糖尿病人群空腹血糖水平与新发脑梗死事件的相关性研究  

The relationship between fasting plasma glucose level and first cerebral infarction event in the population with diabetes

作　　者：周艳茹[1] 刘秀荣[2] 吴寿岭[3] 王丽晔[2] 闫秀纵[4] 刘业强[1] 曹正新[2] 史丽萍[1] 

机构地区：[1]华北煤炭医学院附属开滦医院内分泌科,唐山063000 [2]华北煤炭医学院附属开滦医院体检中心,唐山063000 [3]华北煤炭医学院附属开滦医院心内科,唐山063000 [4]华北煤炭医学院附属开滦医院ICU,唐山063000

出　　处：《中华内分泌代谢杂志》2012年第4期282-285,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的探讨糖尿病人群空腹血糖水平与新发脑梗死事件的相关性。方法采用前瞻性队列研究方法，以空腹血糖t〉7．0mmol／L或〈7．0mmol／L但已确诊为糖尿病、正在使用降糖药物的8306例糖尿人群作为观察队列，随访（48．01±3．14）个月，随访期间每半年收集一次新发脑梗死事件情况。分析糖尿病人群空腹血糖水平与新发脑梗死事件的相关性。结果（1）随访结束时，随着基线空腹血糖水平的增高，研究对象的总胆固醇、甘油三酯的水平逐渐增高[总胆固醇：（4．93±1．15，5．10±1．20，5．15±1．28，5．33±1．35）mmol／L，甘油三酯：（1．70±1．26，1．83±1．29，2．18±1．76，2．41±2．08）mmol／L，P〈O．05]；低密度脂蛋白胆固醇、收缩压、舒张压、体重指数的水平也增高（P〈O．05）。（2）7．0mmol／L≤空腹血糖〈9．0mmol／L组累积发生脑梗死事件率最低（2．1％，P〈O．01）。校正年龄、性别、收缩压、舒张压、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、体重指数、吸烟、糖尿病病程及降糖治疗因素，Cox比例风险回归分析表明，相对于7．0mmol／L≤空腹血糖〈9．0mmol／L组，6．1mmoL／L≤空腹血糖〈7．0mmol／L组和空腹血糖t〉9mmol／L两组发生脑梗死事件的相对危险（RR）各分别增加1．85倍（95％CI1．09～3．15，P〈O．05）、1．54倍（95％C11．16～2．05，P〈O．01）。结论糖尿病人群空腹血糖控制在7．0—9．0mmol／L水平者似新发生脑梗死事件率最低。Objective To study the relationship between fasting plasma glucose （FPG） level and the first cerebral infarction event in the population with diabetes. Methods This was a prospective cohort study. 8 306 diabetic subjects who determined FPG ≥ 7.0 mmol/L or treated with insulin or hypoglycemic drugs and FPG 〈7.0 mmol/L as the observation population and were followed-up for （48. 01 ± 3.14） months. During the course, cerebral infarction events were determined every 6 months. Results （ 1 ） By the end of following-up, with the increasing levels of the baseline FPG, the total cholesterol （ TC ）, triglyceride （TG） levels were gradually increased in the diabetic population, the differences were significant [ TC ： （4.93 ± 1.15,5.10 ±1.20,5.15 ± 1.28,5.33 ± 1.35 ） mmol/L, TG： （ 1.70 ± 1.26,1.83 ± 1.29,2.18 ± 1.76,2.41 ±2.08 ） mmol/L, P〈0.05 ] ;the plasma low density lipoprotein- cholesterol （ LDL-C ） , systolic blood pressure （SBP） , diastolic blood pressure （ DBP）, and body mass index （ B MI ） levels were also increased significantly （ P〈O. 05 ）. （ 2 ） The incidence of cerebral infarction event in the group of patients with 7. 0 mmol/L ≤ FPG 〈 9. 0 mmol/L was the lowest, the differences were significant （ 2. 1%, P 〈 0. O1 ）. Compared with the group of 7.0 mmol/L≤ FPG〈9.0 mmol/L, after adjusting for age, sex, BMI, SBP, DBP, TC, TG, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol, smoking, diabetic duration and treatment, the relative risk for cerebral infarction events were 1.85 （ 95 % CI 1.09-3.15, P〈O. 05 ） and 1.54 （ 95% CI 1.16-2.05, P 〈 O. 01 ） for those groups with 6. 1 mmol/L ≤ FPG 〈 7. 0 mmol/L and FPG ≥ 9. 0 mmoL/L respectively. Conclusion The risk of new in cidence of cerebral infarction events seems to be the lowest in the group of diabetic patients whose FPGs are wihin 7.0-9.0 mmol/L range.

关 键 词：空腹血糖 糖尿病 脑梗死 

分 类 号：R587.1[医药卫生—内分泌]