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Lancet:1型糖尿病:发病年龄影响生存率和心血管结局?

2018-08-13 聂少芳(武汉协和医院) 信诺医讯

1型糖尿病是儿童第二常见慢性疾病,具有高死亡率和高心血管疾病风险。研究提示发病年龄可辅助鉴别2型糖尿病的亚型并预测其危险因素的改变轨迹,同时有证据显示早发病较晚发危害更大。然而目前有关发病年龄对1型糖尿病预后影响的类似研究数量甚少且证据不足。

1型糖尿病儿童第二常见慢性疾病,具有高死亡率和高血管疾病风险。研究提示发病年龄可辅助鉴别2型糖尿病的亚型并预测其危险因素的改变轨迹,同时有证据显示早发病较晚发危害更大。然而目前有关发病年龄对1型糖尿病预后影响的类似研究数量甚少且证据不足。 

本研究为全国范围内的队列研究,研究对象来自瑞典糖尿病数据库1型糖尿病患者(1998年7月1日至2012年12月31日有至少一次记录)和与患者性别、年龄、区县相匹配的普通人群(无糖尿病)。

采用Cox比例风险回归模型,同时矫正糖尿病患病时间,作者评估了全因死亡率、血管疾病等终点事件的升高风险。病例组根据1型糖尿病确诊年龄共分为五组(0-10岁,11-15岁,16-20岁,21-25岁和26-30岁)。共2.7万余例1型糖尿病患者和13.5万余例对照被纳入此项研究,其中959例患者和1501例对照在随访期间死亡(平均随访时间10年)。

结果显示发病年龄在0-10岁组较26-30岁组的各风险比增加可高达5倍,其中全因死亡风险比两组分别为4.11 (95% CI 3.24–5.22) vs 2.83 (95% CI 2.38–3.37) , 冠心病风险比两组分别为30.50 (95% CI 19.98–46.57) vs 6.08 (95% CI 4.71–7.84)。1型糖尿病全因死亡的最高总发生率为1.9每十万人年(95% CI 1.71–2.11) 。 

结论提示1型糖尿病的发病年龄是影响生存率和心血管结局的一个关键因素,女性患者尤为显著。因此,1型糖尿病早发人群的心血管保护值得更多关注。

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    2018-11-17 howi
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  5. 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  6. 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createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Mon Aug 13 06:55:47 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338250, encodeId=af4b338250ae, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Mon Aug 13 06:52:08 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1041773, encodeId=95961041e7393, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Mon Aug 13 03:56:00 CST 2018, time=2018-08-13, status=1, ipAttribution=)]
    2018-08-13 惠映实验室

    学习了,谢谢分享。

    0

  7. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Mon Aug 13 03:56:00 CST 2018, time=2018-08-13, status=1, ipAttribution=)]
    2018-08-13 太阳系小猪

    意思是血早发现,预后越差~

    0

  8. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Mon Aug 13 03:56:00 CST 2018, time=2018-08-13, status=1, ipAttribution=)]
    2018-08-13 哈哈869

    ??(

    0

  9. 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createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Mon Aug 13 22:37:53 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338266, encodeId=569d338266c6, content=意思是血早发现,预后越差~, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7e71713450, createdName=太阳系小猪, createdTime=Mon Aug 13 07:06:04 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338259, encodeId=ed883382599f, content=??(, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Mon Aug 13 03:56:00 CST 2018, time=2018-08-13, status=1, ipAttribution=)]
    2018-08-13 sunfeifeiyang

    0

  10. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Mon Aug 13 03:56:00 CST 2018, time=2018-08-13, status=1, ipAttribution=)]
    2018-08-13 misszhang

    谢谢MedSci提供最新的资讯

    0

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