文章摘要
田园梦,井丽,阎涵,张博强,姜海强,李爽,宋家宝,刘爽,邢立莹.辽宁省2017-2019年60岁及以上老年人群糖尿病患病情况及其与死亡风险的相关性分析[J].中华流行病学杂志,2024,45(7):941-946
辽宁省2017-2019年60岁及以上老年人群糖尿病患病情况及其与死亡风险的相关性分析
Association between diabetes prevalence and mortality risk in the elderly aged 60 years and above in Liaoning Province, 2017-2019
收稿日期:2024-01-11  出版日期:2024-07-13
DOI:10.3760/cma.j.cn112338-20240111-00012
中文关键词: 糖尿病  老年人  患病  死亡  前瞻性队列研究
英文关键词: Diabetes  Elderly  Prevalence  Death  Prospective cohort study
基金项目:2019年辽宁省重点研发计划(2019JH2/10300001);2022年辽宁省应用基础研究计划(2022JH2/101300051)
作者单位E-mail
田园梦 辽宁省疾病预防控制中心慢性非传染性疾病预防控制所, 沈阳 110172  
井丽 辽宁省疾病预防控制中心慢性非传染性疾病预防控制所, 沈阳 110172  
阎涵 辽宁省疾病预防控制中心慢性非传染性疾病预防控制所, 沈阳 110172  
张博强 辽宁省疾病预防控制中心慢性非传染性疾病预防控制所, 沈阳 110172  
姜海强 辽宁省疾病预防控制中心慢性非传染性疾病预防控制所, 沈阳 110172  
李爽 辽宁省疾病预防控制中心慢性非传染性疾病预防控制所, 沈阳 110172  
宋家宝 辽宁省疾病预防控制中心慢性非传染性疾病预防控制所, 沈阳 110172  
刘爽 中国医科大学附属第四医院超声科, 沈阳 110004  
邢立莹 辽宁省疾病预防控制中心慢性非传染性疾病预防控制所, 沈阳 110172 xly1983sy@163.com 
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中文摘要:
      目的 了解辽宁省2017-2019年≥60岁老年人群糖尿病患病现状,分析糖尿病患者血糖控制情况对发生全因死亡和心血管疾病(CVD)死亡的影响。方法 对辽宁省2017-2019年≥60岁老年人群9 958人进行调查,收集糖尿病患病率以及患者慢性病共病情况。2023年9月调查入组对象的死亡情况,利用Cox比例风险回归模型估计糖尿病患者血糖控制情况与患者发生全因死亡和CVD死亡风险的关联强度。结果 辽宁省2017-2019年≥60岁老年人群糖尿病粗患病率为20.2%(2 014/9 958),标化患病率为19.9%。糖尿病患者高血压、血脂异常和超重肥胖率分别为77.0%、51.7%和67.5%。中位随访时间为5.5年,糖尿病患者的全因死亡和CVD死亡率分别为244.3/万人年和142.9/万人年。Cox比例风险回归模型分析结果显示,与非糖尿病患者相比,糖尿病患者的全因死亡风险升高至1.68倍[风险比(HR)=1.68,95%CI:1.44~1.94],CVD死亡风险升高至1.56倍(HR=1.56,95%CI:1.29~1.89)。FPG和糖化血红蛋白(HbA1c)均达标的糖尿病患者发生全因死亡和CVD死亡风险与非糖尿病者的差异无统计学意义(均P>0.05);FPG或HbA1c任一指标不达标会导致全因死亡风险升高(均P<0.05);HbA1c不达标者,CVD死亡风险升高(均P<0.05)。结论 辽宁省老年糖尿病患者慢性病共患率高于非糖尿病患者,老年糖尿病患者能够从良好的血糖控制中受益。
英文摘要:
      Objective To investigate the prevalence of diabetes in the elderly aged ≥60 years in Liaoning Province from 2017 to 2019 and analyze the impact of blood glucose control on all-cause mortality and cardiovascular disease (CVD) mortality. Methods A survey was conducted in the elderly aged ≥60 years in Liaoning from 2017 to 2019 to collect the information about the prevalence of diabetes and other chronic diseases in the diabetes patients. The mortality of the enrolled subjects was investigated in September 2023. Cox proportional hazards regression models were used to estimate the association between blood glucose control in the elderly with diabetes and the risks of all-cause mortality and CVD mortality. Results The crude prevalence of diabetes in the elderly aged ≥60 years was 20.2% (2 014/9 958) in Liaoning from 2017 to 2019, and the standardized prevalence rate was 19.9%. The prevalence rates of hypertension, dyslipidemia, and overweight/obesity in the diabetes patients were 77.0%, 51.7%, and 67.5% respectively. The median follow-up time was 5.5 years, and the all-cause mortality and CVD mortality rates in the diabetes patients were 244.3/10 000 person-years and 142.9/10 000 person-years, respectively. The results of the Cox proportional hazards regression model analysis showed that compared with non-diabetic individuals, diabetes patients had an increased risk of all-cause mortality by 1.68 times [hazard ratio (HR)=1.68, 95%CI: 1.44-1.94] and an increased risk of CVD mortality by 1.56 times (HR=1.56, 95%CI: 1.29-1.89). The differences in risks of all-cause mortality and CVD mortality between the diabetes patients with normal fasting blood glucose and glycated hemoglobin levels and people without diabetes were not significant (all P>0.05). The failure to meet either the FPG or HbA1c target increased the risk of all-cause mortality (all P<0.05). For individuals who failed to meet the HbA1c target, there was an increased risk of CVD mortality (all P<0.05). Conclusions The comorbidity rate of chronic diseases was higher in the elderly with diabetes than in the elderly without diabetes in Liaoning. Elderly diabetes patients can benefit from good blood glucose control.
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