20年随访期间与糖尿病发生相关的因素。一项针对一组同质中年男性的前瞻性研究。

Factors related to the development of diabetes during a 20-year follow-up. A prospective study in a homogeneous group of middle-aged men.

作者信息

Strandberg T E, Salomaa V

机构信息

Department of Medicine, University of Helsinki, and National Public Health Institute, Helsinki, Finland.

出版信息

Nutr Metab Cardiovasc Dis. 2000 Oct;10(5):239-46.

PMID:11213532

Abstract

BACKGROUND AND AIMS

To investigate factors associated with the development of type 2 diabetes mellitus (DM) during a 20-year follow-up in a homogeneous group of initially healthy middle-aged men with similar socioeconomic status.

METHODS AND RESULTS

We studied 1802 executives and businessmen, born 1919-34, without type 2 DM at baseline and with coronary heart disease (CHD) risk factor measurements in 1974-75. Diagnosis of type 2 DM during the follow-up was based on entitlement to re-imbursement for type 2 DM medication during 1975-1995, retrieved from national registers, self-report of type 2 DM or fasting blood glucose (> or = 6.7 mmol/L) in 1985-1986 (72% of the initial cohort re-evaluated). During the follow-up (up to 1995) type 2 DM was diagnosed using the above criteria in 94 men (5.2%). At baseline, men who later developed type 2 DM smoked more (p = 0.01), and had significantly higher body mass index (BMI), systolic and diastolic blood pressure, pulse pressure, serum triglycerides, and fasting and one-hour blood glucose. In a subset of high-risk men, those who developed type 2 DM also showed signs of white-coat effect on blood pressure (p = 0.008). Already at baseline, the CHD risk score was 23% higher in future type 2 DM subjects (p = 0.008). Re-evaluation in 1985-1986 showed essentially similar results for risk factors, but in addition, LDL cholesterol without lipid lowering drugs was significantly lower (p = 0.0018) in type 2 DM subjects. During the follow-up, 23.4% of the men with type 2 DM developed CHD as compared to 13.4% of those without (p = 0.008).

CONCLUSIONS

During a 20-year follow-up, several cardiovascular risk factors, including smoking, pulse pressure and the white-coat effect, predicted the development of type 2 DM in initially healthy middle-aged men. However, despite the higher incidence of CHD, development of type 2 DM was associated with lowered LDL cholesterol.

摘要

背景与目的

在一组社会经济地位相似、初始健康的中年男性中，进行为期20年的随访，以调查与2型糖尿病（DM）发生相关的因素。

方法与结果

我们研究了1802名出生于1919年至1934年的企业高管和商人，他们在基线时无2型DM，并于1974 - 1975年进行了冠心病（CHD）危险因素测量。随访期间2型DM的诊断基于1975 - 1995年从国家登记处获取的2型DM药物报销资格、2型DM的自我报告或1985 - 1986年的空腹血糖（≥6.7 mmol/L）（对初始队列的72%进行了重新评估）。在随访期间（至1995年），根据上述标准，94名男性（5.2%）被诊断为2型DM。基线时，后来发生2型DM的男性吸烟更多（p = 0.01），且体重指数（BMI）、收缩压和舒张压、脉压、血清甘油三酯以及空腹和餐后1小时血糖显著更高。在一部分高危男性中，发生2型DM的男性在血压方面也表现出白大衣效应（p = 0.008）。早在基线时，未来发生2型DM的受试者CHD风险评分就高出23%（p = 0.008）。1985 - 1986年的重新评估显示危险因素的结果基本相似，但此外，未使用降脂药物时，2型DM受试者的低密度脂蛋白胆固醇显著更低（p = 0.0018）。随访期间，2型DM男性中有23.4%发生了CHD，而无2型DM的男性中这一比例为13.4%（p = 0.008）。