小時糖耐量試驗的臨床意義-文庫吧資料
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【正文】 0 .7 – 2 .5 ) All c a use 1 .9 ( 1 .7 – 2 .2 ) 1 .7 ( 1 .5 – 2 .1 ) The DECODE group, Arch Intern Med 2022。308:13238 ROC curves for prevalence of retinopathy (top) and nephropathy (bottom) for 2hPG (), FPG (....), and HbA1 () concentrations 1Specificity Relative risk (95% CI) of mortality significantly increased in subjects with IGT Multivariate adjusted: for age, center, sex, cholesterol, BMI, BP, smoking Mortality RR, multivariate adjusted RR, adjusted also for FPG CVD () () CHD () () Stroke () () Allcause () () The DECODE group, Arch Intern Med 2022。290:486 HR () (. 32/686 vs. 15/682 MI, Angina, Revasc, CV Death, CHF, Stroke, or PVD) Copyright 169。353:2643 MI, Stroke, CV Death RRR= 57% (1279) Chronic G Lowering amp。353:2643 Primary CV Composite RRR= 42% (963) RRR after adj. for updated GHb until end of DCCT (or CV event during DCCT): 16% (64 – 57) P= Intensive Insulin Rx amp。 17 yrs altogether GHb Results: DCCT End EDIC End Intensive () () Conventional () () Intensive Insulin Rx amp。 OR documented angina。 OR CV death。 CVD: T1 DM DCCT/EDIC NEJM 2022。 23: 290:48694 The main changes from baseline to 3 years: Acarbose Placebo STOPNIDDM Trial (3) Body Weight (kg) BMI (kg/m2) Waist (cm) SysBP (mmHg) DiasBP (mmHg) 2hPG (mmol/L) Triglycerides (mmol/L) All p for the difference between the two groups Summary ? Diabetes diagnosed by either FPG or 2h criteria are risk factor for CVD disease, but 2h criteria identify those who are not diabetic by FPG alone ? IGT is over IFG with regard to the prediction of the CVD ? More trials are required to show that intensive treatment of postprandial hyperglycemia can reduce the CVD RCT Metaanalysis: G Lowering Type 1 Diabetes Trials Am Heart J 2022。 26:29102914 Effect of intensive glycemic control on the risk for any type of macrovascular events C Stettler, Am Heart J 2022。 47: 385394 Nondiabetic Diabetic Followup Baseline 2hPG NGT IGT Nondiabetic CHD incidence CVD mortality Allcause mortality Incidence density (no./per 1000 personyears) Qiao et al. Diabetes Care 2022。 26: 688696 010002022300040001 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 1701234513 .02 h o u r pla s ma g luc o s e ( mm o l/ l)CVD mortality by 2hour plasma glucose Frequency Hazard ratio DECODE, Diabetes Care 26: 688696 CVD mortality by fasting plasma glucose 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 170123450202240006000800010000 8 . 5 4 . 0F a s t ing pla s ma glu c o s e ( mm o l/ l)Frequency Hazard ratio DECODE, Diabetes Care 26: 688696 Hazard ratio for mortality by FPG categories, the DECODA Study FPG (mmol/l) (n=5547) (n=462) ? (n=297) P for trend CVD Model 1 Model 2 1 1 () () () ()
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