Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland.
Diabetes Care. 2013 Jul;36(7):2020-6. doi: 10.2337/dc12-1048. Epub 2013 Mar 27.
Type 2 diabetes is a risk factor for other forms of stroke, but its association with subarachnoid hemorrhage (SAH) from ruptured saccular intracranial aneurysm (sIA) has remained unclear.
Kuopio Intracranial Aneurysm Database (www.uef.fi/ns) includes all ruptured and unruptured sIA cases from a defined catchment population in eastern Finland since 1980. We compared the age-adjusted incidences of type 2 diabetes in 1,058 ruptured and 484 unruptured sIA patients during 1994-2008, using the national registry of prescribed medicine purchases.
Of the 1,058 ruptured sIA patients, 43% were males and 57% females, with a median age at rupture of 51 and 56 years, respectively. From 1994 to 2008 or until death, 9% had been prescribed antidiabetes medication (ADM) with a median starting age of 58 years for males and 66 years for females. Of the 484 unruptured sIA patients, 44% were males and 56% females, with a median age at the diagnosis of 53 and 55 years, respectively, and 9% had used ADM, with a median starting age of 61 years for males and 66 years for females. The incidence of type 2 diabetes was highest in the age-group 60-70 years, with no significant differences between the ruptured and unruptured sIA patients.
Our study suggests that type 2 diabetes does not increase the risk of rupture of sIA, which is by far the most frequent cause of nontraumatic SAH.
2 型糖尿病是其他类型中风的一个危险因素,但它与破裂的囊状颅内动脉瘤(sIA)引起的蛛网膜下腔出血(SAH)之间的关系仍不清楚。
库奥皮奥颅内动脉瘤数据库(www.uef.fi/ns)包括自 1980 年以来芬兰东部一个特定人群中所有破裂和未破裂的 sIA 病例。我们比较了 1994 年至 2008 年期间 1058 例破裂和 484 例未破裂 sIA 患者的年龄调整后 2 型糖尿病发病率,使用国家处方药物购买登记。
在 1058 例破裂的 sIA 患者中,43%为男性,57%为女性,破裂时的中位年龄分别为 51 岁和 56 岁。从 1994 年到 2008 年或直至死亡,9%的患者接受了抗糖尿病药物(ADM)治疗,男性的中位起始年龄为 58 岁,女性为 66 岁。在 484 例未破裂的 sIA 患者中,44%为男性,56%为女性,诊断时的中位年龄分别为 53 岁和 55 岁,9%的患者使用了 ADM,男性的中位起始年龄为 61 岁,女性为 66 岁。2 型糖尿病的发病率在 60-70 岁年龄组最高,破裂和未破裂的 sIA 患者之间没有显著差异。
我们的研究表明,2 型糖尿病不会增加 sIA 破裂的风险,sIA 是迄今为止最常见的非创伤性 SAH 原因。