Sajjad Muhammad Amber, Holloway Kara L, de Abreu Lelia L F, Mohebbi Mohammadreza, Kotowicz Mark A, Pedler Daryl, Pasco Julie A
Deakin University, Geelong, Victoria, Australia.
Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
BMJ Open. 2018 Mar 23;8(3):e020346. doi: 10.1136/bmjopen-2017-020346.
To determine whether adults with normoglycaemia, impaired fasting glucose (IFG) and diabetes differed according to the incidence, rate, length and primary reasons for hospital admission.
Retrospective cohort study.
Barwon Statistical Division, Geelong, Australia.
Cohort included 971 men and 924 women, aged 20+ years, participating in the Geelong Osteoporosis Study. Glycaemic status was assessed at cohort entry using fasting plasma glucose, use of antihyperglycaemic medication and/or self-report.
Primary outcome measure was any admission to the major tertiary public hospital in the study region over the follow-up period. Secondary outcome measures were admission rate and length (days).
Over a median follow-up of 7.4 years (IQR 5.3-9.6), participants with diabetes, compared with those with normoglycaemia, were two times as likely to be hospitalised (OR 2.07, 95% CI 1.42 to 3.02), had a higher admission rate (incidence rate ratio 1.61, 95% CI 1.17 to 2.23) and longer hospital stay (third quartile difference 7.7, 95% CI 1.3 to 14.1 and ninth decile difference 16.2, 95% CI 4.2 to 28.3). IFG group was similar to normoglycaemia for the incidence, rate and length of admission. Cardiovascular disease-related diagnoses were the most common primary reasons for hospitalisation across all glycaemic categories.
Our results show increased incidence, rate and length of all-cause hospital admission in adults with diabetes as compared with normoglycaemia; however, we did not detect any associations for IFG. Interventions should focus on preventing IFG-to-diabetes progression and reducing cardiovascular risk in IFG and diabetes.
确定血糖正常、空腹血糖受损（IFG）和糖尿病成人在住院发生率、住院率、住院时长及主要原因方面是否存在差异。
回顾性队列研究。
澳大利亚吉朗市的巴旺统计区。
队列包括971名男性和924名女性，年龄在20岁及以上，参与吉朗骨质疏松症研究。在队列入组时，使用空腹血糖、降糖药物使用情况和/或自我报告评估血糖状态。
主要结局指标是随访期间在研究区域内的大型三级公立医院的任何一次住院情况。次要结局指标是住院率和住院时长（天数）。
在中位随访7.4年（四分位间距5.3 - 9.6年）期间，与血糖正常者相比，糖尿病患者住院的可能性是其两倍（比值比2.07，95%置信区间1.42至3.02），住院率更高（发病率比1.61，95%置信区间1.17至2.23），住院时间更长（第三四分位数差异为7.7，95%置信区间1.3至14.1；第九十分位数差异为16.2，95%置信区间4.2至28.3）。IFG组在住院发生率、住院率和住院时长方面与血糖正常组相似。在所有血糖类别中，心血管疾病相关诊断是最常见的住院主要原因。
我们的结果表明，与血糖正常的成年人相比，糖尿病成年人全因住院的发生率、住院率和住院时长均有所增加；然而，我们未发现IFG存在任何关联。干预措施应侧重于预防IFG进展为糖尿病，并降低IFG和糖尿病患者的心血管风险。
