Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.
Prev Med. 2012 Dec;55(6):603-7. doi: 10.1016/j.ypmed.2012.09.013. Epub 2012 Sep 23.
The objective was to determine whether non-fasting glucose concentration is a predictor for incident coronary heart disease.
We investigated a cohort data of 9,900 40- to 69-year-old residents in four Japanese communities for 1975-1986 baseline surveys of the Circulatory Risk in Communities Study (CIRCS). Non-fasting blood glucose concentrations were available for 7,332 participants. Diabetic type was defined as a glucose level of ≥ 11.1 mmol/L and/or the use of medication for diabetes mellitus.
A total of 170 coronary heart disease including 113 myocardial infarctions occurred in non-fasting participants within the median 22-year follow-up period. Multivariable hazard ratios (HRs) of incident coronary heart disease for the participants with diabetic type compared with the normal type were 1.98 (0.84-4.68) for men, 3.39 (1.47-7.81) for women, and 2.47 (1.37-4.46) for total subjects. Corresponding HRs for myocardial infarction were 2.14 (0.83-5.55), 5.70 (2.21-14.67) and 3.17 (1.65-6.10), respectively. Multivariable HRs of incident coronary heart disease per one standard deviation of serum glucose levels were 1.17 (1.02-1.36), 1.19 (1.03-1.38), and 1.19 (1.08-1.32), respectively. The corresponding HRs for myocardial infarction were 1.18 (1.00-1.38), 1.27 (1.07-1.49) and 1.23 (1.10-1.37).
Non-fasting glucose concentration, either as diagnosis of diabetic type or as continuous variable, proved to be an independent predictor for incident coronary heart disease in middle-aged general population.
确定非空腹血糖浓度是否是冠心病发病的预测因素。
我们对来自四个日本社区的 9900 名 40 至 69 岁居民的队列数据进行了调查,这些居民参加了 1975-1986 年社区循环风险研究(CIRCS)的基线调查。7332 名参与者提供了非空腹血糖浓度数据。糖尿病类型定义为血糖水平≥11.1mmol/L 和/或使用糖尿病药物。
在中位 22 年的随访期间,非空腹参与者中共有 170 例冠心病(包括 113 例心肌梗死)发生。与正常类型相比,男性、女性和总人群中患有糖尿病类型的参与者发生冠心病的多变量风险比(HR)分别为 1.98(0.84-4.68)、3.39(1.47-7.81)和 2.47(1.37-4.46)。相应的心肌梗死 HR 分别为 2.14(0.83-5.55)、5.70(2.21-14.67)和 3.17(1.65-6.10)。血清葡萄糖水平每增加一个标准差,发生冠心病的多变量 HR 分别为 1.17(1.02-1.36)、1.19(1.03-1.38)和 1.19(1.08-1.32)。相应的心肌梗死 HR 分别为 1.18(1.00-1.38)、1.27(1.07-1.49)和 1.23(1.10-1.37)。
非空腹血糖浓度,无论是作为糖尿病类型的诊断还是作为连续变量,都证明是中年普通人群冠心病发病的独立预测因素。