累积空腹血糖暴露与全因死亡的关系  

The relationship between cumulative fasting blood glucose exposure and all-cause mortality

作　　者：刘婷婷[1] 王希柱[1] 宋巧凤[1] 刘爱娟[2] 杜悦 吴寿岭[4] Liu Tingting;Wang Xizhu;Song Qiaofeng;Liu Aijuan;Du Yue;Wu Shouling(Department of Cardiology,Tangshan People′s Hospital,Tangshan 063000,China;Office of Doctor-patient Relationship,Tangshan People′s Hospital,Tangshan 063000,China;Medical Record Management Division,Tangshan People′s Hospital,Tangshan 063000,China;Department of Cardiology,Kailuan Hospital,Tangshan 063000,China)

机构地区：[1]唐山市人民医院心内科,063000 [2]唐山市人民医院医患办,063000 [3]唐山市人民医院病案管理科,063000 [4]开滦总医院心内科

出　　处：《中华内分泌代谢杂志》2022年第1期7-13,共7页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的探讨累积空腹血糖(cumFPG)暴露与全因死亡的关系。方法采用前瞻性队列研究方法,以连续参加2006—2007、2008—2009、2010—2011年度健康体检且资料完整的开滦集团56845名职工为观察对象,平均随访7.77年,以发生全因死亡为终点事件。按cumFPG四分位分组,比较各组全因死亡发生密度的差异;采用Cox比例风险模型和自然样条函数分析cumFPG对全因死亡的影响。结果平均随访(7.77±1.05)年,全因死亡发生密度随cumFPG增加呈上升趋势(分别为4.93/千人年、5.87/千人年、8.48/千人年、14.02/千人年),经Log-rank检验,差异有统计学意义(P<0.001)。Cox比例风险模型显示,校正年龄、性别、体重指数、高血压、基线空腹血糖等混杂因素,与Q1组比较,Q4组发生全因死亡的HR(95%CI)为1.28(1.15~1.42),cumFPG每增加1个标准差,发生全因死亡的风险增加17%。自然样条函数分析显示cumFPG与全因死亡风险呈现类似J形曲线关系。结论高cumFPG是发生全因死亡的危险因素。Objective To investigate the relationship between cumulative fasting blood glucose(cumFPG)exposure and all-cause mortality.Methods The prospective cohort study included 56845 subjects of Kailuan Group who participated in physical examinations from 2006 to 2007,2008 to 2009,and 2010 to 2011 with complete data and a median of 7.77 years of follow up.The end point event was all-cause mortality.The incidence of all-cause mortality was compared in various groups divided by four quartile of cumFPG.The Cox proportional hazards model and natural spline were used to analyze the effect of cumFPG on all-cause mortality.Results During the average(7.77±1.05)years of follow-up,the incidence density of all-cause mortality was on the rise with the increase of cumFPG(4.93,5.87,8.48,and 14.02 per 1000 person-years),with statistically significant difference by Log-rank test(P<0.001).Cox proportional hazards model showed that after adjusting for potential confounding factors(age,sex,body mass index,hypertension,baseline fasting plasma glucose),the HR value(95%CI)of all-cause mortality in the fourth quartile group was 1.28(1.15-1.42)compared to the first quartile.When cumFPG increased every standard deviation,the risk of all-cause mortality increased by 17%.Natural spline analysis exhibited a similar J curve relationship between cumFPG and all-cause mortality.Conclusion High cumFPG is a risk factor of all-cause mortality.

关 键 词：累积空腹血糖 全因死亡 危险因素 

分 类 号：R195[医药卫生—卫生统计学]