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新诊断的糖尿病和高血压对貌似健康人群全因死亡率的影响:一项为期十年的随访研究。

The Impact of New-Onset Diabetes Mellitus and Hypertension on All-Cause Mortality in an Apparently Healthy Population: A Ten-Year Follow-Up Study.

机构信息

Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

出版信息

J Diabetes Res. 2021 Nov 5;2021:3964013. doi: 10.1155/2021/3964013. eCollection 2021.

Abstract

INTRODUCTION

The comparative effect of new-onset diabetes mellitus (DM) and hypertension (HT) on long-term mortality is a matter of debate.

MATERIALS AND METHODS

From 2007 to 2017, a 10-year longitudinal retrospective cohort study was conducted in Thailand's tertiary care setting. As baseline data, health check-up data from apparently healthy participants without underlying disease from 2007 were extracted. The vital status of all participants was determined in 2017, ten years after an initial examination. The impact of new-onset DM and HT at baseline on 10-year all-cause mortality was investigated using multivariable logistic regression analysis.

RESULTS

The prevalence of new-onset DM and HT was 6.4% and 28.8%, respectively, at baseline. Newly diagnosed diabetes increased the risk of all-cause mortality over 10 years (adjusted OR 4.77 and 95% CI 2.23-9.99). HT, on the other hand, did not increase the risk of death (adjusted OR 1.24 and 95% CI 0.65-2.35). Different HT and DM status combinations were compared to a nondiabetic, nonhypertensive reference. Individuals who were diabetic and hypertensive had a greater risk of death (adjusted OR 6.22 and 95% CI 2.22-17.00). Having DM without HT also increased the risk of death (adjusted OR 4.36 and 95% CI 1.35-12.87). However, having HT without DM did not result in a significant increase in 10-year mortality risk (adjusted OR 1.21 and 95% CI 0.57-2.56).

CONCLUSION

In an apparently healthy population, new-onset DM is more strongly associated with 10-year all-cause mortality than new-onset HT. Having both DM and HT was associated with a greater risk of death when compared to having DM or HT alone.

摘要

简介

新发糖尿病(DM)和高血压(HT)对长期死亡率的影响仍存在争议。

材料和方法

本研究为 2007 年至 2017 年在泰国三级保健机构进行的 10 年纵向回顾性队列研究。本研究提取了 2007 年健康体检数据作为基线资料,这些数据来自无潜在疾病的健康体检者。2017 年,在初始检查 10 年后,确定所有参与者的生存状态。采用多变量逻辑回归分析探讨基线时新发 DM 和 HT 对 10 年全因死亡率的影响。

结果

基线时新发 DM 和 HT 的患病率分别为 6.4%和 28.8%。新诊断的糖尿病使 10 年内全因死亡率的风险增加(调整后的 OR 4.77,95%CI 2.23-9.99)。HT 则不会增加死亡风险(调整后的 OR 1.24,95%CI 0.65-2.35)。将不同的 HT 和 DM 状态组合与非糖尿病、非高血压的参考组进行比较。糖尿病和高血压并存的患者死亡风险更高(调整后的 OR 6.22,95%CI 2.22-17.00)。无 HT 的 DM 患者死亡风险也增加(调整后的 OR 4.36,95%CI 1.35-12.87)。然而,无 DM 的 HT 并不导致 10 年死亡率风险显著增加(调整后的 OR 1.21,95%CI 0.57-2.56)。

结论

在看似健康的人群中,新发 DM 与 10 年全因死亡率的相关性强于新发 HT。与仅患 DM 或 HT 相比,DM 和 HT 同时存在与死亡风险增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88f5/8589482/65870b1330ea/JDR2021-3964013.001.jpg

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