Stroke:血糖与脑出血风险成J形曲线关系

2018-01-02 卢芳 中国循环杂志

开滦研究的一项最新分析显示,长期空腹血糖升高,或空腹血糖低于4 mmol/L,均会增加脑出血风险。


开滦研究的一项最新分析显示,长期空腹血糖升高,或空腹血糖低于4 mmol/L,均会增加脑出血风险。
 
研究发现,空腹血糖在5.3 mmol/L时,脑出血风险最低。
 

图1 不同空腹血糖水平的脑出血风险
 
研究显示,与正常空腹血糖4-5.59 mmol/L相比,在糖尿病患者或空腹血糖≥7 mmol/L时,脑出血风险增加59%;空腹血糖在6.10-6.99 mmol/L时,即出现糖耐量受损时,脑出血风险增加31%。
 
而且这一结果在排除使用降糖药,阿司匹林,抗高血压药或抗凝剂的受试者,和随访前两年发生脑出血的患者后,依然如此。
 
而且,与男性相比,空腹血糖升高对女性的脑出血风险影响更为显著。
 
此外,空腹血糖<4 mmol/L时,也会增加2.04倍的脑出血风险。
 
该研究共纳入开滦研究中96110位无心血管病及癌症的受试者,在2006-2015年试验期间,随访了817531人-年,共发生755例脑出血。
 
原始出处: 

JinC, Li G, Rexrode KM, et al. Prospective Study of Fasting Blood Glucose and Intracerebral Hemorrhagic Risk. Stroke. 2018 Jan;49(1):27-33.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=275070, encodeId=b9162e507003, content=血糖高和血糖低者基线血压任何?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ad162150, createdName=tjdsyyzg, createdTime=Wed Jan 03 14:21:16 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=275069, encodeId=64bc2e506950, content=糖尿病脑出血的主要原因可以还是血压没有控制好吧?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ad162150, createdName=tjdsyyzg, createdTime=Wed Jan 03 14:19:33 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=274835, encodeId=19f12e483511, content=王拥军教授开滦研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Tue Jan 02 20:55:46 CST 2018, time=2018-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=274828, encodeId=c27e2e4828cb, content=谢谢分享. , beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Jan 02 20:35:30 CST 2018, time=2018-01-02, status=1, ipAttribution=)]
    2018-01-03 tjdsyyzg

    血糖高和血糖低者基线血压任何?

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=275070, encodeId=b9162e507003, content=血糖高和血糖低者基线血压任何?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ad162150, createdName=tjdsyyzg, createdTime=Wed Jan 03 14:21:16 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=275069, encodeId=64bc2e506950, content=糖尿病脑出血的主要原因可以还是血压没有控制好吧?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ad162150, createdName=tjdsyyzg, createdTime=Wed Jan 03 14:19:33 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=274835, encodeId=19f12e483511, content=王拥军教授开滦研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Tue Jan 02 20:55:46 CST 2018, time=2018-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=274828, encodeId=c27e2e4828cb, content=谢谢分享. , beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Jan 02 20:35:30 CST 2018, time=2018-01-02, status=1, ipAttribution=)]
    2018-01-03 tjdsyyzg

    糖尿病脑出血的主要原因可以还是血压没有控制好吧?

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=275070, encodeId=b9162e507003, content=血糖高和血糖低者基线血压任何?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ad162150, createdName=tjdsyyzg, createdTime=Wed Jan 03 14:21:16 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=275069, encodeId=64bc2e506950, content=糖尿病脑出血的主要原因可以还是血压没有控制好吧?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ad162150, createdName=tjdsyyzg, createdTime=Wed Jan 03 14:19:33 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=274835, encodeId=19f12e483511, content=王拥军教授开滦研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Tue Jan 02 20:55:46 CST 2018, time=2018-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=274828, encodeId=c27e2e4828cb, content=谢谢分享. , beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Jan 02 20:35:30 CST 2018, time=2018-01-02, status=1, ipAttribution=)]
    2018-01-02 lovetcm

    王拥军教授开滦研究

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=275070, encodeId=b9162e507003, content=血糖高和血糖低者基线血压任何?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ad162150, createdName=tjdsyyzg, createdTime=Wed Jan 03 14:21:16 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=275069, encodeId=64bc2e506950, content=糖尿病脑出血的主要原因可以还是血压没有控制好吧?, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ad162150, createdName=tjdsyyzg, createdTime=Wed Jan 03 14:19:33 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=274835, encodeId=19f12e483511, content=王拥军教授开滦研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Tue Jan 02 20:55:46 CST 2018, time=2018-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=274828, encodeId=c27e2e4828cb, content=谢谢分享. , beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Jan 02 20:35:30 CST 2018, time=2018-01-02, status=1, ipAttribution=)]
    2018-01-02 doctorJiangchao

    谢谢分享.

    0

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