糖耐量减低对老年男性人群非致死性卒中风险的影响

Influence of impaired glucose tolerance on non-fatal stroke in elderly male persons

目的探讨糖耐量减低(IGT)对老年男性人群非致死性卒中风险的影响。方法纳入2005年5月-2007年5月在解放军总医院第二医学中心行口服葡萄糖耐量试验检出的老年男性IGT和正常糖耐量(NGT)人群,每年至少随访1次,随访至2017年3月,观察非致死性卒中的发病情况,比较两组人群非致死性卒中发病风险的差异。结果共纳入老年男性IGT 201例、NGT 259例,平均随访11.2年。单因素Cox比例风险回归分析提示,IGT组2型糖尿病(HR=2.18,95%CI1.54~3.08,P<0.001)、非致死性卒中(HR=2.54,95%CI1.38~4.68,P=0.003)的发病风险高于NGT组。在调整基线时年龄、体重指数(BMI)、吸烟、胰岛素抵抗指数(HOMA2-IR)、肾小球滤过率(eGFR)、高血压病史、血脂紊乱病史后,IGT组的2型糖尿病(HR=2.25,95%CI 1.58~3.20,P<0.001)、非致死性卒中(HR=2.42,95%CI 1.30~4.52,P=0.005)的发病风险仍明显高于NGT组。结论 IGT与老年男性人群非致死性卒中密切相关,是非致死性卒中发病风险的独立危险因素。

Objective To investigate the influence of impaired glucose tolerance(IGT) on the risk of non-fatal stroke in elderly male persons. Methods The elderly male persons with IGT and normal glucose tolerance(NGT), undergoing oral glucose tolerance test in our hospital from May 2005 to May 2007, were recruited and then followed up to March 2017 at least once a year to observe the incidence of non-fatal stroke, and then the risk of non-fatal stroke was compared between the two groups. Results A total of 201 IGT and 259 NGT subjects were enrolled in present study. The average period of follow-up was 11.2 years. Univariate Cox proportional risk regression analysis indicated that the risk of type 2 diabetes and non-fatal stroke was higher in IGT group[(HR=2.18, 95%CI 1.54-3.08, P<0.001) and(HR=2.54, 95%CI 1.38-4.68, P=0.003)] than in NGT group. After adjusting the baseline age, body mass index(BMI), smoking, insulin resistance index(HOMA2-IR), estimated glomerular filtration rate(eGFR),history of hypertension and of dyslipidemia, multivariate Cox proportional risk regression analysis indicated that the risk of type2 diabetes and non-fatal stroke was still higher in IGT group [(HR=2.25, 95%CI 1.58-3.20, P<0.001) and(HR=2.42, 95%CI 1.30-4.52, P=0.005)] than in NGT group. Conclusion IGT is closely related to non-fatal stroke in elderly male persons, and is an independent risk factor of non-fatal stroke.