Saydah Sharon, Tao Min, Imperatore Giuseppina, Gregg Edward
Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Diabetes Care. 2009 Aug;32(8):1440-6. doi: 10.2337/dc09-0117. Epub 2009 Apr 28.
OBJECTIVE To examine the association of hyperglycemia, as measured by GHb, with subsequent mortality in a nationally representative sample of adults. RESEARCH DESIGN AND METHODS We included adults aged > or =20 years who participated in Third National Health and Nutrition Examination Survey (1988-1994) and had complete information, including baseline diabetes status by self-report and measured GHb (n = 19,025) and follow-up through the end of 2000 for mortality. RESULTS In the overall population, higher levels of GHb were associated with increased risk of mortality from all causes, heart disease, and cancer. After adjustment for potential risk factors, the relative hazard (RH) for adults with GHb > or =8% compared with adults with GHb <6% was 2.59 (95% CI 1.88-3.56) for all-cause mortality, 3.38 (1.98-5.77) for heart disease mortality, and 2.64 (1.17-5.97) for cancer mortality. Among adults with diagnosed diabetes, having GHb > or =8% compared with GHb <6% was associated with higher all-cause mortality (RH 1.68, 95% CI 1.03-2.74) and heart disease mortality (2.48, 1.09-5.64), but there was no increased risk of cancer mortality by GHb category. Among adults without diagnosed diabetes, there was no significant association of all-cause, heart disease, or cancer mortality and GHb category. CONCLUSIONS These results highlight the importance of GHb levels in mortality risk among a nationally representative sample of adults with and without diagnosed diabetes and indicate that higher levels are associated with increased mortality in adults with diabetes.
目的 通过糖化血红蛋白（GHb）检测来研究高血糖与具有全国代表性的成年人群随后死亡率之间的关联。研究设计与方法 我们纳入年龄≥20岁且参与了第三次全国健康和营养检查调查（1988 - 1994年）的成年人，他们拥有完整信息，包括通过自我报告得出的基线糖尿病状态、检测的GHb（n = 19,025）以及截至2000年底的死亡随访情况。结果 在总体人群中，较高水平的GHb与全因、心脏病和癌症死亡风险增加相关。在对潜在风险因素进行调整后，与GHb<6%的成年人相比，GHb≥8%的成年人全因死亡率的相对风险（RH）为2.59（95%CI 1.88 - 3.56），心脏病死亡率为3.38（1.98 - 5.77），癌症死亡率为2.64（1.17 - 5.97）。在已诊断糖尿病的成年人中，与GHb<6%相比，GHb≥8%与更高的全因死亡率（RH 1.68，95%CI 1.03 - 直2.74）和心脏病死亡率（2.48，1.09 - 5.64）相关，但按GHb类别划分，癌症死亡率没有增加风险。在未诊断糖尿病的成年人中，全因、心脏病或癌症死亡率与GHb类别之间没有显著关联。结论 这些结果突出了GHb水平在具有全国代表性的有或无糖尿病诊断的成年人群死亡风险中的重要性，并表明较高水平与糖尿病成年人死亡率增加相关。 （注：“直2.74”原文可能有误，推测为“2.74”）
