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目的调查卒中死亡率在高血糖不同种类的个体中的情况,并比较OGTT2小时血糖(2hPG)和空腹血糖水平增加1-SD时的风险比。研究设计与方法我们研究了2小时75g口服葡萄糖耐量试验的数据。这些数据来自于由11,844(55%)位男性和9,862(45%)位女性所组成的13个欧洲群组,他们平均被随访了10.5年。我们用一个多变量校正的Cox比例风险模型来评估卒中死亡率的风险比(HRs)。结果在没有糖尿病病史的男性和女性中,FPG增加1-SD所对应的多变量校正卒中死亡率HRs分别为1.02(95%CI0.83～1.25)和1.52(95%CI1.22～1.88)。2hPG增加1-SD对应的HRs分别是1.21(95%CI1.06～1.38)和1.31(95%CI1.06～1.61)。在使用FPG的模型上附加2hPG可显著提高对男性卒中死亡率(χ2=10.12;P=0.001)的预测而对女性(χ2=0.01;P=0.94)无效,相反将FPG附加到2hPG模型则能提高对女性卒中死亡率(χ2=4.08;P=0.04)的预测而对男性(χ2=3.29;P=0.07)无效。结论无论是通过FPG或2hPG确诊的糖尿病其卒中死亡风险都会增加。在没有糖尿病病史的个体中,对于男性增高的2hPG比增高的FPG更有预测意义,而对于女性则相反。
Objective To investigate the prevalence of stroke mortality among individuals with different types of hyperglycaemia and to compare the risk ratio of 2-hour OGTT (2hPG) to 1-SD when fasting blood glucose was increased. Study Design and Methods We studied data for a 2-hour, 75-g oral glucose tolerance test. The data come from 13 European cohorts of 11,844 (55%) men and 9,862 (45%) women who were followed for an average of 10.5 years. We used a multivariate adjusted Cox proportional hazards model to assess the risk of stroke mortality (HRs). Results In men and women without a history of diabetes mellitus, the multivariate adjusted stroke fatality rates for FPG plus 1-SD were 1.02 (95% CI 0.83 to 1.25) and 1.52 (95% CI 1.22 to 1.88), respectively. The HRs for 2-hPG increased 1-SD were 1.21 (95% CI 1.06-1.38) and 1.31 (95% CI 1.06-1.61), respectively. The addition of 2 hPG to the FPG model significantly improved the prediction of male stroke mortality (χ2 = 10.12; P = 0.001) but was not valid for women (χ2 = 0.01; P = 0.94), whereas FPG addition to the 2 hPG model Increasing the prediction of female stroke mortality (χ2 = 4.08; P = 0.04) was not valid for males (χ2 = 3.29; P = 0.07). Conclusions Both the risk of death from stroke and diabetes diagnosed by FPG or 2hPG increase. In individuals without a history of diabetes, 2-hPG elevation in men is more predictive than increased FPG, whereas in women the opposite is true.