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BMJ:严重低血糖的II型糖尿病患者心脑血管疾病风险较高

  1. BMJ
  2. II型糖尿病
  3. 低血糖
  4. 心脑血管疾病
  5. 患者
  6. 风险

来源:生物谷 2013-08-03 16:10

2013年8月3日 讯 /生物谷BIOON/ --近日,一项刊登在国际杂志BMJ上的研究报告中指出,严重低血糖的II型糖尿病患者或患心血管疾病的风险较高。严重低血糖是一种个体血液中糖含量过低的疾病表现,当患者发病通常需要紧急治疗;同样严重低血糖也是II型糖尿病患者引发心血管疾病的一个风险因子,最新的临床研究显示,在整体的CVD事件(心血管疾病事件)中加强血糖控制并没有表现出任何益处。

2013年8月3日 讯 /生物谷BIOON/ --近日,一项刊登在国际杂志BMJ上的研究报告中指出,严重低血糖的II型糖尿病患者或患心血管疾病的风险较高。严重低血糖是一种个体血液中糖含量过低的疾病表现,当患者发病通常需要紧急治疗;同样严重低血糖也是II型糖尿病患者引发心血管疾病的一个风险因子,最新的临床研究显示,在整体的CVD事件(心血管疾病事件)中加强血糖控制并没有表现出任何益处。

尽管保守型研究报道了严重低血糖和CVD风险之间存在正相关效应,但是这种关联至今仍存在争议,因此来自美国、日本及荷兰的研究者首次进行研究来评估其二者之间的关联。

研究者对包含有903510位个体的6项研究进行分析包括对个体的年龄、性别、糖尿病时间、CVD历史、胰岛素使用、BMI及抽烟情况进行了调查分析。结果显示,其中有0.6%-5.8%的个体经历了严重的低血糖症状1至5年不等;这也在研究对象中增加了1.56%的患心血管疾病风险。

研究者建议,严重疾病的流行可能在人群中会出现一种“虚高”的现象,而且严重疾病和心血管疾病的关联表现却十分明显。总的来讲,研究结果显示,严重的低血糖会导致CVD风险增加2倍;对病人血糖的控制将有助于抑制严重的低血糖症状,这或许对于预防II型糖尿病患者患心血管疾病也至关重要。(生物谷Bioon.com)

Severe hypoglycaemia and cardiovascular disease: systematic review and meta-analysis with bias analysis

Atsushi Goto, senior researcher12, Onyebuchi A Arah, professor34, Maki Goto, researcher12, Yasuo Terauchi, professor2, Mitsuhiko Noda, director1o

Objectives To provide a systematic and quantitative summary of the association between severe hypoglycaemia and risk of cardiovascular disease in people with type 2 diabetes and to examine the sensitivity of the association to possible uncontrolled confounding by unmeasured comorbid severe illness using a bias analysis. Design Meta-analysis of observational studies. Data sources Medline, Embase, the Cochrane Library, and Web of Science databases were searched to February 2013, without any language restrictions. Eligibility criteria Two independent reviewers selected cohort studies that evaluated the association of severe hypoglycaemia with cardiovascular events in people with type 2 diabetes; we excluded studies from acute hospital settings. We extracted descriptive and quantitative data. Results Of 3443 citations screened, six eligible studies with 903 510 participants were identified. In the conventional random effects meta-analysis, severe hypoglycaemia was strongly associated with a higher risk of cardiovascular disease (relative risk 2.05, 95% confidence interval 1.74 to 2.42; P<0.001). The excess fraction of cardiovascular disease incidence that was attributable to severe hypoglycaemia (the population attributable fraction) was 1.56% (95% confidence interval 1.32% to 1.81%; P<0.001). Although moderate heterogeneity across the studies was suggested (I2=73.1%; P=0.002 for heterogeneity), most subgroups showed similar results in stratified analyses. The bias analysis indicated that comorbid severe illness alone may not explain the association between hypoglycaemia and cardiovascular disease; to explain this association, comorbid severe illness would have had to be extremely strongly associated with both severe hypoglycaemia and cardiovascular disease. Conclusion Our findings suggest that severe hypoglycaemia is associated with a higher risk of cardiovascular disease; they also support the notion that avoiding severe hypoglycaemia may be important to prevent cardiovascular disease in people with type 2 diabetes.

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