Gu Weijun, Ren Yanfeng, Ji Linong, Hong Tianpei, Mu Yiming, Guo Lixin, Li Qiang, Tian Qing, Yang Xilin
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
J Diabetes Complications. 2016 Apr;30(3):462-8. doi: 10.1016/j.jdiacomp.2015.12.024. Epub 2015 Dec 29.
The present study aimed to examine the nonlinear associations between risk factors and mild hypoglycemia in Chinese patients with type 2 diabetes mellitus (T2DM).
From May 2013 to August 2013, we conducted a cross sectional survey of 6633 inpatients with T2DM and without severe hypoglycemia, aged 21-77 years, from 81 top tertiary hospitals in China. Mild hypoglycemia was defined as having hypoglycemia with symptoms in one month. Binary logistic regression analysis with restricted cubic splines was used to estimate odds ratio curves of non-linear risk factors for mild hypoglycemia.
Increasing body mass index was associated with decreasing risk of mild hypoglycemia in a linear manner while age, duration of diabetes, glycated hemoglobin (HbA1c), mean artery pressure and lipids were associated with mild hypoglycemia in non-linear manners. Age ≥40 years, duration ≥2 years, HbA1c ≥7.0-<11.5% (≥53-<102 mmol/mol), triglyceride ≥1.7-<3.6 mmol/L, low-density lipoprotein cholesterol (LDL-C) ≥2.6-<4.8 mmol/L, and high-density lipoprotein cholesterol (HDL-C) ≥1.2-<4.8 mmol/L were associated with increased risks of mild hypoglycemia.
Chinese T2DM patients with age≥40 years, duration of diabetes ≥2-<6 years, HbA1c ≥7.0-<11.5% (≥53-<102 mmol/mol), LDL-C ≥2.6-<4.8mmol/L, HDL-C ≥1.2-<4.8 mmol/L or triglyceride ≥1.7-<3.6 mmol/L were at particularly high risk for mild hypoglycemia.
本研究旨在探讨中国2型糖尿病（T2DM）患者中危险因素与轻度低血糖之间的非线性关联。
2013年5月至2013年8月，我们对来自中国81家顶级三级医院的6633例年龄在21 - 77岁、无严重低血糖的T2DM住院患者进行了横断面调查。轻度低血糖定义为在一个月内有低血糖症状。采用受限立方样条的二元逻辑回归分析来估计轻度低血糖非线性危险因素的比值比曲线。
体重指数增加与轻度低血糖风险呈线性下降相关，而年龄、糖尿病病程、糖化血红蛋白（HbA1c）、平均动脉压和血脂与轻度低血糖呈非线性相关。年龄≥40岁、病程≥2年、HbA1c≥7.0 - <11.5%（≥53 - <102 mmol/mol）、甘油三酯≥1.7 - <3.6 mmol/L、低密度脂蛋白胆固醇（LDL - C）≥2.6 - <4.8 mmol/L以及高密度脂蛋白胆固醇（HDL - C）≥1.2 - <4.8 mmol/L与轻度低血糖风险增加相关。
年龄≥40岁、糖尿病病程≥2 - <6年、HbA1c≥7.0 - <11.5%（≥53 - <102 mmol/mol）、LDL - C≥2.6 - <4.8mmol/L、HDL - C≥1.2 - <4.8 mmol/L或甘油三酯≥1.7 - <3.6 mmol/L的中国T2DM患者发生轻度低血糖的风险特别高。
