the follow-up were added up to the total metabolic score(TMS).According to the TMS,the patients were divided into four groups:low(TMS≤28.0),medium(>28.0-32.5),high(>32.5-37.5)and extremely high(TMS>37.5).The relationship between TMS and cerebrovascular events in elderly T2DM was explored.EpiData3.0 software was used to establish a special BCDS database.SAS 9.1 software was used for statistical analysis,and Cox regression model was used to analyze the risk factors affecting the occurrence of cerebrovascular events in elderly patients with T2DM.Kaplan-Meier survival analysis was used to calculate the cumulative incidence of cerebrovascular events during follow-up and log-rank test was performed.Results For baseline characteristics,there was no significant difference in age among the four groups(P>0.05).The blood pressure,fasting blood glucose(FPG),2 hours postprandial blood glucose,glycosylated hemoglobin(HbA1c),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),triglycerides(TG)levels in extremely high TMS group were significantly higher than those in low,medium and high TMS group(all P<0.05),while the serum uric acid level was lower than the other groups(all P<0.05).The proportion of patients receiving anti-platelet therapy in extremely high TMS group was 51.09%(257/503),which was significantly lower than that in low TMS group(62.41%[332/532]).At the end of follow-up,blood pressure levels in extremely high TMS group were significantly higher than those in low TMS group(all P<0.05).The levels of FPG,2 hours postprandial blood glucos
作者
张雪莲
袁申元
万钢
袁明霞
杨光燃
傅汉菁
朱良湘
北京社区糖尿病研究课题组
Zhang Xuelian;Yuan Shenyuan;Wan Gang;Yuan Mingxia;Yang Guangran;Fu Hanjing;Zhu Liangxiang(Beijing Community Diabetes Study Group.Department of Endocrinology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2021年第6期361-370,共10页
Chinese Journal of Cerebrovascular Diseases
基金
首都卫生发展科研专项(首发2011-2005-01、首发2016-1-2057)
首都临床特色应用研究项目(Z151100004015021)。
关键词
脑血管事件
总代谢评分
老年
2型糖尿病
Cerebrovascular events
Total metabolic score
Elderly
Type 2 diabetes
