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。

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、心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。

原始出处：Araz Rawshani, Naveed Sattar, Ann-Marie Svensson, et al. Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset: a nationwide, register-based cohort study. Lancet. August 11, 2018

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2018-11-17 howi

#Lancet#

23 0
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2018-08-17 1e1c07bdm01(暂无匿称)

好

69 0
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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=)]
2018-08-14 guoyibin

#生存率#

23 0
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2018-08-14 gous

#心血管结局#

29 0
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2018-08-14 showtest

#发病年龄#

27 0
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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 惠映实验室

学习了，谢谢分享。

63 0
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2018-08-13 太阳系小猪

意思是血早发现，预后越差~

64 0
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2018-08-13 哈哈869

?？(

62 0
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2018-08-13 sunfeifeiyang

阅

75 0
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2018-08-13 misszhang

谢谢MedSci提供最新的资讯

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