Chen Siqi, Yalkun Gulbahram, Gu Hongqiu, Yang Xin, Wang Chunjuan, Zhao Xingquan, Wang Yilong, Liu Liping, Meng Xia, Jiang Yong, Li Hao, Wang Yongjun, Li Zixiao, Liu Jue, Mi Donghua
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
J Diabetes. 2025 Mar;17(3):e70059. doi: 10.1111/1753-0407.70059.
A comprehensive epidemiological investigation of the coexistence between diabetes and stroke/TIA in China is urged.
Data from the Chinese Stroke Center Alliance program, a nationwide multi-center registry study, were used to detect the prevalence, awareness, treatment, and control of diabetes among stroke/TIA. The distribution of diagnosed and undiagnosed diabetes and prediabetes among stroke/TIA patients was investigated, the medical care around diabetes and their respective risk predictors were analyzed, and the association of all above diabetes characteristics with in-hospital death was evaluated using multi-variable Cox regression models.
Of 980 625 patients included, 308 426 (31.5%) had prediabetes, while 365 052 (37.2%) had diabetes, with nearly a third of them undiagnosed (112 969, 30.9%). Of residual aware diabetic patients, 59.0% were treated, with 27.3% controlled. Compared to Han ethnicity, Zhuang ethnicity had a lower prevalence of diabetes (37.3% vs. 35.1%) but were less aware (69.4% vs. 56.5%), treated (59.4% vs. 47.8%), and controlled (27.4% vs. 26.0%). Patients with prediabetes, diagnosed, and undiagnosed diabetes had increasingly higher risks of in-hospital death (adjusted HR [95% CI]: 1.47 [1.35-1.60]; 2.15 [1.97-2.34]; 4.20 [3.87-4.56], all p < 0.001). Unaware and untreated diabetes were independently associated with in-hospital death (adjusted HR [95% CI]: 1.99 [1.85-2.14]; 2.84 [2.63-3.07, both p < 0.001]). Compared with controlled diabetes, those with uncontrolled diabetes had a lower risk of in-hospital death (adjusted HR [95% CI]: 0.77[0.68-0.88], p < 0.001).
The findings indicate that over two-thirds of stroke/TIA patients are exposed to diabetes in China, causing higher in-hospital mortality, which should be screened and intervened early.
迫切需要在中国对糖尿病与中风/短暂性脑缺血发作（TIA）并存情况进行全面的流行病学调查。
来自中国卒中中心联盟项目（一项全国性多中心注册研究）的数据，用于检测中风/TIA患者中糖尿病的患病率、知晓率、治疗率和控制率。调查了中风/TIA患者中已诊断和未诊断的糖尿病及糖尿病前期的分布情况，分析了糖尿病相关的医疗护理及其各自的风险预测因素，并使用多变量Cox回归模型评估上述所有糖尿病特征与住院死亡的关联。
在纳入的980625例患者中，308426例（31.5%）患有糖尿病前期，365052例（37.2%）患有糖尿病，其中近三分之一未被诊断（112969例，30.9%）。在已知患有糖尿病的患者中，59.0%接受了治疗，27.3%得到了控制。与汉族相比，壮族糖尿病患病率较低（37.3%对35.1%），但知晓率较低（69.4%对56.5%）、治疗率较低（59.4%对47.8%）和控制率较低（27.4%对26.0%）。糖尿病前期、已诊断和未诊断糖尿病的患者住院死亡风险越来越高（调整后风险比[95%置信区间]：1.47[1.35 - 1.60]；2.15[1.97 - 2.34]；4.20[3.87 - 4.56]，均p < 0.001）。未被知晓和未接受治疗的糖尿病独立与住院死亡相关（调整后风险比[95%置信区间]：1.99[1.85 - 2.14]；2.84[2.63 - 3.07]，均p < 0.001）。与血糖得到控制的糖尿病患者相比，血糖未得到控制的患者住院死亡风险较低（调整后风险比[95%置信区间]：0.77[0.68 - 0.88]，p < 0.001）。
研究结果表明，在中国超过三分之二的中风/TIA患者患有糖尿病，导致更高的住院死亡率，应尽早进行筛查和干预。
