Qiao Qing, Jousilahti Pekka, Eriksson Johan, Tuomilehto Jaakko
Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
Diabetes Care. 2003 Oct;26(10):2910-4. doi: 10.2337/diacare.26.10.2910.
To evaluate the relationship of impaired glucose tolerance (IGT) at baseline to coronary heart disease (CHD) incidence, and cardiovascular disease (CVD) and total mortality at follow-up, and to analyze whether the relationship is independent of the subsequent development of diabetes during follow-up.
A baseline screening survey for diabetes was performed in 1987 using a 2-h 75-g oral glucose tolerance test. A total of 1234 men and 1386 women aged 45-64 years, who were free of diabetes at baseline, were followed up for 10 years. During the follow-up, 153 subjects had an incident CHD event, 224 died, and 100 deaths were due to cardiovascular causes. Multivariate adjusted (adjusted for age, sex, waist-to-hip ratio, systolic blood pressure, cholesterol, HDL cholesterol, and smoking) hazard ratio (HR) was estimated using Cox regression analysis.
In subjects who had IGT at baseline and who did not progress to diabetes during the follow-up, the multivariate adjusted HR (95% CI) was 1.49 (0.95-2.34) for CHD incidence, 2.34 (1.42-3.85) for CVD mortality, and 1.65 (1.13-2.40) for all-cause mortality.
Baseline IGT was an independent risk predictor for cardiovascular morbidity and mortality and for total mortality, which was not confounded by the subsequent development of overt diabetes.
评估基线时糖耐量受损（IGT）与冠心病（CHD）发病率、随访期间心血管疾病（CVD）及总死亡率之间的关系，并分析这种关系是否独立于随访期间糖尿病的后续发展。
1987年采用2小时75克口服葡萄糖耐量试验进行糖尿病基线筛查调查。共有1234名男性和1386名年龄在45 - 64岁、基线时无糖尿病的女性接受了10年的随访。随访期间，153名受试者发生了冠心病事件，224人死亡，其中100人死于心血管疾病。使用Cox回归分析估计多变量调整（调整年龄、性别、腰臀比、收缩压、胆固醇、高密度脂蛋白胆固醇和吸烟情况）后的风险比（HR）。
在基线时患有IGT且随访期间未进展为糖尿病的受试者中，冠心病发病率的多变量调整HR（95%CI）为1.49（0.95 - 2.34），心血管疾病死亡率为2.34（1.42 - 3.85），全因死亡率为1.65（1.13 - 2.40）。
基线IGT是心血管疾病发病和死亡以及总死亡率的独立风险预测因素，不受后续显性糖尿病发展的影响。
