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Diabetes Care: 低血糖和空腹血糖受损均可预测心血管疾病发病风险

2013-03-12 Diabetes Care 丁香园

心血管疾病低血糖空腹血糖
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不同空腹血糖水平下的心血管疾病HRs 尽管糖尿病增加心血管疾病发病风险和死亡率，但是低于糖尿病诊断标准的空腹血糖水平与心血管事件间的量效关系尚未十分明确。针对这种情况，来自韩国Severance医院国家健康护理中心的Park博士等人进行了一项研究，研究发现，低血糖和空腹血糖受损均可作为中风和冠状动脉心脏病的预测因子，并且，与最低心血管疾病发病风险相关的空腹血糖水平范围较窄。研究结果在线发表于


不同空腹血糖水平下的心血管疾病HRs

尽管糖尿病增加心血管疾病发病风险和死亡率，但是低于糖尿病诊断标准的空腹血糖水平与心血管事件间的量效关系尚未十分明确。针对这种情况，来自韩国Severance医院国家健康护理中心的Park博士等人进行了一项研究，研究发现，低血糖和空腹血糖受损均可作为中风和冠状动脉心脏病的预测因子，并且，与最低心血管疾病发病风险相关的空腹血糖水平范围较窄。研究结果在线发表于2013年2月12日的美国《糖尿病护理》(Diabetes Care)杂志上。

研究对象来自韩国一项100多万人的前瞻性队列研究(平均随访时间16年)。该研究最终共纳入1,197,384例韩国成年人，均没有特殊疾病，根据基线空腹血糖水平进行分类。空腹血糖水平与心血管疾病发病率和死亡率、中风发病率和死亡率以及全因死亡率的关系采用多变量比例风险回归分析。

研究结果显示，空腹血糖水平与心血管疾病发病风险的关系遵循J形曲线，血糖范围在85-99mg/dL时风险最低。随着空腹血糖水平升高到>100mg/dL，心血管疾病、缺血性心脏病、心肌梗塞以及血栓性中风发病风险逐渐升高，但是出血性中风风险没有升高。空腹血糖水平<70 mg/dL时，中风发病风险升高，危害比在男性中为1.06(95% CI 1.01-1.11)，女性中为1.11(95% CI 1.05-1.17)。

该项研究表明，低血糖和空腹血糖受损均可作为中风和冠状动脉心脏病的预测因子。与最低心血管疾病发病风险相关的空腹血糖水平范围较窄。
OBJECTIVE 
Although diabetes increases the risk of cardiovascular disease and mortality, the dose-response relationship between fasting glucose levels below those diagnostic of diabetes with cardiovascular events has not been well-characterized.
RESEARCH DESIGN AND METHODS 
A prospective cohort study of more than one million Koreans was conducted with a mean follow-up of 16 years. A total of 1,197,384 Korean adults with no specific medical conditions diagnosed were classified by baseline fasting serum glucose level. Associations of fasting glucose level with cardiovascular disease incidence and mortality, stroke incidence and mortality, and all-cause mortality were analyzed using multivariate proportional hazards regression.
RESULTS 
The relationships between fasting glucose levels and cardiovascular disease risks generally followed J-shape curves, with lowest risk in the glucose range of 85–99 mg/dL. As fasting glucose levels increased to >100 mg/dL, risks for cardiovascular disease, ischemic heart disease, myocardial infarction, and thrombotic stroke progressively increased, but risk for hemorrhagic stroke did not. Fasting glucose levels <70 mg/dL were associated with increased risk of all stroke (hazard ratio 1.06, 95% CI 1.01–1.11) in men and (hazard ratio 1.11, 95% CI 1.05–1.17) in women.
CONCLUSIONS 
Both low glucose level and impaired fasting glucose should be considered as predictors of risk for stroke and coronary heart disease. The fasting glucose level associated with the lowest cardiovascular risk may be in a narrow range.

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    2013-08-18 ms5439512287675881

    #BET#

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    2013-07-16 木头人513

    #Diabetes#

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    2013-05-11 ms9608593228839890

    #DIA#

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    2013-03-14 手留余香

    #空腹血糖#

    0

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    2013-03-14 andy2090

    #血管疾病#

    0

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JCEM：初潮和绝经延迟与心血管病低风险相关

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面相老的人患心血管疾病风险高

　　洛杉矶——美国心脏协会(AHA)年会上公布的标志性哥本哈根市心脏研究显示，面相老的人的冠状动脉可能也在加速老化。 Anne Tybjaerg-Hansen博士 　　在这项由哥本哈根大学Anne Tybaerg-Hansen博士及其同事进行的前瞻性研究中，近11,000例患者在1976~1978年进行首次体检，当时研究者不知晓患者的健康状态和根据预定标准系统记录的可见老化体征

JAMA Intern Med：男性大量补钙或致心脏病死亡风险升高

  　　美国学者的一项研究表明，男性大量补钙与其心血管疾病（CVD）死亡风险增加相关。论文2013年2月4日在线发表于《美国医学会杂志·内科学》（JAMA Intern Med）。 　　研究共纳入38万多名50～71岁的受试者。在平均12年随访期间，与不补钙者相比，男性补充性钙摄入超过1000 mg/d与CVD死亡风险升高相关[相对危险（RR）=1.20