Diabetes Care:1型糖尿病患者长期死亡率研究

2016-10-26 MedSci MedSci原创

调查15岁–29年确诊为1型糖尿病患者的长期死亡率、死亡原因和终末期肾脏疾病(ESRD)情况。研究纳入1978–1982年间诊断为1型糖尿病的患者,组成这项全国性、以人口为基础的队列;随访到死亡、移民、或是2013年9月。通过相关数据库获取患者的死亡、ESRD等情况。在30年的随访中,参与者发展为终末期肾病和死亡的比例分别为4.6%和20.6% (n = 148; 106例男性和42例女性)。自诊

调查15岁–29年确诊为1型糖尿病患者的长期死亡率、死亡原因和终末期肾脏疾病(ESRD)情况。

研究纳入1978–1982年间诊断为1型糖尿病的患者,组成这项全国性、以人口为基础的队列;随访到死亡、移民、或是2013年9月。通过相关数据库获取患者的死亡、ESRD等情况。

在30年的随访中,参与者发展为终末期肾病和死亡的比例分别为4.6%和20.6% (n = 148; 106例男性和42例女性)。

自诊断后的10年累积死亡率为6%(95% CI 4.5–8.0),20年累积死亡率为12.2% (10.0–14.8),30年累积死亡率为18.4% (15.8–21.5)。

标准死亡率(SMR)为4.4 (95% CI 3.7–5.1)。

从诊断糖尿病到终末期肾病的平均时间是23.6年(范围14.2–33.5)。

死因主要有慢性并发症(32.2%)、急性并发症(20.5%)、暴力死亡(19.9%)或任何其他原因(27.4%)。

15%的案例,其死亡与酒精有关。

酒精相关死亡的SMR为6.8 (95% CI 4.5–10.3)。心血管死亡的SMR为7.3 (5.4–10.0)。暴力死亡的SMR为3.6 (2.3–5.3)。

在这一类1型糖尿病患者中,随访30年的ESRD累积发生率低。死亡率为普通人群的4.4倍,超过50%的死亡是由急性或慢性并发症引起的。与酒精有关的死亡比例相对较高。

原始出处:

Vibeke Gagnum,et al.Long-term Mortality and End-Stage Renal Disease in a Type 1 Diabetes Population Diagnosed at Age 15–29 Years in Norway.Diabetes Care 2016 Oct

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