Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China.
Front Public Health. 2022 May 20;10:883383. doi: 10.3389/fpubh.2022.883383. eCollection 2022.
Living alone is often associated with reduced social support. However, there are limited data on the relationship between living alone and cardiovascular events or hypoglycemia in patients with type 2 diabetes mellitus (T2DM). This study reports a analysis of the "Action to Control Cardiovascular Risk in Diabetes (ACCORD)" study.
The Cox proportional hazard models were used to compare the hazard ratios (HRs) for the adverse health events selected as primary endpoints in the study participants; these were compared between those living alone and those living with others. The primary outcomes were hypoglycemia requiring any assistance (HAA), hypoglycemia requiring medical assistance (HMA), and major cardiovascular events (MACEs, including cardiac death, non-fatal myocardial infarction (MI), and non-fatal stroke). Our study included 10,249 participants (2,078 living alone) with a follow-up period of 4.91 ± 1.22 years.
After a multivariable adjustment, the risk of HAA, HMA, and MACEs did not differ significantly between participants living alone and those living with others (HAA, HR: 0.88, 95% CI: 0.75-1.04, = 0.13; HMA, HR: 1.11, 95% CI: 0.92-1.34, = 0.26; MACEs, HR: 0.98, 95% CI: 0.80-1.19, = 0.82). Participants living alone had higher levels of glycated hemoglobin in the middle follow-up period than those living with others.
In patients with T2DM, living alone did not increase the risk of cardiovascular events (cardiac death, non-fatal MI, or non-fatal stroke) and hypoglycemia. Patients living alone had higher Hb1AC levels than those living with others. Clinicians should consider an effective blood glucose control regardless of their living arrangement.
独居通常与社会支持减少有关。然而,关于 2 型糖尿病(T2DM)患者独居与心血管事件或低血糖之间的关系,数据有限。本研究报告了对“控制糖尿病心血管风险行动(ACCORD)”研究的分析。
使用 Cox 比例风险模型比较作为研究参与者主要终点的不良健康事件的风险比(HR);将这些 HR 与独居者和与他人同住者进行比较。主要结局是需要任何帮助的低血糖(HAA)、需要医疗帮助的低血糖(HMA)和主要心血管事件(MACE,包括心源性死亡、非致死性心肌梗死(MI)和非致死性中风)。我们的研究包括 10249 名参与者(2078 名独居者),随访时间为 4.91±1.22 年。
经过多变量调整,独居者和与他人同住者的 HAA、HMA 和 MACE 风险无显著差异(HAA,HR:0.88,95%CI:0.75-1.04,P=0.13;HMA,HR:1.11,95%CI:0.92-1.34,P=0.26;MACEs,HR:0.98,95%CI:0.80-1.19,P=0.82)。在随访中期,独居者的糖化血红蛋白水平高于与他人同住者。
在 T2DM 患者中,独居不会增加心血管事件(心源性死亡、非致死性 MI 或非致死性中风)和低血糖的风险。独居者的 Hb1AC 水平高于与他人同住者。临床医生应考虑有效控制血糖,而不论其居住安排如何。