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在急性冠状动脉综合征患者中,院内死亡与入院时的血糖有关,但与性别无关。

In-hospital death in acute coronary syndrome was related to admission glucose in men but not in women.

机构信息

Heart Institute-InCor, University of São Paulo Medical School, Avenue Enéas de Carvalho de Aguiar 44, 05403-000 São Paulo, Brazil.

出版信息

Cardiovasc Diabetol. 2012 May 17;11:47. doi: 10.1186/1475-2840-11-47.

Abstract

BACKGROUND

Admission hyperglycaemia is associated with mortality in patients with acute coronary syndrome (ACS), but controversy exists whether hyperglycaemia uniformly affects both genders. We evaluated coronary risk factors, gender, hyperglycaemia and their effect on hospital mortality.

METHODS

959 ACS patients (363 women and 596 men) were grouped based on glycaemia ≥ or < 200 mg/dL and gender: men with glucose < 200 mg/dL (menG-); women with glucose < 200 mg/dL (womenG-); men with glucose ≥ 200 mg/dL (menG+); and women with glucose ≥ 200 mg/dL (womenG+). A logistic regression analysis compared the relation between gender and glycaemia groups and death, adjusted for coronary risk factors and laboratory data. RESULTS GROUP: menG- had lower mortality than menG + (OR = 0.172, IC95% 0.062-0.478), and womenG + (OR = 0.275, IC95% 0.090-0.841); womenG- mortality was lower than menG + (OR = 0.230, IC95% 0.074-0.717). No difference was found between menG + vs womenG + (p = 0.461), or womenG- vs womenG + (p = 0.110). Age (OR = 1.067, IC95% 1.031-1.104), EF (OR = 0.942, IC95% 0.915-0.968), and serum creatinine (OR = 1.329, IC95% 1.128-1.566) were other independent factors related to in-hospital death.

CONCLUSIONS

Death was greater in hyperglycemic men compared to lower blood glucose men and women groups, but there was no differences between women groups in respect to glycaemia after adjustment for coronary risk factors.

摘要

背景

入院高血糖与急性冠状动脉综合征(ACS)患者的死亡率相关,但高血糖是否均匀影响两性仍存在争议。我们评估了冠状动脉危险因素、性别、高血糖及其对住院死亡率的影响。

方法

959 例 ACS 患者(363 名女性和 596 名男性)根据血糖水平≥或<200mg/dL 和性别分组:血糖<200mg/dL 的男性(男性低血糖组,menG-);血糖<200mg/dL 的女性(女性低血糖组,womenG-);血糖≥200mg/dL 的男性(男性高血糖组,menG+);血糖≥200mg/dL 的女性(女性高血糖组,womenG+)。采用逻辑回归分析比较了性别与血糖组和死亡之间的关系,并对冠状动脉危险因素和实验室数据进行了调整。

结果

与 menG+相比,menG-的死亡率较低(OR=0.172,95%CI95%0.062-0.478),与 womenG+相比(OR=0.275,95%CI95%0.090-0.841);与 menG+相比,womenG-的死亡率较低(OR=0.230,95%CI95%0.074-0.717)。menG+与 womenG+之间(p=0.461),或 womenG-与 womenG+之间(p=0.110)差异无统计学意义。年龄(OR=1.067,95%CI1.031-1.104)、EF(OR=0.942,95%CI0.915-0.968)和血清肌酐(OR=1.329,95%CI1.128-1.566)是与院内死亡相关的其他独立因素。

结论

与低血糖男性相比,高血糖男性的死亡率更高,与女性各血糖组相比,但在校正冠状动脉危险因素后,女性各血糖组之间无差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1e9/3355051/2e298df7809e/1475-2840-11-47-2.jpg

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