Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China.
Department of Cardiology, Da Qing First Hospital, Da Qing, China.
J Diabetes. 2024 Aug;16(8):e13598. doi: 10.1111/1753-0407.13598.
This study aimed to investigate the potential differences in the influence of impaired glucose tolerance (IGT) with and without metabolic syndrome (MetS) on cardiovascular (CV) events and mortality.
Participants having IGT with MetS (IGT_MetS), those having IGT without MetS (IGT_non_MetS), and those having normal glucose tolerance (NGT) without MetS (NGT_non_MetS) (N = 246, N = 294, and N = 471, respectively) were included in this study. Cox proportional hazards regression was used to examine the relationship among these three groups and CV events and mortality.
Over the 30-year follow-up period, 57 (12.1%) participants having NGT_non_MetS, 55 (18.71%) with IGT_non_MetS, and 74 (30.08%) with IGT_MetS experienced CV mortality. After adjusting for risk factors, the hazard ratios for CV mortality were 2 (95% confidence interval [CI], 1.38-2.91) for the IGT_non_MetS group and 2.96 (95% CI, 2.09-4.19) for the IGT_MetS group, compared with the NGT_non_MetS group. Similar patterns were observed for CV events, with hazard ratios of 1.49 (95% CI, 1.19-1.88) for the IGT_non_MetS group and 1.97 (95% CI, 1.58-2.47) for the IGT_MetS group. Sensitivity analysis revealed that the hazard ratios of the IGT_non_MetS and IGT_MetS groups indicated a higher risk of all-cause mortality, myocardial infarction events or myocardial infarction mortality, and stroke events or stroke mortality compared with that of the NGT_non_MetS group.
IGT_non_MetS increased the risk of CV mortality and events. Furthermore, when it occurred in conjunction with MetS, it further increased the risk of CV mortality and events. This suggested that active intervention is required.
本研究旨在探讨合并和不合并代谢综合征（MetS）的糖耐量受损（IGT）对心血管（CV）事件和死亡率的潜在影响差异。
纳入糖耐量正常且不合并 MetS（NGT_non_MetS）、单纯 IGT 且不合并 MetS（IGT_non_MetS）和单纯 IGT 合并 MetS（IGT_MetS）的参与者（分别为 246、294 和 471 人）。采用 Cox 比例风险回归分析三组间 CV 事件和死亡率的关系。
在 30 年的随访期间，57 名 NGT_non_MetS 参与者（12.1%）、55 名 IGT_non_MetS 参与者（18.71%）和 74 名 IGT_MetS 参与者（30.08%）发生 CV 死亡。校正危险因素后，IGT_non_MetS 组和 IGT_MetS 组的 CV 死亡率的风险比分别为 2（95%置信区间[CI]：1.38-2.91）和 2.96（95%CI：2.09-4.19），与 NGT_non_MetS 组相比。CV 事件也出现类似模式，IGT_non_MetS 组的风险比为 1.49（95%CI：1.19-1.88），IGT_MetS 组为 1.97（95%CI：1.58-2.47）。敏感性分析显示，IGT_non_MetS 组和 IGT_MetS 组的风险比表明，与 NGT_non_MetS 组相比，全因死亡率、心肌梗死事件或心肌梗死死亡率以及卒中和卒中死亡率的风险更高。
IGT_non_MetS 增加了 CV 死亡和事件的风险。此外，当与 MetS 同时发生时，会进一步增加 CV 死亡和事件的风险。这表明需要积极干预。
