Fan X K, Li M Y, Qin Y, Shen C, Lu Y, Sun Z M, Yang J, Tao R, Zhou J Y, Hang D, Su J
Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Apr 10;45(4):498-505. doi: 10.3760/cma.j.cn112338-20231009-00210.
To investigate the associations of onset age, diabetes duration, and glycated hemoglobin (HbA1c) levels with ischemic stroke risk in type 2 diabetes patients. The participants were from Comprehensive Research on the Prevention and Control of the Diabetes in Jiangsu Province. The study used data from baseline survey from December 2013 to January 2014 and follow-up until December 31, 2021. After excluding the participants who had been diagnosed with stroke at baseline survey and those with incomplete information on onset age, diabetes duration, and HbA1c level, a total of 17 576 type 2 diabetes patients were included. Cox proportional hazard model was used to calculate the hazard ratio () and 95% of onset age, diabetes duration, and HbA1c level for ischemic stroke. During the median follow-up time of 8.02 years, 2 622 ischemic stroke cases were registered. Multivariate Cox proportional risk regression model showed that a 5-year increase in type 2 diabetes onset age was significantly associated with a 5% decreased risk for ischemic stroke (=0.95, 95%: 0.92-0.99). A 5-year increase in diabetes duration was associated with a 5% increased risk for ischemic stroke (=1.05, 95%: 1.02-1.10). Higher HbA1c (per 1 standard deviation increase:=1.17, 95%: 1.13-1.21) was associated with an increased risk for ischemic stroke. The earlier onset age of diabetes, longer diabetes duration, and high levels of HbA1c are associated with an increased risk for ischemic stroke in type 2 diabetes patients.
探讨2型糖尿病患者的发病年龄、糖尿病病程及糖化血红蛋白(HbA1c)水平与缺血性卒中风险的相关性。研究对象来自江苏省糖尿病综合防治研究。本研究使用了2013年12月至2014年1月基线调查的数据,并随访至2021年12月31日。在排除基线调查时已诊断为卒中的参与者以及发病年龄、糖尿病病程和HbA1c水平信息不完整的参与者后,共纳入17576例2型糖尿病患者。采用Cox比例风险模型计算缺血性卒中的发病年龄、糖尿病病程和HbA1c水平的风险比(HR)及95%置信区间。在8.02年的中位随访时间内,共登记了2622例缺血性卒中病例。多变量Cox比例风险回归模型显示,2型糖尿病发病年龄每增加5岁,缺血性卒中风险显著降低5%(HR=0.95,95%置信区间:0.92-0.99)。糖尿病病程每增加5年,缺血性卒中风险增加5%(HR=1.05,95%置信区间:1.02-1.10)。较高的HbA1c水平(每增加1个标准差:HR=1.17,95%置信区间:1.13-1.21)与缺血性卒中风险增加相关。2型糖尿病患者糖尿病发病年龄越早、病程越长以及HbA1c水平越高,缺血性卒中风险越高。