男性的心肺适能、血糖状况与死亡风险
Cardiorespiratory fitness, glycemic status, and mortality risk in men.
作者信息
Kohl H W, Gordon N F, Villegas J A, Blair S N
机构信息
Division of Epidemiology, Institute for Aerobics Research, Dallas, Texas 75230.
出版信息
Diabetes Care. 1992 Feb;15(2):184-92. doi: 10.2337/diacare.15.2.184.
OBJECTIVE
To determine the association of baseline cardiorespiratory fitness to all-cause mortality across the range of blood glucose levels.
RESEARCH DESIGN AND METHODS
Data from a prospective study of 8715 men (average age 42 yr), followed for an average of 8.2 yr (range 1-15 yr), were analyzed. Cardiorespiratory fitness was assessed by maximal-exercise treadmill testing. Men with evidence of clinical vascular disease or who did not achieve 85% of their age-predicted maximum heart rate during exercise testing were excluded from analyses.
RESULTS
Age-adjusted death rates increased with higher levels, of fasting blood glucose. Regardless of glycemic status, fit men had lower age-adjusted all-cause death rates than their less fit counterparts. For men with fasting blood glucose greater than or equal to 7.8 mM or physician-diagnosed non-insulin-dependent diabetes mellitus (NIDDM), the age-adjusted death rates per 10,000 person-yr of follow-up in unfit and fit subjects were 82.5 and 45.9, respectively. The age-adjusted relative risk of death due to all causes was significantly elevated in the lower-fitness group within each of three glycemic status levels: fasting blood glucose less than 6.4 mM; relative risk (RR) = 1.93 (95% confidence interval [95% CI] 1.15-3.26); fasting blood glucose 6.4-7.8 mM; RR = 3.42 (95% CI 2.27-5.15); and fasting blood glucose greater than or equal to 7.8 mM or with NIDDM, RR = 1.80 (95% CI = 1.25-2.58). Multivariate analyses, controlling for risk factors of mortality (age, resting systolic blood pressure, serum cholesterol, body mass index, family history of heart disease, follow-up interval, and smoking habit) showed a higher risk of death due to all causes for unfit compared with fit men. Multivariate risks of death associated with low fitness, compared with higher fitness (RR), in the three glycemic status groups were: fasting blood glucose less than 6.4 mM, RR = 1.38 (95% CI 1.09-1.74); fasting blood glucose 6.4-7.8 mM, RR = 1.61 (95% CI 0.91-2.86); and fasting blood glucose greater than or equal to 7.8 mM or with NIDDM, RR = 1.92 (95% CI 0.75-4.90).
目的
确定在不同血糖水平范围内，基线心肺适能与全因死亡率之间的关联。
研究设计与方法
对8715名男性（平均年龄42岁）进行了一项前瞻性研究的数据进行分析，随访平均时间为8.2年（范围1 - 15年）。通过最大运动平板试验评估心肺适能。有临床血管疾病证据或在运动试验中未达到其年龄预测最大心率85%的男性被排除在分析之外。
结果
年龄调整后的死亡率随空腹血糖水平升高而增加。无论血糖状态如何，健康男性的年龄调整后全因死亡率低于身体状况较差的男性。对于空腹血糖大于或等于7.8 mM或经医生诊断为非胰岛素依赖型糖尿病（NIDDM）的男性，身体状况不佳和良好的受试者每10,000人年随访的年龄调整后死亡率分别为82.5和45.9。在三个血糖状态水平的每一组中，身体状况较差组因各种原因导致的年龄调整后相对死亡风险均显著升高：空腹血糖低于6.4 mM；相对风险（RR）= 1.93（95%置信区间[95%CI]1.15 - 3.26）；空腹血糖6.4 - 7.8 mM；RR = 3.42（95%CI 2.27 - 5.15）；空腹血糖大于或等于7.8 mM或患有NIDDM，RR = 1.80（95%CI = 1.25 - 2.58）。多变量分析控制了死亡率的危险因素（年龄、静息收缩压、血清胆固醇、体重指数、心脏病家族史、随访间隔和吸烟习惯），结果显示身体状况不佳的男性比健康男性因各种原因导致的死亡风险更高。在三个血糖状态组中，与身体状况良好相比，身体状况不佳相关的多变量死亡风险（RR）分别为：空腹血糖低于6.4 mM，RR = 1.38（95%CI 1.09 - 1.74）；空腹血糖6.4 - 7.8 mM，RR = 1.61（95%CI 0.91 - 2.86）；空腹血糖大于或等于7.8 mM或患有NIDDM，RR = 1.92（95%CI 0.75 - 4.90）。
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