Department of Cardiology, Skåne University Hospital, and Heart Health Group Department of Clinical Sciences, Lund University, Malmö, Sweden.
Cardiovasc Diabetol. 2011 Dec 28;10:118. doi: 10.1186/1475-2840-10-118.
The increased risk of cardiovascular disease (CVD) in diabetic compared to non-diabetic subjects seems to decrease with age. Whether this age-related reduction applies to CVD risk factors, and whether it is limited to established diabetes mellitus (DM) or also applies to pre-diabetic conditions are not well known.
Using a cross-sectional design we compared the strength of the correlation between glucometabolic disturbances (by grouping), CVD risk factor burden and self-rated health, in two age groups: middle-aged (57-69 years) and older (70-86 years) subjects, (63% men), participating in the Malmö Preventive Project Re-examination Study (n=18,238). Simple (unadjusted) logistic regression analysis was applied to estimate between-group differences and trends. Interaction analysis was applied to estimate differences between age groups.
CVD risk factor burden and the proportion of subjects reporting poor self-rated health increased with increasing glucometabolic disturbance for men and women in both age groups (p-trend<0.0001 for all). The slope of the trend curve with increasing CVD risk factor burden was significantly steeper for older women than for older men (p-interaction=0.002). The slope of the trend curve for poor self-rated health was significantly steeper for middle-aged than for older men (p-interaction=0.005), while no difference was observed between the age groups among women (p-interaction=0.97).
We found no reduction in risk factor accumulation with increasing glucometabolic disturbance between middle-aged and older subjects. Our results indicate life-long CVD risk factor clustering with increased glucometabolic disturbance, and suggest that previously observed age-related reduction in excess CVD risk for subjects with DM might be due to a survival bias. However, our observations indicate more pronounced risk factor clustering and worse self-rated health with increased glucometabolic disturbance in older women than in older men.
与非糖尿病患者相比，糖尿病患者患心血管疾病（CVD）的风险似乎随着年龄的增长而增加。这种与年龄相关的降低是否适用于 CVD 危险因素，以及它是否仅限于已确诊的糖尿病（DM），还是也适用于糖尿病前期，目前还不是很清楚。
我们使用横断面设计，比较了中年（57-69 岁）和老年（70-86 岁）组（63%为男性）参与者在两组中，葡萄糖代谢紊乱（分组）、CVD 危险因素负担和自我报告健康状况之间的相关性强度，这些参与者均来自马尔默预防项目再检查研究（n=18,238）。应用简单（未调整）逻辑回归分析估计组间差异和趋势。应用交互分析估计年龄组之间的差异。
在两组男性和女性中，随着葡萄糖代谢紊乱的增加，CVD 危险因素负担和报告自我健康状况不佳的比例均增加（p 趋势<0.0001 ）。老年女性的趋势曲线斜率明显大于老年男性（p 交互=0.002）。自我健康状况不佳的趋势曲线斜率在中年男性中明显大于老年男性（p 交互=0.005），而在女性中两组之间无差异（p 交互=0.97）。
我们没有发现中年和老年受试者之间随着葡萄糖代谢紊乱增加而导致危险因素积累减少的情况。我们的结果表明，随着葡萄糖代谢紊乱的增加，终生 CVD 危险因素聚集增加，并表明以前观察到的 DM 患者中与年龄相关的 CVD 风险增加的减少可能是由于生存偏差所致。然而，我们的观察结果表明，在老年女性中，随着葡萄糖代谢紊乱的增加，CVD 危险因素聚集和自我健康状况更差。
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