Asturias Central University Hospital, Endocrinology and Nutrition Department, Oviedo, Asturias, Spain.
Málaga Regional University Hospital, Endocrinology and Nutrition Department, Málaga, Andalucía, Spain.
PLoS One. 2019 Jan 31;14(1):e0211070. doi: 10.1371/journal.pone.0211070. eCollection 2019.
People who develop type 2 diabetes (T2D) are known to have a higher mortality risk. We estimated all-cause, cardiovascular, and cancer mortality-risks in our patient cohort according to categories of impaired glucose metabolism. This 18-year retrospective analysis included a region-wide, representative sample of a population aged 30-75 years. Age- and sex-stratified hazard ratios (HRs) were calculated for 48 participants with diagnosed T2D, 83 with undiagnosed T2D (HbA1c ≥6.5%, fasting glycemia ≥126 mg/dL, or glycemia after 75 g glucose load ≥200 mg/dL); 296 with prediabetes (HbA1c 5.7%-6.4%, fasting glycemia 100-125 mg/dL, or glycemia after 75 g glucose load 140-199 mg/dL), and 607 with normoglycemia. Over 18,612 person-years, 32 individuals with undiagnosed T2D, 30 with diagnosed T2D, 62 with prediabetes, and 80 with normoglycemia died. Total sample crude mortality rate (MR) was 10.96 deaths per 1,000 person-years of follow-up. MR of the diagnosed T2D group was more than 3-times higher and that of newly diagnosed T2D was 2-times higher (34.72 and 21.42, respectively) than total sample MR. Adjusted HR for all-cause mortality was 2.02 (95% confidence interval 1.29-3.16) and 1.57 (95% CI 1.00-2.28) in the diagnosed T2D group and the newly diagnosed T2D group, respectively. Adjusted HR for cardiovascular mortality in the T2D group was 2.79 (95% CI 1.35-5.75); this risk was greatly increased in women with T2D: 6.72 (95% CI 2.50-18.07). In Asturias, age- and sex-standardized all-cause mortality is more than 2-times higher for adults with T2D than for adults without T2D. The HR for cardiovascular mortality is considerably higher in T2D women than in normoglycemic women.
已知患有 2 型糖尿病（T2D）的人死亡风险更高。我们根据葡萄糖代谢受损的类别，估算了患者队列的全因、心血管和癌症死亡率风险。这项 18 年的回顾性分析包括了一个年龄在 30-75 岁的全地区代表性人群样本。对于确诊的 T2D 患者（HbA1c≥6.5%、空腹血糖≥126mg/dL 或 75g 葡萄糖负荷后血糖≥200mg/dL）、未确诊的 T2D 患者（HbA1c≥6.5%、空腹血糖≥126mg/dL 或 75g 葡萄糖负荷后血糖≥200mg/dL）、83 例、前期糖尿病患者（HbA1c5.7%-6.4%、空腹血糖 100-125mg/dL 或 75g 葡萄糖负荷后血糖 140-199mg/dL）和血糖正常的患者（HbA1c5.7%-6.4%、空腹血糖 100-125mg/dL 或 75g 葡萄糖负荷后血糖 140-199mg/dL），分别计算了 48 例、296 例和 607 例。在 18612 人年中，32 例未确诊的 T2D 患者、30 例确诊的 T2D 患者、62 例前期糖尿病患者和 80 例血糖正常患者死亡。总样本粗死亡率（MR）为每 1000 人年随访 10.96 人死亡。诊断为 T2D 组的 MR 高于总样本 MR 的 3 倍以上，新诊断为 T2D 组的 MR 高于总样本 MR 的 2 倍以上（分别为 34.72 和 21.42）。全因死亡率的调整后 HR 分别为诊断为 T2D 组 2.02（95%置信区间 1.29-3.16）和新诊断为 T2D 组 1.57（95%置信区间 1.00-2.28）。T2D 组心血管死亡率的调整后 HR 为 2.79（95%置信区间 1.35-5.75）；T2D 女性的这种风险大大增加：6.72（95%置信区间 2.50-18.07）。在阿斯图里亚斯，年龄和性别标准化的全因死亡率对于患有 T2D 的成年人来说是不患有 T2D 的成年人的 2 倍以上。T2D 女性的心血管死亡率 HR 明显高于血糖正常的女性。
