葡萄糖耐量试验后胰岛功能变化与有高血糖病史老年男性的15年死亡率密切相关。

Islet function changes of post-glucose-challenge relate closely to 15 years mortality of elderly men with a history of hyperglycemia.

作者信息

Liu Qianqian, Hu Fan, Zeng Jing, Ma Lichao, Yan Shuangtong, Li Chunlin, Tian Hui, Gong Yanping

机构信息

Department of Endocrinology, The Second Medical Center, The People's Liberation Army General Hospital, National Clinical Research Center of Geriatric Disease, Beijing 100853, China.

Chinese People's Liberation Army Medical School, Beijing 100853, China.

出版信息

Heliyon. 2023 Mar 6;9(3):e14100. doi: 10.1016/j.heliyon.2023.e14100. eCollection 2023 Mar.

DOI:10.1016/j.heliyon.2023.e14100

PMID:36950643

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10025887/

Abstract

AIMS

We aimed to investigate the relationship between islet function changes during a glucose challenge and 15-year mortality in elderly men.

METHODS

Elderly men who did the oral glucose tolerance test in 2005 owing to an abnormal glucose history without diabetes were included. Changes in insulin resistance and secretion were evaluated using the homeostasis model assessment (HOMA) of fast, post-load, and ratios. Comparisons between the dead and the survival groups were analyzed using the Student's t-test (continuous variables) or χ2 test (Categorical variables). Single-factor logistic regression was used to identify the possible affecting factors. Multifactorial logistic regression was used to identify the independent risk factors in total population and in the subgroups. ROC curve was used to assess the predictive ability of risk factor and to determine the cut-off value.

RESULTS

Of the 220 elderly men, 67 died according to 15-year retrospection. Age (OR = 1.243, P = 0.000), diastolic pressure (OR = 0.958, P = 0.027), and HOMA-IR (2 h/0 h) (OR = 1.040, P = 0.010) were independent risk factors for 15-year mortality. Subgroup analysis showed that HOMA-IR (2 h/0 h) was an obvious risk factor, especially for normal glucose tolerance (OR = 1.060, P = 0.030), age 60-70 years (OR = 1.068, P = 0.005), and hypertension (OR = 1.048, P = 0.013); HOMA-β (2 h/0 h) showed some protective effects in the impaired glucose regulation subgroup (OR = 0.779, P = 0.057). HOMA-IR (2 h/0 h) cut-off value was 15.

CONCLUSIONS

HOMA-IR (2 h/0 h) higher than 15 was an independent risk factor for 15-year mortality in elderly men with hyperglycemia history.

摘要

目的

我们旨在研究老年男性在葡萄糖耐量试验期间胰岛功能变化与15年死亡率之间的关系。

方法

纳入2005年因血糖异常史但无糖尿病而进行口服葡萄糖耐量试验的老年男性。使用稳态模型评估（HOMA）来评估空腹、负荷后胰岛素抵抗和分泌变化以及相关比值。死亡组和存活组之间的比较采用Student's t检验（连续变量）或χ2检验（分类变量）。单因素逻辑回归用于识别可能的影响因素。多因素逻辑回归用于识别总体人群和亚组中的独立危险因素。ROC曲线用于评估危险因素的预测能力并确定临界值。

结果

根据15年的随访，220名老年男性中有67人死亡。年龄（OR = 1.243，P = 0.000）、舒张压（OR = 0.958，P = 0.027）和HOMA-IR（2小时/0小时）（OR = 1.040，P = 0.010）是15年死亡率的独立危险因素。亚组分析表明，HOMA-IR（2小时/0小时）是一个明显的危险因素，尤其对于糖耐量正常者（OR = 1.060，P = 0.030）、60 - 70岁者（OR = 1.068，P = 0.005）和高血压患者（OR = 1.048，P = 0.013）；HOMA-β（2小时/0小时）在糖调节受损亚组中显示出一定的保护作用（OR = 0.779，P = 0.057）。HOMA-IR（2小时/0小时）的临界值为15。