Tian Y M, Jing L, Yan H, Zhang B Q, Jiang H Q, Li S, Song J B, Liu S, Xing L Y
Department of Chronic and Non-communicable Disease Control and Prevention, Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110172, China.
Department of Ultrasound, the Fourth Affiliated Hospital of China Medical University, Shenyang 110004, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Jul 10;45(7):941-946. doi: 10.3760/cma.j.cn112338-20240111-00012.
To investigate the prevalence of diabetes in the elderly aged ≥60 years in Liaoning Province from 2017 to 2019 and analyze the impact of blood glucose control on all-cause mortality and cardiovascular disease (CVD) mortality. A survey was conducted in the elderly aged ≥60 years in Liaoning from 2017 to 2019 to collect the information about the prevalence of diabetes and other chronic diseases in the diabetes patients. The mortality of the enrolled subjects was investigated in September 2023. Cox proportional hazards regression models were used to estimate the association between blood glucose control in the elderly with diabetes and the risks of all-cause mortality and CVD mortality. The crude prevalence of diabetes in the elderly aged ≥60 years was 20.2% (2 014/9 958) in Liaoning from 2017 to 2019, and the standardized prevalence rate was 19.9%. The prevalence rates of hypertension, dyslipidemia, and overweight/obesity in the diabetes patients were 77.0%, 51.7%, and 67.5% respectively. The median follow-up time was 5.5 years, and the all-cause mortality and CVD mortality rates in the diabetes patients were 244.3/10 000 person-years and 142.9/10 000 person-years, respectively. The results of the Cox proportional hazards regression model analysis showed that compared with non-diabetic individuals, diabetes patients had an increased risk of all-cause mortality by 1.68 times [hazard ratio ()=1.68, 95%: 1.44-1.94] and an increased risk of CVD mortality by 1.56 times (=1.56, 95%: 1.29-1.89). The differences in risks of all-cause mortality and CVD mortality between the diabetes patients with normal fasting blood glucose and glycated hemoglobin levels and people without diabetes were not significant (all >0.05). The failure to meet either the FPG or HbA1c target increased the risk of all-cause mortality (all <0.05). For individuals who failed to meet the HbA1c target, there was an increased risk of CVD mortality (all <0.05). The comorbidity rate of chronic diseases was higher in the elderly with diabetes than in the elderly without diabetes in Liaoning. Elderly diabetes patients can benefit from good blood glucose control.
调查2017年至2019年辽宁省60岁及以上老年人糖尿病的患病率，并分析血糖控制对全因死亡率和心血管疾病（CVD）死亡率的影响。2017年至2019年对辽宁省60岁及以上老年人进行调查，收集糖尿病患病率及糖尿病患者其他慢性病的信息。2023年9月对纳入研究对象的死亡率进行调查。采用Cox比例风险回归模型估计老年糖尿病患者血糖控制与全因死亡率和CVD死亡率风险之间的关联。2017年至2019年辽宁省60岁及以上老年人糖尿病的粗患病率为20.2%（2014/9958），标准化患病率为19.9%。糖尿病患者中高血压、血脂异常和超重/肥胖的患病率分别为77.0%、51.7%和67.5%。中位随访时间为5.5年，糖尿病患者的全因死亡率和CVD死亡率分别为244.3/10000人年和142.9/10000人年。Cox比例风险回归模型分析结果显示，与非糖尿病个体相比，糖尿病患者全因死亡风险增加1.68倍[风险比（HR）=1.68，95%可信区间（CI）：1.44 - 1.94]，CVD死亡风险增加1.56倍（HR = 1.56，95%CI：1.29 - 1.89）。空腹血糖和糖化血红蛋白水平正常的糖尿病患者与非糖尿病患者在全因死亡率和CVD死亡率风险上的差异无统计学意义（均P>0.05）。未达到空腹血糖或糖化血红蛋白目标会增加全因死亡风险（均P<0.05）。对于未达到糖化血红蛋白目标的个体，CVD死亡风险增加（均P<0.05）。辽宁省糖尿病老年人慢性病合并症发生率高于非糖尿病老年人。老年糖尿病患者可从良好的血糖控制中获益。
