衰弱与糖尿病前期进展为糖尿病相关，且在糖尿病前期和糖尿病患者中，心血管疾病风险及全因死亡率升高：来自两个前瞻性队列的证据。
Frailty is associated with the progression of prediabetes to diabetes and elevated risks of cardiovascular disease and all-cause mortality in individuals with prediabetes and diabetes: Evidence from two prospective cohorts.
作者信息
He Di, Li Jun, Li Yuhao, Zhu Jinghan, Zhou Tianjing, Xu Yuying, Wu Qiong, Cheng Zongxue, Chen Qing, Liu Zuyun, Zhu Yimin
机构信息
Department of Epidemiology & Biostatistics, and Department of Respiratory Diseases of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China.
The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China.
出版信息
Diabetes Res Clin Pract. 2022 Dec;194:110145. doi: 10.1016/j.diabres.2022.110145. Epub 2022 Nov 7.
AIMS
To investigate the impacts of frailty on the progression of prediabetes to diabetes, cardiovascular disease (CVD) and all-cause mortality in individuals with prediabetes and diabetes.
METHODS
7,933 subjects with prediabetes and diabetes were included from the China Health and Retirement Longitudinal Study (CHARLS) and English Longitudinal Study of Ageing (ELSA). Frailty status was assessed by frailty index and classified as robust, pre-frail, and frail. Logistic regression was used to calculate risks of progression to diabetes. Cox regression was used to calculate risks of CVD and all-cause mortality.
RESULTS
In prediabetes, frail subjects had significantly increased risks of progression to diabetes (CHARLS, OR = 1.55, 95 %CI: 1.09-2.20; ELSA, OR = 1.86, 95 %CI: 1.02-3.37) compared with robust subjects. Frail subjects with prediabetes also presented significantly increased risks of CVD (CHARLS: HR = 1.90, 95 %CI: 1.45-2.48; ELSA: HR = 1.94, 95 %CI: 1.31-2.88) and all-cause mortality (CHARLS: HR = 2.45, 95 %CI: 1.79-3.36; ELSA: HR = 2.13, 95 %CI: 1.46-3.10) than robust subjects with prediabetes. In diabetes, frailty still increased risks of CVD (CHARLS, HR = 2.72, 95 %CI: 1.97-3.77; ELSA, HR = 2.41, 95 %CI: 1.43-4.06) and all-cause mortality (CHARLS, HR = 2.28, 95 %CI: 1.56-3.33; ELSA, HR = 2.28, 95 %CI: 1.47-3.53).
CONCLUSIONS
Frailty is associated with the progression of prediabetes to diabetes and elevated risks of CVD and all-cause mortality in individuals with prediabetes and diabetes.
目的
探讨衰弱对糖尿病前期个体进展为糖尿病、心血管疾病（CVD）以及全因死亡率的影响。
方法
从中国健康与养老追踪调查（CHARLS）和英国老龄化纵向研究（ELSA）中纳入7933例糖尿病前期和糖尿病患者。通过衰弱指数评估衰弱状态，并分为健康、衰弱前期和衰弱。采用逻辑回归计算进展为糖尿病的风险。采用Cox回归计算CVD和全因死亡率的风险。
结果
在糖尿病前期，与健康个体相比，衰弱个体进展为糖尿病的风险显著增加（CHARLS：比值比[OR]=1.55，95%置信区间[CI]：1.09-2.20；ELSA：OR=1.86，95%CI：1.02-3.37）。糖尿病前期的衰弱个体发生CVD（CHARLS：风险比[HR]=1.90，95%CI：1.45-2.48；ELSA：HR=1.94，95%CI：1.31-2.88）和全因死亡率（CHARLS：HR=2.45，95%CI：1.79-3.36；ELSA：HR=2.13，95%CI：1.46-3.10）的风险也显著高于糖尿病前期的健康个体。在糖尿病患者中，衰弱仍会增加CVD（CHARLS：HR=2.72，95%CI：1.97-3.77；ELSA：HR=2.41，95%CI：1.43-4.06）和全因死亡率（CHARLS：HR=2.
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