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衰弱对糖尿病患者死亡率、住院率、心血管事件及并发症的影响:一项系统评价与荟萃分析

Impact of frailty on mortality, hospitalization, cardiovascular events, and complications in patients with diabetes mellitus: a systematic review and meta-analysis.

作者信息

Miao Zhiying, Zhang Qiuyi, Yin Jijing, Li Lihua, Feng Yan

机构信息

Jinan Maternal and Child Health Care Hospital, Jinan, Shandong, China.

Jinan Lixia District People's Hospital, 73 Wenhua East Road, Lixia District, Jinan, 250011, Shandong, China.

出版信息

Diabetol Metab Syndr. 2024 May 28;16(1):116. doi: 10.1186/s13098-024-01352-6.

Abstract

BACKGROUND

Several studies have focused on the impact of frailty on the health outcomes of individuals with diabetes mellitus (DM). This meta-analysis aims to systematically synthesize the existing evidence on frailty and its association with mortality, hospitalizations, cardiovascular diseases, and diabetic complications in DM.

METHODS

A comprehensive search in PubMed, Embase, and SCOPUS was carried out to identify relevant studies assessing the impact of frailty on mortality, hospitalizations, complications, and cardiovascular events in individuals with DM. The quality of the included studies was evaluated using the New Castle Ottawa Scale.

RESULTS

From the 22 studies included, our meta-analysis revealed significant associations between frailty and adverse outcomes in individuals with DM. The pooled hazard ratios for mortality and frailty showed a substantial effect size of 1.84 (95% CI 1.46-2.31). Similarly, the odds ratio for hospitalization and frailty demonstrated a significant risk with an effect size of 1.63 (95% CI 1.50-1.78). In addition, frailty was associated with an increased risk of developing diabetic nephropathy (HR, 3.17; 95% CI 1.16-8.68) and diabetic retinopathy (HR, 1.94; 95% CI 0.80-4.71).

CONCLUSION

Our results show a consistent link between frailty and increased mortality, heightened hospitalization rates, and higher risks of cardiovascular disease, diabetic nephropathy, and diabetic retinopathy for patients with DM. PROSPERO Registration Number: CRD42023485166.

摘要

背景

多项研究聚焦于衰弱对糖尿病(DM)患者健康结局的影响。本荟萃分析旨在系统整合关于衰弱及其与DM患者死亡率、住院率、心血管疾病和糖尿病并发症之间关联的现有证据。

方法

在PubMed、Embase和SCOPUS中进行全面检索,以识别评估衰弱对DM患者死亡率、住院率、并发症和心血管事件影响的相关研究。使用纽卡斯尔渥太华量表评估纳入研究的质量。

结果

在纳入的22项研究中,我们的荟萃分析揭示了衰弱与DM患者不良结局之间存在显著关联。死亡率与衰弱的合并风险比显示出1.84的显著效应量(95%置信区间1.46 - 2.31)。同样,住院率与衰弱的比值比显示出显著风险,效应量为1.63(95%置信区间1.50 - 1.78)。此外,衰弱与糖尿病肾病(风险比,3.17;95%置信区间1.16 - 8.68)和糖尿病视网膜病变(风险比,1.94;95%置信区间0.80 - 4.71)的发生风险增加相关。

结论

我们的结果表明,衰弱与DM患者死亡率增加、住院率升高以及心血管疾病、糖尿病肾病和糖尿病视网膜病变的更高风险之间存在一致的关联。PROSPERO注册号:CRD42023485166。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1818/11131325/75cf9865fb0e/13098_2024_1352_Fig1_HTML.jpg

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