Diabetes Care:随访血糖变异与心血管事件和全因死亡风险之间的关系

2019-01-20 xing.T MedSci原创

由此可见,FBG较高的VVV与死亡风险增加有关。该研究的数据强调了维持血糖正常和稳定血糖水平对改善临床结局的重要性。

长期血糖变异的预后价值尚不完全清楚。近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,研究人员旨在评估空腹血糖(FBG)访视变异性(VVV)对血管疾病(CVD)和死亡的影响。

研究人员进行了一项前瞻性队列分析,纳入了抗高血压和降脂治疗预防心脏病发作试验(ALLHAT)的4982名参与者,这些参与者在基线、24个月和48个月接受了访视。FBG的VVV被定义为SD或变异性,且与三次访视时获得的FBG测量值的平均值(VIM)无关。在研究的前48个月内没有CVD的参与者接受CVD事件(冠心病[CHD]、卒中和心力衰竭[HF])和全因死亡随访。

在5年的中位随访期间,共发生305例CVD事件(189例CHD,45例卒中和81例HF),154例死亡。FBG最高与最低四分位数(≥26.4 vs. <5.5)的参与者相比CVD的调整风险比(HR)为1.43(95%CI为0.93-2.19),全因死亡率为2.22(95%CI为1.22-4.04)。血管疾病的HR为1.17(95%CI为0.84-1.62),全因死亡率为1.89(95%CI为1.21-2.93)。在没有糖尿病的个体中,FBG的SD(HR为2.67 [95%CI为0.14-6.25])或VIM(HR为2.50 [95%CI为1.40-4.46])最高四分位数的个体死亡风险更高。

由此可见,FBG较高的VVV与死亡风险增加有关。该研究的数据强调了维持血糖正常和稳定血糖水平对改善临床结局的重要性。

原始出处:

Justin B. Echouffo-Tcheugui, et al.Visit-to-Visit Glycemic Variability and Risks of Cardiovascular Events and All-Cause Mortality: The ALLHAT Study.Diabetes Care.2019.https://doi.org/10.2337/dc18-1430

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血糖变异影响血糖-HbA1c线性关系

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