Janeczko D, Czyzyk A R, Kopczyński J, Krzyzanowski M
Pol Arch Med Wewn. 1989 Mar;81(3):156-67.
A prospective study was made in the years 1973 through 1983 on mortality among 4591 patients (2095 men and 2469 women) with usually noninsulin dependent diabetes, of 1-10 years duration. The anamnestic data and examination parameters obtained during a cross-sectional investigation served as the prognostic changeables (risk factors) to assess the mortality due the most frequent circulatory diseases. The applied model of the logistic regression allowed an attempt of the assessment of their independent effect. Analysis regarding the sex and the methods of diabetes treatment was done in four groups of mortality causes classified according to the VIII Revision of the International Classification of Disease. Injuries and Causes of Death: 1. Cardiovascular system diseases. 2. Ischaemic heart diseases. 3. Other diseases of the cardiovascular system. 4. Vascular diseases of the brain. The quantitative and qualitative effect of the arbitrarily chosen factor of death risk was of varying importance and was related to the sex and the methods of the hypoglycemising treatments. The effect of ageing was an independent factor of death risk among all analysed causes of mortality in both sexes independent from the methods of the hypoglycemising treatment with the one exception of women treated with insulin who died of stroke. Generally however, the ageing factor showed a greater prognostic value in patients treated with insulin. Hypertension, especially if marked, showed to have the most prognostic value among the all analysed factors of death-risk especially in patients on oral antidiabetics. The risk in this group was due mainly to the cerebral stroke, to a lesser degree to the "other" diseases of the circulatory system, and to the all diseases of the circulatory system but to the least degree it was related to the ischaemic heart disease, in both sexes. Among insulin treated diabetics the hypertension was a death-risk of most importance in men usually due to the vascular brain disease and other diseases of the cardiovascular system but to a lesser degree to the circulatory diseases, as a whole. In women however the marked hypertension increased the death-risk in patients with coexisting circulatory disease, not a particular one, but as a whole. Albuminuria had a pronounced prognostic value, especially if massive, in both types of diabetes, mainly, however, among women who died of any cardiovascular causes.(ABSTRACT TRUNCATED AT 400 WORDS)
1973年至1983年对4591例病程1至10年的非胰岛素依赖型糖尿病患者(2095例男性和2469例女性)的死亡率进行了前瞻性研究。横断面调查期间获得的既往病史数据和检查参数用作评估最常见循环系统疾病所致死亡率的预后变量(危险因素)。逻辑回归应用模型尝试评估其独立效应。根据《国际疾病分类》第八版将死亡原因分为四组,对性别和糖尿病治疗方法进行了分析。损伤与死亡原因:1. 心血管系统疾病。2. 缺血性心脏病。3. 其他心血管系统疾病。4. 脑血管疾病。任意选择的死亡风险因素的定量和定性效应重要性各异,且与性别及降糖治疗方法有关。衰老效应是两性所有分析的死亡原因中独立于降糖治疗方法的死亡风险因素,但死于中风的胰岛素治疗女性除外。然而总体而言,衰老因素在胰岛素治疗患者中显示出更大的预后价值。高血压,尤其是重度高血压,在所有分析的死亡风险因素中显示出最大的预后价值,特别是在口服降糖药治疗的患者中。该组的风险主要归因于脑卒,在较小程度上归因于循环系统的“其他”疾病以及所有循环系统疾病,但与缺血性心脏病的相关性最小,男女皆是如此。在胰岛素治疗的糖尿病患者中,高血压对男性而言是最重要的死亡风险,通常归因于脑血管疾病和其他心血管系统疾病,但对整体循环系统疾病的影响较小。然而在女性中,重度高血压会增加合并循环系统疾病患者的死亡风险,并非特定某一种疾病,而是整体增加。蛋白尿具有显著的预后价值,尤其是大量蛋白尿,在两种类型的糖尿病中均如此,不过主要体现在死于任何心血管原因的女性中。(摘要截选至400词)