Division of Nephrology, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University, College of Medicine, Seoul, Republic of Korea.
Division of Nephrology, Department of Internal Medicine, Korea University, College of Medicine, Seoul, Republic of Korea.
J Diabetes. 2024 Sep;16(9):e13601. doi: 10.1111/1753-0407.13601.
Glycemic control is crucial in peritoneal dialysis (PD) patients with diabetes. Although fasting blood glucose (FBG) is the most commonly used index to measure blood glucose levels, there is currently no evidence supporting the association between FBG level and mortality risk in PD patients.
A total of 3548 diabetic PD patients between 2002 and 2018 were enrolled from the National Health Insurance Service database of Korea. We investigated the association between FBG levels and the risk of all-cause and cause-specific mortality.
Patients with FBG levels 80-99 mg/dL exhibited the highest survival rates, whereas those with FBG levels ≥180 mg/dL had the lowest survival rates. Compared with FBG levels 80-99 mg/dL, the adjusted hazard ratios and 95% confidence interval for all-cause mortality significantly increased as follows: 1.02 (0.87-1.21), 1.41 (1.17-1.70), 1.44 (1.18-2.75), and 2.05 (1.73-2.42) for patients with FBG 100-124 mg/dL, FBG 125-149 mg/dL, FBG 150-179 mg/dL, and FBG ≥180 mg/dL, respectively. The risk for all-cause mortality also showed an increasing pattern in patients with FBG levels <80 mg/L. The risk of cardiovascular death significantly increased as FBG levels exceeded 125 mg/dL. However, the risk of infection-related and malignancy-related deaths did not show a significant increase with increasing FBG levels.
There was an increase in the risk of all-cause mortality as FBG levels exceeded 125 mg/dL in PD patients with diabetes, and the risk of cardiovascular death showed a strong correlation with FBG levels compared with other causes of death.
血糖控制对于接受腹膜透析（peritoneal dialysis，PD）治疗的糖尿病患者至关重要。尽管空腹血糖（fasting blood glucose，FBG）是最常用于测量血糖水平的指标，但目前尚无证据表明 FBG 水平与 PD 患者的死亡风险之间存在关联。
本研究共纳入了 2002 年至 2018 年期间韩国国家健康保险服务数据库中的 3548 名患有糖尿病的 PD 患者。我们研究了 FBG 水平与全因和特定原因死亡率风险之间的关系。
FBG 水平为 80-99mg/dL 的患者生存率最高，而 FBG 水平≥180mg/dL 的患者生存率最低。与 FBG 水平为 80-99mg/dL 的患者相比，FBG 水平为 100-124mg/dL、125-149mg/dL、150-179mg/dL 和≥180mg/dL 的患者发生全因死亡的调整后风险比和 95%置信区间分别显著升高（1.02[0.87-1.21]、1.41[1.17-1.70]、1.44[1.18-2.75]和 2.05[1.73-2.42]）。FBG 水平<80mg/L 的患者发生全因死亡的风险也呈现出升高的趋势。当 FBG 水平超过 125mg/dL 时，心血管死亡的风险显著增加。然而，感染相关和恶性肿瘤相关死亡的风险并未随着 FBG 水平的升高而显著增加。
在患有糖尿病的 PD 患者中，FBG 水平超过 125mg/dL 会增加全因死亡风险，与其他死亡原因相比，心血管死亡的风险与 FBG 水平具有很强的相关性。
