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糖尿病前期逆转至正常血糖水平后的死亡率及心血管风险降低:一项系统评价

MORTALITY AND CARDIOVASCULAR RISK REDUCTION AFTER REVERSION OF PREDIABETES TO NORMOGLYCEMIA: A SYSTEMATIC REVIEW.

作者信息

Hengky A, Pratama K G, Tandarto K

机构信息

Atma Jaya Catholic University of Indonesia - Pluit Campus -Jl. Pluit Raya II , Jakarta.

Rumah Sakit Ken Saras - General Medicine, Semarang Regency, Central Java, Indonesia.

出版信息

Acta Endocrinol (Buchar). 2024 Jan-Mar;20(1):74-79. doi: 10.4183/aeb.2024.74. Epub 2024 Oct 3.

DOI:10.4183/aeb.2024.74
PMID:39372294
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11449248/
Abstract

INTRODUCTION

It is unclear whether reversion to normoglycemia decreases overall cardiovascular events and all-cause mortality risk in the long term. We aim to investigate the magnitude of change in cardiovascular risk and mortality in patients who reverted from a prediabetes state.

METHODS

Three electronic databases, including PubMed, Proquest, and EBSCOHost databases, were utilized. A manual hand search of articles was also done. We selected studies that measure cardiovascular risk and all-cause mortality risk after reversion from prediabetes to normoglycemia. The following terms and its variant were used in the search strategy: 'reversion,' 'prediabetes,' 'normoglycemia,' cardiovascular risk,' and 'mortality.'

RESULTS

Seven studies with a total of 73,845 participants were obtained. Most studies suggest that reversion of prediabetes reduced the cardiovascular and all-cause mortality risk (RR: 0.50 - 0.78) compared to persistent prediabetes state or progression to diabetes with long-term follow-up ranging from 5 to 12 years, while two studies did not show significant association in CVD and all-cause morality risk.

CONCLUSION

Although there were mixed results regarding if prediabetes poses a higher risk than normoglycemia for cardiovascular events and all-cause mortality, measures to normalize blood glucose for prediabetes should still be advocated.

摘要

引言

目前尚不清楚恢复正常血糖水平能否长期降低总体心血管事件及全因死亡风险。我们旨在研究从糖尿病前期状态恢复过来的患者心血管风险及死亡率的变化幅度。

方法

使用了三个电子数据库,包括PubMed、Proquest和EBSCOHost数据库。还对手头文章进行了人工检索。我们选择了测量从糖尿病前期恢复到正常血糖水平后的心血管风险及全因死亡风险的研究。检索策略中使用了以下术语及其变体:“恢复”“糖尿病前期”“正常血糖水平”“心血管风险”和“死亡率”。

结果

共获得7项研究,涉及73845名参与者。大多数研究表明,与持续处于糖尿病前期状态或进展为糖尿病相比,糖尿病前期的恢复降低了心血管及全因死亡风险(风险比:0.50 - 0.78),长期随访时间为5至12年,而两项研究未显示在心血管疾病和全因死亡风险方面存在显著关联。

结论

尽管关于糖尿病前期在心血管事件和全因死亡方面是否比正常血糖水平带来更高风险存在不同结果,但仍应提倡采取措施使糖尿病前期患者的血糖恢复正常。

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JAMA Netw Open. 2023 Mar 1;6(3):e234989. doi: 10.1001/jamanetworkopen.2023.4989.
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Cardiovascular Risk Among Saudi Adults with Prediabetes: A Sub-Cohort Analysis from the Heart Health Promotion (HHP) Study.沙特成人糖尿病前期患者的心血管风险:来自心脏健康促进(HHP)研究的亚队列分析。
Int J Gen Med. 2022 Aug 29;15:6861-6870. doi: 10.2147/IJGM.S374190. eCollection 2022.
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Multi-level Diabetes Prevention and Treatment Interventions for Native People in the USA and Canada: a Scoping Review.多层面糖尿病防治干预措施在美加原住民中的应用:综述
Curr Diab Rep. 2021 Nov 7;21(11):46. doi: 10.1007/s11892-021-01414-3.
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Global, Regional, and National Burden of Diabetes-Related Chronic Kidney Disease From 1990 to 2019.全球、区域和国家 1990 年至 2019 年与糖尿病相关的慢性肾脏病负担。
Front Endocrinol (Lausanne). 2021 Jul 1;12:672350. doi: 10.3389/fendo.2021.672350. eCollection 2021.
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Sensitivity to Thyroid Hormones and Risk of Prediabetes: A Cross-Sectional Study.对甲状腺激素的敏感性与糖尿病前期风险:一项横断面研究。
Front Endocrinol (Lausanne). 2021 May 4;12:657114. doi: 10.3389/fendo.2021.657114. eCollection 2021.
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The complex link between NAFLD and type 2 diabetes mellitus - mechanisms and treatments.非酒精性脂肪性肝病与 2 型糖尿病之间的复杂关系——机制与治疗。
Nat Rev Gastroenterol Hepatol. 2021 Sep;18(9):599-612. doi: 10.1038/s41575-021-00448-y. Epub 2021 May 10.
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Adverse Childhood Experiences and the Risk of Coronary Heart Disease in Adulthood: Examining Potential Psychological, Biological, and Behavioral Mediators in the Whitehall II Cohort Study.不良童年经历与成年人患冠心病的风险:在白厅 II 队列研究中检验潜在的心理、生物和行为中介因素。
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Reversion from prediabetes to normoglycaemia after weight change in older persons: The KORA F4/FF4 study.老年人体重变化后从糖尿病前期恢复为正常血糖:KORA F4/FF4 研究。
Nutr Metab Cardiovasc Dis. 2021 Feb 8;31(2):429-438. doi: 10.1016/j.numecd.2020.09.008. Epub 2020 Sep 12.
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