Sievers M L, Bennett P H, Nelson R G
Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Arizona 85014-4972, USA.
Diabetes. 1999 Apr;48(4):896-902. doi: 10.2337/diabetes.48.4.896.
The effect of plasma glucose concentration on overall and cause-specific mortality was examined in 1,745 Pima Indians (725 men, 1,020 women) > or = 15 years old with type 2 diabetes. During a median follow-up of 10.6 years (range 0.1-24.8), 533 subjects (275 men, 258 women) died; 113 of the deaths were attributable to cardiovascular disease, 96 to diabetes-related diseases (diabetic nephropathy for 92 of these), 249 to other natural causes, and 75 to external causes. After adjusting for age, sex, duration of diabetes, and BMI in a generalized additive proportional hazards model, higher baseline 2-h postload plasma glucose concentration predicted deaths from cardiovascular disease (P = 0.007) and diabetes-related diseases (P = 0.003), but not from other natural causes (P = 0.73). An increment of 5.6 mmol/l (100 mg/dl) in the 2-h plasma glucose concentration was associated with 1.2 times (95% CI 1.1-1.4) the death rate from cardiovascular disease, 1.3 times (95% CI 1.1-1.5) the death rate from diabetes-related diseases, and almost no change in the death rate from other natural causes (rate ratio = 1.0; 95% CI 0.94-1.1). In Pima Indians with type 2 diabetes, higher plasma glucose concentration predicts deaths from cardiovascular and diabetes-related diseases but has little or no effect on deaths from other natural or external causes.
在1745名年龄≥15岁的2型糖尿病皮马印第安人（725名男性，1020名女性）中，研究了血浆葡萄糖浓度对全因死亡率和特定病因死亡率的影响。在中位随访10.6年（范围0.1 - 24.8年）期间，533名受试者（275名男性，258名女性）死亡；其中113例死亡归因于心血管疾病，96例归因于糖尿病相关疾病（其中92例为糖尿病肾病），249例归因于其他自然原因，75例归因于外部原因。在广义相加比例风险模型中对年龄、性别、糖尿病病程和体重指数进行校正后，较高的基线2小时负荷后血浆葡萄糖浓度可预测心血管疾病（P = 0.007）和糖尿病相关疾病（P = 0.003）导致的死亡，但不能预测其他自然原因导致的死亡（P = 0.73）。2小时血浆葡萄糖浓度每增加5.6 mmol/l（100 mg/dl），心血管疾病死亡率增加1.2倍（95%可信区间1.1 - 1.4），糖尿病相关疾病死亡率增加1.3倍（95%可信区间1.1 - 1.5），而其他自然原因导致的死亡率几乎没有变化（率比 = 1.0；95%可信区间0.94 - 1.1）。在2型糖尿病皮马印第安人中，较高的血浆葡萄糖浓度可预测心血管疾病和糖尿病相关疾病导致的死亡，但对其他自然或外部原因导致的死亡几乎没有影响。
