May O, Arildsen H, Damsgaard E M, Mickley H
Department of Cardiology, Odense University Hospital, Denmark.
Cardiovasc Res. 1997 Apr;34(1):241-7. doi: 10.1016/s0008-6363(97)00046-1.
The aim of the study was to estimate the prevalence of silent ischaemia in diabetic subjects in the population, to compare the prevalence of silent ischaemia in diabetics and non-diabetics and to attempt to predict the presence of silent ischaemia in diabetic subjects.
A random sample of 120 users of insulin and 120 users of oral hypoglycaemic agents aged 40-75 years living in the Danish municipality of Horsens were asked to participate in the study. Corresponding to the youngest half of the sample two non-diabetic controls were randomly selected from the Central Population Register. ST-depression of horizontal or descending character of at least 0.1 mV measured 80 ms after the J-point on either exercise ECG or Holter ECG was considered indicative of myocardial ischaemia. Angina pectoris was considered present if the Rose questionnaire was positive, or chest pain was registered simultaneously with ECG evidence of ischaemia. Individuals with ischaemia, but without angina pectoris, were defined as persons with silent ischaemia.
Seventy-four percent of the invited group were included. The observed prevalence of silent ischaemia in diabetics was 13.5% (95% CI = 8.5-19.8%). No association was found between silent ischaemia and gender (P = 0.83) or diabetes type (P = 0.67). In the group of diabetics who had controls, the prevalence was 11.4%, and among the controls the prevalence was 6.4% (OR = 1.87, one-sided P = 0.079). Systolic blood pressure was highly predictive of silent ischaemia in the diabetic subjects (P = 0.005). No predictive value could be shown for other variables.
This is the first population-based study of silent ischaemia in diabetes. The prevalence of silent ischaemia in diabetic subjects was 13.5%. The frequency of silent ischaemia did not differ significantly between diabetics and non-diabetics. Systolic blood pressure was predictive of silent ischaemia in diabetes.
本研究旨在估计人群中糖尿病患者无症状性缺血的患病率，比较糖尿病患者和非糖尿病患者无症状性缺血的患病率，并尝试预测糖尿病患者无症状性缺血的存在情况。
随机抽取居住在丹麦霍森斯市的120名年龄在40 - 75岁的胰岛素使用者和120名口服降糖药使用者参与研究。对应样本中年龄较小的一半，从中央人口登记处随机选取两名非糖尿病对照。运动心电图或动态心电图上J点后80毫秒测量的水平或下斜型ST段压低至少0.1 mV被认为提示心肌缺血。如果罗斯问卷呈阳性，或胸痛与缺血性心电图证据同时记录，则认为存在心绞痛。缺血但无心绞痛的个体被定义为无症状性缺血患者。
受邀组的74%被纳入研究。糖尿病患者中无症状性缺血的观察患病率为13.5%（95%可信区间 = 8.5 - 19.8%）。未发现无症状性缺血与性别（P = 0.83）或糖尿病类型（P = 0.67）之间存在关联。在有对照的糖尿病患者组中，患病率为11.4%，对照组中的患病率为6.4%（比值比 = 1.87，单侧P = 0.079）。收缩压对糖尿病患者无症状性缺血具有高度预测性（P = 0.005）。其他变量未显示出预测价值。
这是第一项基于人群的糖尿病无症状性缺血研究。糖尿病患者无症状性缺血的患病率为13.5%。糖尿病患者和非糖尿病患者无症状性缺血的频率无显著差异。收缩压可预测糖尿病患者的无症状性缺血。
