2型糖尿病患者发病年龄、病程、糖化血红蛋白与缺血性脑卒中发病风险的前瞻性队列研究

范习康; 李梦瑶; 覃玉; 沈冲; 陆艳; 孙中明; 杨婕; 陶然; 周金意; 杭栋; 苏健

Abstract

范习康,李梦瑶,覃玉,沈冲,陆艳,孙中明,杨婕,陶然,周金意,杭栋,苏健.2型糖尿病患者发病年龄、病程、糖化血红蛋白与缺血性脑卒中发病风险的前瞻性队列研究[J].Chinese journal of Epidemiology,2024,45(4):498-505

2型糖尿病患者发病年龄、病程、糖化血红蛋白与缺血性脑卒中发病风险的前瞻性队列研究

Associations of onset age, diabetes duration and glycated hemoglobin level with ischemic stroke risk in type 2 diabetes patients: a prospective cohort study

Received:October 09, 2023

DOI：10.3760/cma.j.cn112338-20231009-00210

KeyWord: 糖尿病，2型缺血性脑卒中前瞻性研究

English Key Word: Diabetes mellitus,type 2 Ischemic stroke Prospective study

FundProject:江苏省卫生健康委员会医学科研项目（M2020085，H2023022）；苏州市科技局民生科技-科技示范工程项目（SS202010）

Author Name	Affiliation	E-mail
Fan Xikang	Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
Li Mengyao	School of Public Health, Nanjing Medical University, Nanjing 211166, China
Qin Yu	Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
Shen Chong	School of Public Health, Nanjing Medical University, Nanjing 211166, China
Lu Yan	Suzhou Prefectural Center for Disease Control and Prevention, Suzhou 215003, China
Sun Zhongming	Huai'an Prefectural Center for Disease Control and Prevention, Huai'an 223001, China
Yang Jie	Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China School of Public Health, Nanjing Medical University, Nanjing 211166, China
Tao Ran	Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China School of Public Health, Nanjing Medical University, Nanjing 211166, China
Zhou Jinyi	Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China School of Public Health, Nanjing Medical University, Nanjing 211166, China
Hang Dong	School of Public Health, Nanjing Medical University, Nanjing 211166, China
Su Jian	Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China School of Public Health, Nanjing Medical University, Nanjing 211166, China	sujiangx@163.com

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Abstract:

目的分析江苏省2型糖尿病患者发病年龄、病程和糖化血红蛋白（HbA1c）与缺血性脑卒中（IS）发病风险的关联。方法研究对象来自江苏省社区糖尿病综合干预及应用研究，2013年12月至2014年1月开展基线调查，本研究随访数据截至2021年12月31日，剔除基线诊断为脑卒中以及发病年龄、病程和HbA1c信息缺失的参与者后，最终共纳入17 576名研究对象。采用Cox比例风险回归模型计算发病年龄、病程、HbA1c与IS发病的风险比（HR）值及其95%CI。结果研究对象中位随访时间8.02年，期间共登记IS新发病例2 622名。多因素Cox比例风险回归分析显示，糖尿病发病年龄每延迟5年，IS发病风险降低5%（HR=0.95，95%CI：0.92~0.99），糖尿病病程每增加5年，IS发病风险增加5%（HR=1.05，95%CI：1.02~1.10），较高的HbA1c（每增加1个标准差：HR=1.17，95%CI：1.13~1.21）与IS发病风险增加相关。结论 2型糖尿病患者较早的发病年龄、更长的病程和较高水平的HbA1c均与IS发病风险增加相关。

English Abstract:

Objective To investigate the associations of onset age, diabetes duration, and glycated hemoglobin (HbA1c) levels with ischemic stroke risk in type 2 diabetes patients. Methods The participants were from Comprehensive Research on the Prevention and Control of the Diabetes in Jiangsu Province. The study used data from baseline survey from December 2013 to January 2014 and follow-up until December 31, 2021. After excluding the participants who had been diagnosed with stroke at baseline survey and those with incomplete information on onset age, diabetes duration, and HbA1c level, a total of 17 576 type 2 diabetes patients were included. Cox proportional hazard model was used to calculate the hazard ratio (HR) and 95%CI of onset age, diabetes duration, and HbA1c level for ischemic stroke. Results During the median follow-up time of 8.02 years, 2 622 ischemic stroke cases were registered. Multivariate Cox proportional risk regression model showed that a 5-year increase in type 2 diabetes onset age was significantly associated with a 5% decreased risk for ischemic stroke (HR=0.95, 95%CI: 0.92-0.99). A 5-year increase in diabetes duration was associated with a 5% increased risk for ischemic stroke (HR=1.05, 95%CI: 1.02-1.10). Higher HbA1c (per 1 standard deviation increase:HR=1.17, 95%CI: 1.13-1.21) was associated with an increased risk for ischemic stroke. Conclusion The earlier onset age of diabetes, longer diabetes duration, and high levels of HbA1c are associated with an increased risk for ischemic stroke in type 2 diabetes patients.

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