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2 型糖尿病患者颈动脉介入治疗后的血糖控制与结局:一项瑞典全国队列研究。

Glycemic control and outcome after carotid intervention in patients with T2D: A Swedish nationwide cohort study.

机构信息

Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Sweden.

Department of Clinical Sciences, Lund University, Malmö, Sweden.

出版信息

Diab Vasc Dis Res. 2023 May-Jun;20(3):14791641231176767. doi: 10.1177/14791641231176767.

Abstract

AIMS

To investigate the association between glycemic control and outcome in people with type 2 diabetes (T2D) after carotid intervention due to carotid stenosis.

METHODS

Observational nationwide population-based cohort study using inverse probability treatment weighting (IPTW) and Cox regressions with covariates, that is, 4 stepwise models, investigating the relationship between terciles of glycated hemoglobin (HbA1c) levels and stroke or death.

RESULTS

1115 subjects with T2D undergoing carotid intervention were included during Jan 1st 2009 to Dec 31st 2015. Divided into terciles, with a mean HbA1c level of 44 (tercile 1), 53 (tercile 2), and 72 (tercile 3) mmol/mol. By using IPTW and Cox regression, each model was stepwise introduced for the investigating of relative risks, that is, hazard ratios (HRs) with associated 95% confidence intervals (CI). There was a significant increased risk for stroke or death, in every model observed for tercile 3, compared to tercile 1: HR for model 4: 1.35 (95% CI 1.02-1.78). No difference for stroke or death within 30 days was observed between the groups.

CONCLUSION

Poor glycemic control in people with T2D after carotid intervention is associated with an increased long-term risk for stroke or death.

摘要

目的

探讨 2 型糖尿病(T2D)患者颈动脉狭窄行颈动脉介入治疗后血糖控制与结局的关系。

方法

采用逆概率治疗加权(IPTW)和协变量 Cox 回归(即 4 个逐步模型)进行观察性全国人群队列研究,探讨糖化血红蛋白(HbA1c)水平三分位数与卒中或死亡之间的关系。

结果

2009 年 1 月 1 日至 2015 年 12 月 31 日期间,共纳入 1115 例 T2D 患者行颈动脉介入治疗。根据 HbA1c 水平分为三分位数,平均水平分别为 44(三分位数 1)、53(三分位数 2)和 72(三分位数 3)mmol/mol。采用 IPTW 和 Cox 回归,逐步引入每个模型,以研究相对风险,即风险比(HR)及其相关的 95%置信区间(CI)。与三分位数 1 相比,三分位数 3 的卒中或死亡风险在每个模型中均显著增加:模型 4 的 HR 为 1.35(95%CI 1.02-1.78)。两组间 30 天内卒中或死亡无差异。

结论

T2D 患者颈动脉介入治疗后血糖控制不佳与长期卒中或死亡风险增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d5/10286178/b4196fddc50d/10.1177_14791641231176767-fig1.jpg

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