内科理论与实践

内科理论与实践 ›› 2025, Vol. 20 ›› Issue (02): 120-125.doi: 10.16138/j.1673-6087.2025.02.04

• 论著 • 上一篇    下一篇

中老年人群糖代谢状态与全因死亡及心脑血管疾病死亡风险的关联研究

张计委1,*, 吴小琼2,*, 崔金煌1, 俞春明1, 黎衍云3()   

  1. 1.上海市青浦区练塘镇社区卫生服务中心预防保健科，上海 201715
    2.上海市青浦区白鹤镇社区卫生服务中心预防保健科，上海 201709
    3.上海市疾病预防控制中心健康管理科，上海 200336
  • 收稿日期:2025-01-08 出版日期:2025-04-28 发布日期:2025-07-08
  • 通讯作者: 黎衍云 E-mail:liyanyun@scdc.sh.cn
  • 作者简介:第一联系人：

    *：张计委与吴小琼为并列第一作者

  • 基金资助:
    上海市加强公共卫生体系建设三年行动计划（2023—2025年）重点学科建设项目(GWVI-11.1-20)

Association between glucose metabolism and risk of all-cause mortality and cardio-cerebrovascular mortality in middle-aged and elderly populations

ZHANG Jiwei1,*, WU Xiaoqiong2,*, CUI Jinhuang1, YU Chunming1, LI Yanyun3()   

  1. 1. Department of Prevention and Healthcare，Liantang Town Community Health Service Center, Qingpu District, Shanghai 201715，China
    2. Department of Prevention and Healthcare， Baihe Town Community Health Service Center, Qingpu District, Shanghai 201709，China
    3. Department of Health Manamgement, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336，China
  • Received:2025-01-08 Online:2025-04-28 Published:2025-07-08
  • Contact: LI Yanyun E-mail:liyanyun@scdc.sh.cn

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摘要：

目的：探讨不同糖代谢状态与中老年人群全因死亡及心脑血管死亡风险的相关性。方法：对2009年上海市35岁及以上人群2型糖尿病（type 2 diabetes mellitus, T2DM）流行病学调查中纳入的981名青浦区社区居民进行为期15年的随访研究，采用Cox比例风险回归模型分析不同糖代谢状态人群全因死亡和心脑血管疾病死亡风险比（hazard ratio，HR）及其95%CI。结果：累计随访14 464.01人年，随访期间全因死亡114例，死亡密度788.16/10万人年；心脑血管疾病死亡30例，死亡密度207.41/10万人年。以糖代谢正常人群为对照，糖尿病前期全因死亡风险增加77%（HR=1.77，95%CI：1.08~2.90），T2DM患者全因死亡及心脑血管疾病死亡风险分别增加155%（HR=2.55，95%CI：1.53~4.25）和299%（HR=3.99，95%CI：1.52~10.45）。按年龄分层，60岁以下人群中糖尿病前期心脑血管死亡风险高于糖代谢正常人群（HR=6.91，95%CI：1.19~40.07），60岁及以上人群中T2DM全因死亡及心脑血管死亡风险高于糖代谢正常人群（HR=2.64，95%CI：1.42~4.90；HR=4.87，95%CI：1.62~14.62）。结论：糖尿病前期和T2DM是上海市青浦区中老年人群全因死亡和心脑血管死亡的重要危险因素，应根据区域实际情况实施有针对性的分级、分类防治措施，早期干预血糖改善预后，减少全因死亡及心脑血管死亡风险。

关键词: 糖尿病前期, 2型糖尿病, 中老年人, 死亡风险, 流行病学

Abstract:

Objective To explore the association between different glucose metabolism status and death from all causes, cardio-cerebrovascular diseases in middle-aged and elderly population. Methods Totally 981 community residents aged 35 years and above in Qingpu district, Shanghai were enrolled in 2009 and a 15-year follow-up study of epidemiological survey on type 2 diabetes mellitus (T2DM) among them were conducted. Cox proportional hazards regression model was used to analyze hazard ratio (HR) of all-cause mortality, cardio-cerebrovascular mortality and their 95%CI in middle-aged and elderly population with different glucose metabolism status. Results The cumulative follow-up period was 14 464.01 person-years. During this period, 114 subjects died, and all-cause death density were 788.16/100 000 person-years. In which, 30 patients were dead from cardio-cerebrovascular diseases, and its death density was 207.41/100 000 person-years. Compared with the population with normal sugar metabolism, the risk of all-cause death in patients with prediabetes increased 77%, all- cause death and cardio- cerebrovascular diseases cause death in T2DM patients increased 155% (HR=2.55, 95%CI: 1.53-4.25) and 299% (HR=3.99, 95%CI:1.52-10.45), respectively. Stratified by age, the risk of cardio - cerebrovascular disease caused death in people under 60 years with prediabetes was higher than that in people with normal glucose metabolism (HR=6.91, 95%CI：1.19-40.07), and the risk of all - cause death and cardio - cerebrovascular death in T2DM patient over 60 years was higher than that in people with normal glucose metabolism (HR=2.64，95%CI：1.42-4.90；HR=4.87，95%CI：1.62-14.62). Conclusions Prediabetes and T2DM were important risk factors for all - cause death and cardio - cerebrovascular diseases death in middle-aged and elderly people. Targeted classified prevention and early intervention of blood sugar should be implemented to reduce all-cause death and cardio-cerebrovascular diseases death.

Key words: Prediabetes, Type 2 diabetes mellitus, Middle-aged and elderly, Risk of death, Epidemiology

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