NHS England, Wellington House, 122-135 Waterloo Road, London SE1 8UG, UK; Department of Metabolism, Digestion and Reproduction, Imperial College London, South Kensington, London; Chelsea and Westminster hospital NHS Foundation Trust, London, UK.
MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
Diabetes Res Clin Pract. 2024 Jun;212:111692. doi: 10.1016/j.diabres.2024.111692. Epub 2024 May 7.
To assess the effects of non-diabetic hyperglycaemia (NDH, also known as pre-diabetes), including the impact of the NHS Diabetes Prevention Programme (NHS DPP), on COVID-19-related mortality during the pandemic.
This study included all 61,438,225 individuals registered with General Practices in England and alive on 1st March 2020. We assessed COVID-19-related mortality in the 2,290,280(3.7 %) individuals with diagnosed NDH between March 2020 and February 2022 compared to those without diagnosed NDH or diabetes using Cox regression to adjust for demographic factors and cardiovascular comorbidities. Individuals with diagnosed NDH were further sub-categorised based on their contact with the NHS DPP (N = 376,590). Analyses were stratified by age (years) (<50, 50-69 and ≥ 70).
There were 158,070 COVID-19 deaths; 17,280(11 %) for people with diagnosed NDH. The adjusted hazard ratio (HR) was 0.95(0.93-0.96),p < 0.001 for those with diagnosed NDH compared to those without diagnosed diabetes or NDH. By age (years), HRs were, 2.53(2.23-2.88),p < 0.001 for < 50, 1.29(1.24-1.35),p < 0.001 for 50-69 and 0.87(0.85-0.89),p < 0.001 for ≥ 70. NHS DPP attendance was associated with lower COVID-19 mortality with a dose-response relationship with engagement.
Younger people with diagnosed NDH were at higher relative risk of COVID-19 mortality. Attendance at the NHS DPP was associated with significantly lower COVID-19-related mortality.
评估非糖尿病性高血糖（NDH，也称为糖尿病前期）的影响，包括国民保健制度糖尿病预防计划（NHS DPP）对大流行期间与 COVID-19 相关的死亡率的影响。
本研究纳入了 2020 年 3 月 1 日在英格兰注册且存活的所有 61438225 名个体。我们评估了 2020 年 3 月至 2022 年 2 月期间，2290280 名（3.7%）诊断为 NDH 的个体与未诊断为 NDH 或糖尿病的个体之间与 COVID-19 相关的死亡率，使用 Cox 回归调整人口统计学因素和心血管合并症。根据与 NHS DPP 的接触情况，进一步对诊断为 NDH 的个体进行亚分类（N=376590）。分析按年龄（岁）分层（<50、50-69 和≥70）。
有 158070 例 COVID-19 死亡；17280（11%）例发生在诊断为 NDH 的患者中。与未诊断为糖尿病或 NDH 的患者相比，诊断为 NDH 的患者的调整后危险比（HR）为 0.95（0.93-0.96），p<0.001。按年龄（岁）分层，<50 岁的 HR 为 2.53（2.23-2.88），p<0.001，50-69 岁的 HR 为 1.29（1.24-1.35），p<0.001，≥70 岁的 HR 为 0.87（0.85-0.89），p<0.001。参加 NHS DPP 与 COVID-19 死亡率降低相关，且与参与程度呈剂量反应关系。
诊断为 NDH 的年轻人 COVID-19 死亡率相对较高。参加 NHS DPP 与 COVID-19 相关死亡率显著降低相关。
