日本 2 型糖尿病患者中风的发生率及其与血糖控制和生活方式的关系：福冈糖尿病登记研究。
Incidence of stroke and its association with glycemic control and lifestyle in Japanese patients with type 2 diabetes mellitus: The Fukuoka diabetes registry.
机构信息
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Diabetes Center and Clinical Research Center, Hakujyuji Hospital, Fukuoka, Japan.
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
出版信息
Diabetes Res Clin Pract. 2021 Feb;172:108518. doi: 10.1016/j.diabres.2020.108518. Epub 2020 Oct 21.
AIMS
We prospectively investigated the incidence of stroke and its subtypes, risk factors and prognosis in Japanese patients with type 2 diabetes.
METHODS
A total of 4,875 participants with type 2 diabetes (mean age 65.4 years, male 57%, previous stroke 10%) were investigated for the development of stroke for 5 years. Risk factors were evaluated using multivariable adjusted Cox proportional models.
RESULTS
The incidence rates per 1,000 person-years were 6.7 for new-onset stroke (ischemic 5.5, hemorrhagic 1.2) and 22.7 for recurrent stroke (ischemic 18.8, hemorrhagic 3.8), respectively. Ischemic stroke was significantly associated with age, male, reduced regular physical activity, HbA, diabetic kidney disease and previous stroke. Lacunar infarction was significantly associated with obesity, reduced regular physical activity, HbA and diabetic kidney disease, whereas atherothrombotic stroke was significantly associated with age, reduced intake of dietary fiber, reduced regular physical activity, HbA and previous stroke. Recurrent stroke was significantly associated with depressive symptom. Thirty-day and one-year survival was 76% and 64% for hemorrhagic stroke, and 96% and 91% for ischemic stroke, respectively.
CONCLUSIONS
The current study reemphasized the importance of glycemic control and lifestyle modification such as regular physical exercise for stroke prevention in patients with type 2 diabetes.
目的
我们前瞻性地研究了日本 2 型糖尿病患者中风及其亚型的发生率、危险因素和预后。
方法
共调查了 4875 名 2 型糖尿病患者（平均年龄 65.4 岁，男性 57%，既往中风 10%），随访 5 年观察中风的发生情况。使用多变量调整 Cox 比例模型评估危险因素。
结果
新发病例中风的发生率为每 1000 人年 6.7 例（缺血性 5.5 例，出血性 1.2 例），复发性中风为 22.7 例（缺血性 18.8 例，出血性 3.8 例）。缺血性中风与年龄、男性、规律体力活动减少、HbA、糖尿病肾病和既往中风显著相关。腔隙性梗死与肥胖、规律体力活动减少、HbA 和糖尿病肾病显著相关，而动脉粥样硬化血栓性中风与年龄、膳食纤维摄入减少、规律体力活动减少、HbA 和既往中风显著相关。复发性中风与抑郁症状显著相关。出血性中风 30 天和 1 年生存率分别为 76%和 64%，缺血性中风分别为 96%和 91%。
结论
本研究再次强调了控制血糖和生活方式改变（如规律体育锻炼）对 2 型糖尿病患者预防中风的重要性。
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