目的:了解新筛查糖尿病(D M)人的血糖情况。方法:应用A dvantageⅡ血糖仪对以前未诊断为D M的1702人进行75g O G TT检查,分析空腹及2h血糖与D M、IG T、IFG的关系及A D A新建议的情况。结果:2h血糖≥11.1m m ol/L者占D M的91.49%,空腹...目的:了解新筛查糖尿病(D M)人的血糖情况。方法:应用A dvantageⅡ血糖仪对以前未诊断为D M的1702人进行75g O G TT检查,分析空腹及2h血糖与D M、IG T、IFG的关系及A D A新建议的情况。结果:2h血糖≥11.1m m ol/L者占D M的91.49%,空腹血糖≥7.0者占D M的45.37%、占2h血糖≥11.1m m ol/L者的40.28%。2h血糖≥11.1m m ol/L、空腹血糖≥6.11m m ol/L、空腹血糖≥5.56m m ol/L分别涵盖了91.5%、65.2%、79.6%的D M者。虽然正常空腹血糖降低后可筛查出更多的D M及IG T,但与2h血糖指标比较仍不理想。经R O C曲线分析用空腹血糖预测2h血糖≥11.1m m ol/L及D M的最佳切点都是5.78m m ol/L(104m g/dL),与A D A新建议的正常值<5.56m m ol/L(100m g/dL)基本相符。将IFG标准降低有利于D M的预防,将IFG与IG T统称为糖尿病前期可减少一些交叉和混乱,但又会出现新的问题。结论:依靠2h血糖与空腹血糖诊断D M差异显著,应加强O G TT检测。展开更多
Aims: Contemporary data on the incidence of unrecognized myocardial infarction(MI) among subjects aged 55 and older are limited. Methods and results: We studied the incidence of recognized and unrecognized MI in the R...Aims: Contemporary data on the incidence of unrecognized myocardial infarction(MI) among subjects aged 55 and older are limited. Methods and results: We studied the incidence of recognized and unrecognized MI in the Rotterdam Study, a population-based cohort of men and women aged 55 and older. The baseline examination was performed during 1990-93, with follow-up examinations during 1994- 95, and 1997-2000. Baseline and follow-up 12-lead ECGs were analysed by the Modular ECG Analysis System. The 5148 participants who had no evidence of prevalent infarction were the subjects for analysis. Incident recognized infarction was defined as the occurrence of a fatal or non-fatal event coded as 121 according to the International Classification of Diseases, 10th edition. A repeat ECG was available in 4187 subjects. An unrecognized infarction was considered to have occurred if there was electrocardiographic evidence in the absence of a clinically recognized event. During a median follow-up of 6.4 years, 141 incident recognized infarctions occurred and the incidence rate of this event was 5.0 per 1000 person years. The incidence was higher in men(8.4) than in women(3.1). The incidence rate of unrecognized infarction was 3.8 per 1000 person years. Men(4.2) and women(3.6) had approximately similar incidence. Hence, the proportion of unrecognized infarction was lower in men(33% ) than in women(54% ). This difference in proportion of unrecognized infarctions was independent of age. Conclusion: A high proportion of incident MIs remains clinically unrecognized. As a history of MI is associated with an increased risk of repeat cardiovascular complications, our data suggest a need for periodical electrocardiographic screening to recognize(prevalent) infarctions and to install effective preventive treatment in those aged 55 and older.展开更多
文摘目的:了解新筛查糖尿病(D M)人的血糖情况。方法:应用A dvantageⅡ血糖仪对以前未诊断为D M的1702人进行75g O G TT检查,分析空腹及2h血糖与D M、IG T、IFG的关系及A D A新建议的情况。结果:2h血糖≥11.1m m ol/L者占D M的91.49%,空腹血糖≥7.0者占D M的45.37%、占2h血糖≥11.1m m ol/L者的40.28%。2h血糖≥11.1m m ol/L、空腹血糖≥6.11m m ol/L、空腹血糖≥5.56m m ol/L分别涵盖了91.5%、65.2%、79.6%的D M者。虽然正常空腹血糖降低后可筛查出更多的D M及IG T,但与2h血糖指标比较仍不理想。经R O C曲线分析用空腹血糖预测2h血糖≥11.1m m ol/L及D M的最佳切点都是5.78m m ol/L(104m g/dL),与A D A新建议的正常值<5.56m m ol/L(100m g/dL)基本相符。将IFG标准降低有利于D M的预防,将IFG与IG T统称为糖尿病前期可减少一些交叉和混乱,但又会出现新的问题。结论:依靠2h血糖与空腹血糖诊断D M差异显著,应加强O G TT检测。
文摘Aims: Contemporary data on the incidence of unrecognized myocardial infarction(MI) among subjects aged 55 and older are limited. Methods and results: We studied the incidence of recognized and unrecognized MI in the Rotterdam Study, a population-based cohort of men and women aged 55 and older. The baseline examination was performed during 1990-93, with follow-up examinations during 1994- 95, and 1997-2000. Baseline and follow-up 12-lead ECGs were analysed by the Modular ECG Analysis System. The 5148 participants who had no evidence of prevalent infarction were the subjects for analysis. Incident recognized infarction was defined as the occurrence of a fatal or non-fatal event coded as 121 according to the International Classification of Diseases, 10th edition. A repeat ECG was available in 4187 subjects. An unrecognized infarction was considered to have occurred if there was electrocardiographic evidence in the absence of a clinically recognized event. During a median follow-up of 6.4 years, 141 incident recognized infarctions occurred and the incidence rate of this event was 5.0 per 1000 person years. The incidence was higher in men(8.4) than in women(3.1). The incidence rate of unrecognized infarction was 3.8 per 1000 person years. Men(4.2) and women(3.6) had approximately similar incidence. Hence, the proportion of unrecognized infarction was lower in men(33% ) than in women(54% ). This difference in proportion of unrecognized infarctions was independent of age. Conclusion: A high proportion of incident MIs remains clinically unrecognized. As a history of MI is associated with an increased risk of repeat cardiovascular complications, our data suggest a need for periodical electrocardiographic screening to recognize(prevalent) infarctions and to install effective preventive treatment in those aged 55 and older.