一种易于测量的代谢指标预测老年人死亡率。

Mortality prediction in the elderly by an easily measured metabolic index.

机构信息

Department of Medicine, Karolinska University Hospital, Stockholm, Sweden.

出版信息

Diab Vasc Dis Res. 2012 Jul;9(3):226-33. doi: 10.1177/1479164111434317. Epub 2012 Jan 25.

DOI:10.1177/1479164111434317

PMID:22278735

Abstract

OBJECTIVE

Hyperglycaemia enhances the risk of cardiovascular events and death, while high-density lipoprotein cholesterol (HDLc) is protective. Information on these associations among the elderly population is scanty. We applied a cardiometabolic risk index (CMRI) based on HDLc and fasting plasma glucose (FPG) in an elderly Swedish population.

METHODS

In total, 432 75-year-olds were followed for 10-year mortality. The impact of risk factors on survival was analysed using Cox regression.

RESULTS

HDLc (mmol/l; median and interquartile range) was 1.6 (1.3-2.0) in women and 1.4 (1.2-1.5) in men, while FPG was 5.9 (5.5-6.6) and 5.9 (5.5-6.5). Some 89 persons were at high risk according to CMRI, and 163 persons died. FPG was related to mortality in women (HR; 95% CI: 1.23; 1.10-1.37) and there was a similar trend in men (1.08; 1.00-1.17; p = 0.061). Increasing HDLc was protective in men (0.38; 0.19-0.77) but not in women (0.77; 0.45-1.29). CMRI was related to mortality in both genders even after adjustment for established risk factors (1.79; 1.14-2.79; p = 0.011).

CONCLUSIONS

The CMRI helps identify elderly subjects at risk and may serve as a cost-effective risk prediction tool.

摘要

目的

高血糖会增加心血管事件和死亡的风险，而高密度脂蛋白胆固醇（HDLc）则具有保护作用。关于老年人中这些关联的信息很少。我们在一个瑞典老年人群中应用了基于 HDLc 和空腹血糖（FPG）的心脏代谢风险指数（CMRI）。

方法

共有 432 名 75 岁的老年人被随访了 10 年的死亡率。使用 Cox 回归分析了危险因素对生存率的影响。

结果

女性的 HDLc（mmol/l；中位数和四分位间距）为 1.6（1.3-2.0），男性为 1.4（1.2-1.5），FPG 为 5.9（5.5-6.6）和 5.9（5.5-6.5）。根据 CMRI，约 89 人处于高风险，163 人死亡。FPG 与女性死亡率相关（HR；95%CI：1.23；1.10-1.37），男性也存在类似趋势（1.08；1.00-1.17；p=0.061）。HDLc 升高对男性有保护作用（0.38；0.19-0.77），但对女性没有（0.77；0.45-1.29）。即使在调整了已确立的危险因素后，CMRI 与两性的死亡率相关（1.79；1.14-2.79；p=0.011）。