Diabetes Care:新发2型糖尿病患者的体重指数和死亡率相关性分析!

2018-01-04 xing.T MedSci原创

由此可见,该研究结果表明在这一领域的存在的与其他研究明显自相矛盾的发现可能受到反向因果关系的影响。长期来看,超重(BMI为25-30kg/m2)的2型糖尿病患者与对照者相比有较低的死亡率风险,而在那些BMI≥40kg/m2的患者中风险大幅增加。

2型糖尿病与肥胖密切相关,但与没有糖尿病的人相比,2型糖尿病患者体重增加相关的死亡风险尚未确定。近日,糖尿病领域权威杂志Diabetes Care上针对这一问题发表了一篇研究文章。

研究人员前瞻性地评估了从瑞典国家糖尿病登记处确定的1988年至2012年期间糖尿病病程≤5年的2型糖尿病患者短期和长期死亡率,并从一般人群中为每一名参与者匹配5名年龄和性别相当的对照者。

中位随访5.5年,149345例2型糖尿病患者(平均年龄59.6岁,40%女性)和743907名对照者中分别有17546人和68429人发生死亡。短期全因死亡率风险(≤5年)显示与BMI存在U型关系,经过多次调整后,与对照者相比,在BMI为30-35kg/m2的糖尿病患者风险比(HR)为0.81(95%可信区间(CI)为 0.75-0.88);BMI≥40 kg/m2的患者为1.37(95%CI为1.11-1.71)。长期来看,所有体重分组均显示死亡率增加,最低点在BMI为25-30kg/m2的组别,并且在BMI≥40 kg/m2的患者中HR逐步增加到2(95%CI为1.58-2.54),这在小于65岁的患者中更为明显。

由此可见,该研究结果表明在这一领域的存在的与其他研究明显自相矛盾的发现可能受到反向因果关系的影响。长期来看,超重(BMI为25-30kg/m2)的2型糖尿病患者与对照者相比有较低的死亡率风险,而在那些BMI≥40kg/m2的患者中风险大幅增加。

原始出处:

Jon Edqvist,et al. BMI and Mortality in Patients With New-Onset Type 2 Diabetes: A Comparison With Age- and Sex-Matched Control Subjects From the General Population
.Diabetes Care 2018. https://doi.org/10.2337/dc17-1309

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GetPortalCommentsPageByObjectIdResponse(id=275591, encodeId=2a522e55914d, content=继续研究!, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdgSW0vVibEHQRlKXLlvMibvcHmy5ibwM7Luib2am6ywX6FqBrXibF8k7JVEzriaOSghltmYz1nomRd6TgSp2Yj9xHGAY/0, createdBy=9b2f2045808, createdName=haige, createdTime=Fri Jan 05 06:55:36 CST 2018, time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=275498, encodeId=ddaa2e549896, content=学习一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Thu Jan 04 22:23:19 CST 2018, time=2018-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=275320, encodeId=1b412e532084, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Jan 04 08:45:26 CST 2018, time=2018-01-04, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1901919, encodeId=73a1190191942, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Mon Sep 10 21:59:00 CST 2018, time=2018-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638318, encodeId=9c53163831869, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, 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GetPortalCommentsPageByObjectIdResponse(id=275591, encodeId=2a522e55914d, content=继续研究!, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdgSW0vVibEHQRlKXLlvMibvcHmy5ibwM7Luib2am6ywX6FqBrXibF8k7JVEzriaOSghltmYz1nomRd6TgSp2Yj9xHGAY/0, createdBy=9b2f2045808, createdName=haige, createdTime=Fri Jan 05 06:55:36 CST 2018, time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=275498, encodeId=ddaa2e549896, content=学习一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Thu Jan 04 22:23:19 CST 2018, time=2018-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=275320, encodeId=1b412e532084, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Jan 04 08:45:26 CST 2018, time=2018-01-04, status=1, ipAttribution=)]
    2018-01-05 haige

    继续研究!

    0

  9. 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time=2018-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=275320, encodeId=1b412e532084, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Jan 04 08:45:26 CST 2018, time=2018-01-04, status=1, ipAttribution=)]
    2018-01-04 天地飞扬

    学习一下.谢谢分享!

    0

  10. 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time=2018-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=275320, encodeId=1b412e532084, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Jan 04 08:45:26 CST 2018, time=2018-01-04, status=1, ipAttribution=)]
    2018-01-04 龙胆草

    学习谢谢分享

    0

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肌肉发生胰岛素抵抗是2型糖尿病的典型特征之一,并且在糖尿病发生之前很长时间内就已经存在。普遍认为体育活动能够改善对血糖的控制,但是其中的隐藏机制还没有得到完全了解。体育锻炼的过程中会伴随着肌肉氧气水平下降,进而导致转录因子HIF-1a得到诱导表达。HIF-1a是许多基因表达所需要的一个关键转录因子,因此可能在骨骼肌功能和代谢中发挥重要作用。

Clin Epidemiol:非酒精性脂肪肝的临床过程:对疾病严重性、进展和结果的评估

在中位随访2.3年的过程中,大约有17%的患者发生疾病进展或死亡。存在T2DM的NALFD患者发生疾病进展的风险约为非T2DM的NALFD患者的两倍,死亡风险随着疾病阶段的增加而增加。早期诊断和监测疾病进展,特别是对T2DM患者,是值得的。

新视野:中国2型糖尿病策略中磺脲类药物应用思考

针对早期或新诊断2型糖尿病患者,给予早期强化降糖治疗,是优化血糖管理的重要策略之一。

J Diabetes:警惕!糖皮质激素显著增加2型糖尿病患者的致命并发症

在一项新的研究中,研究人员表示,服用短期口服糖皮质激素的成人2型糖尿病患者发生不良事件的风险增加。

2017 KDA立场声明:胰高血糖素样肽-1受体激动剂治疗2型糖尿病

2017年12月,韩国糖尿病协会(KDA)发布了胰高血糖素样肽-1受体激动剂治疗2型糖尿病的立场声明。在2017年KDA药物治疗糖果尿病的立场声明中,胰高血糖素样肽-1受体激动剂(GLP-1RAs)建议单药应用或者与其他口服降糖药或基础胰岛素联合应用。本文主要针对GLP-1RAs的应用提供建议。

Diabetes Obes Metab:基础胰岛素治疗的2型糖尿病患者治疗持续性与糖化血红蛋白的关系!

由此可见,2型糖尿病患者糖化血红蛋白与采用基础胰岛素治疗的持续性有关。