Ioacără S, Ionescu-Tîrgovişte C, Sabău S, Enăchescu Cornelia, Farcaşiu Eugenia, Brădescu O
"N. Paulescu" Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest, Romania.
Rom J Intern Med. 2007;45(4):371-7.
To investigate the major aspects of mortality in patients with noninsulin-treated type 2 diabetes mellitus (T2DM), from 1942 till 2000.
We performed a retrospective study in 9698 noninsulin-treated T2DM patients, 5001 (51.6%) males and 4695 (48.4%) females, registered in Bucharest Diabetes Center and deceased between 1943 and 2000. For each patient the age at diabetes onset, disease duration, age at death, cause of death, sex, height and weight were recorded.
The mean age at diabetes onset was 58.3 +/- 9.1 years in 1943-1960 period (no significant differences by sex) and 60.6 +/- 10.3 years in 1981-2000 (59.3 +/- 10.3 years in males and 61.8 +/- 10.1 years in females, p < 0.01 vs. males). The mean disease duration at death was 7.7 +/- 5.2 years in 1943-1960 period (no significant differences by sex) and 11.3 +/- 8.1 years in 1981-2000 (11.9 +/- 8.4 years in males and 10.7 +/- 7.6 years in females, p < 0.01 vs. males). The mean age at death was 66 +/- 9.8 years in 1943-1960 period (no significant differences by sex) and 71.9 +/- 9.7 years in 1981-2000 (71.2 +/- 9.9 years in males and 72.5 +/- 9.5 years in females, p < 0.01 vs. males). In the Cox regression analysis, an increase in mortality was associated with the masculine sex--9.6% (CI 95% 1-19%, p = 0.028) compared with feminine sex; 1 year increase in age at onset--4.8% (CI 95% 4.3-5.3%, p < 0.01); 1 kg/m2 increase in body mass index--2.9% (CI 95% 1.9-3.8%, p < 0.01); 1 mg/dl increase in mean fasting blood glucose--0.1% (CI 95% 0-0.2%, p = 0.025). The major causes of death in noninsulin-treated T2DM patients in the 1981-2000 period were: ischemic heart disease (53.8%), stroke (14.4%), cancer (9%), digestive diseases (6.3%), diabetes (5.3%), end stage renal disease (4.6%), infections (2.7%), diabetes coma (2.2%) and others (1.7%).
There is a statistically significant increase in the proportion of death caused by ischemic heart disease, while infections significantly decreased in importance during the study period. The masculine sex, age at onset, mean fasting blood glucose and body mass index were all significant predictors of mortality in the Cox regression analysis, adjusted for the year of death.
调查1942年至2000年非胰岛素治疗的2型糖尿病（T2DM）患者死亡的主要方面。
我们对9698例非胰岛素治疗的T2DM患者进行了一项回顾性研究，其中男性5001例（51.6%），女性4695例（48.4%），这些患者在布加勒斯特糖尿病中心登记，并于1943年至2000年期间死亡。记录了每位患者的糖尿病发病年龄、病程、死亡年龄、死亡原因、性别、身高和体重。
1943 - 1960年期间糖尿病发病的平均年龄为58.3±9.1岁（性别间无显著差异），1981 - 2000年为60.6±10.3岁（男性为59.3±10.3岁，女性为61.8±10.1岁，与男性相比p<0.01）。1943 - 1960年期间死亡时的平均病程为7.7±5.2年（性别间无显著差异），1981 - 2000年为11.3±8.1年（男性为11.9±8.4年，女性为10.7±7.6年，与男性相比p<0.01）。1943 - 1960年期间的平均死亡年龄为66±9.8岁（性别间无显著差异），1981 - 2000年为71.9±9.7岁（男性为71.2±9.9岁，女性为72.5±9.5岁，与男性相比p<0.01）。在Cox回归分析中，死亡率的增加与男性性别相关——与女性相比为9.6%（95%CI 1 - 19%，p = 0.028）；发病年龄每增加1岁——4.8%（95%CI 4.3 - 5.3%，p<0.01）；体重指数每增加1kg/m²——2.9%（95%CI 1.9 - 3.8%，p<0.01）；平均空腹血糖每增加1mg/dl——0.1%（95%CI 0 - 0.2%，p = 0.025）。1981 - 2000年期间非胰岛素治疗的T2DM患者的主要死亡原因是：缺血性心脏病（53.8%）、中风（14.4%）、癌症（9%）、消化系统疾病（6.3%）、糖尿病（5.3%）、终末期肾病（4.6%）、感染（2.7%）、糖尿病昏迷（2.2%）和其他（1.7%）。
在研究期间，缺血性心脏病导致的死亡比例有统计学意义的增加，而感染的重要性显著降低。在Cox回归分析中，校正死亡年份后，男性性别、发病年龄、平均空腹血糖和体重指数均是死亡率的显著预测因素。
