美国2型糖尿病患者的缺血性卒中死亡率：1999年至2019年的全国趋势及人口统计学差异

Ischemic Stroke Mortality in Type 2 Diabetes in the U.S.: National Trends and Demographic Disparities From 1999 to 2019.

作者信息

Nasir Muhammad Moiz, Farhan Syed Husain, Mushahid Hasan, Shah Syeda Ayesha, Shuja Muhammad Hamza, Khan Adam Bilal, Ali Syed Hassaan, Farhan Syed Ahmed, Hassan Azeem, Ahmed Jawad, Hamza Mohammad, Iqbal Javed

机构信息

Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan.

Department of Internal Medicine, McLaren Greater Lansing Hospital, Michigan, Indiana, USA.

出版信息

Endocrinol Diabetes Metab. 2025 Jul;8(4):e70065. doi: 10.1002/edm2.70065.

DOI:10.1002/edm2.70065

PMID:40653749

Abstract

BACKGROUND

The pathological changes in the lining of blood vessels associated with diabetes are a well-established risk factor for stroke, with some studies suggesting a two times increase in risk compared to non-diabetics.

METHODS

Death certificates from the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research) database were examined from 1999 to 2019 for ischemic stroke-related mortality in patients with type 2 diabetes mellitus (T2DM). Annual percent change (APC) and age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated and stratified by year, sex, and race/ethnicity.

RESULTS

From 1999 to 2019 there were 18,135 deaths from ischemic stroke in patients with T2DM. The AAMR remained relatively constant from 0.31 in 1999 to 0.32 in 2004, gradually declining to 0.14 in 2014 (APC: -6.74), followed by a rapid increase to 0.44 in 2017 (APC: 53.11). Men showed consistently higher AAMR than women in 1999 (AAMR men: 0.34 vs. women: 0.29) and 2019 (AAMR men: 0.55 vs. women: 0.42). When comparing race, African Americans (AA) presented with a consistently higher AAMR in 1999 (AAMR AA: 0.4 vs. white: 0.29) and in 2019 (AAMR AA: 0.62 vs. white:0.44). Notably, a significant escalation in AAMR occurred from 2014 to 2019, affecting both populations; this trend reached its pinnacle in 2019 (2016 AAMR AA: 0.4 vs. white: 0.26) (2019 AAMR AA: 0.62 vs. white: 0.44).

CONCLUSION

The findings highlight fluctuating trends in AAMRs with distinct shifts observed after 2014. Noteworthy gender and racial disparities in AAMRs were also evident. The study emphasises the need for ongoing vigilance and focused interventions to address the evolving dynamics of ischaemic stroke-related mortality in the T2DM population.

摘要

背景

与糖尿病相关的血管内膜病理变化是公认的中风危险因素，一些研究表明，与非糖尿病患者相比，中风风险增加两倍。

方法

研究了疾病控制与预防中心广泛在线流行病学研究数据（CDC WONDER）数据库中1999年至2019年2型糖尿病（T2DM）患者缺血性中风相关死亡率的死亡证明。计算了每年每10万人的百分比变化（APC）和年龄调整死亡率（AAMR），并按年份、性别和种族/族裔进行分层。

结果

1999年至2019年，T2DM患者中有18135例死于缺血性中风。AAMR从1999年的0.31相对稳定地保持到2004年的0.32，然后逐渐下降到2014年的0.14（APC：-6.74），随后在2017年迅速上升到0.44（APC：53.11）。1999年（男性AAMR：0.34，女性：0.29）和2019年（男性AAMR：0.55，女性：0.42），男性的AAMR始终高于女性。在比较种族时，非裔美国人（AA）在1999年（AA的AAMR：0.4，白人：0.29）和2019年（AA的AAMR：0.62，白人：0.44）的AAMR始终较高。值得注意的是，2014年至2019年AAMR显著上升，影响了这两个人群；这一趋势在2019年达到顶峰（2016年AA的AAMR：0.4，白人：0.26）（2019年AA的AAMR：0.62，白人：0.44）。