空腹血糖变化对糖尿病发生的作用：一项前瞻性队列研究的结果课件.ppt

1、空腹血糖变化对糖尿病发生的作用：一项前瞻性队列研究的结果SCI文章解析实例2Change in fasting plasma glucose and incident type 2 diabetes mellitus:results from a prospective cohort study.Objective（目的）:To investigate the association between changes in fasting plasma glucose(FPG)values and incident type 2 diabetes(T2D)in a cohort of the I

2、ranian population.（在一个伊朗人群队列中，探讨空腹血浆葡萄糖（FPG）值的改变与2型糖尿病（T2D）发病之间的关系。）Design（设计）:Prospective cohort study.（前瞻性队列研究）Setting(研究场所):This study was conducted within the framework of the Tehran Lipid and Glucose Study(TLGS)to investigate the association between change in FPG between baseline examination(19

3、992001)and the second visit(20022005)with incident T2D.(这项研究是在德黑兰脂质和葡萄糖调查研究（TLGS）的框架内进行的，主要研究：基线检查（1999-2001）与第二次检查（2002-2005年）期间的FPG变化值与2型糖尿病（T2D）发病之间的关系。)Participants(参与者)A total of 3981 non-diabetic participants aged 20years.(共有3981例年龄20岁的非糖尿病参与者)Outcome measure(结果测量)T2D was defined if the partic

4、ipant was using antidiabetic drugs or if FPG was 7mmol/L or if the 2h post-challenge plasma glucose(2-hPCG)was 11.1mmol/L.(如果参与者使用抗糖尿病药物或FPG7mmol/L，或者2小时后血浆葡萄糖（2-hPCG）11.1mmol/L，则定义T2D。)Results During a median follow-up of 6.17years,after the second examination,288 new cases of T2D were identified.I

5、n a multivariate Cox proportional hazard analysis using age as timescale,we presented a simple model including FPG change(HR 1.19,95%CI 1.07 to 1.33)and baseline waist circumference(WC)(HR 1.004,95%CI 1.001 to 1.008)with a discriminative power(C-index)of 72%.Furthermore,we showed that the highest qu

6、artile of FPG change enhanced the T2D risk to 1.65(95%CI 1.2 to 2.27)compared with the lowest quartile(p for trend=0.004).The independent risk of FPG change resisted further adjustment with 2-hPCG change.Adding the 2-hPCG change only slightly increased the discriminative power of the model including

7、 FPG change and baseline value of WC(0.73%vs 0.72%).After the study population had been limited to those with normal fasting glucose/normal glucose tolerance,FPG change remained an independent predictor(HR 1.57,95%CI 1.31 to 1.88).结果结果 所有参与者中位随访时间为6.17年，第二次检查以后进行随访，确定了288例新发T2D病例。在使用年龄作为时间尺度的多变量Cox比

8、例风险分析中，我们提出了一个简单的模型，包括FPG变化（HR 1.19,95CI 1.07至1.33）和基线腰围（WC）（HR 1.004,95CI 1.001至1.008），达到了72的模型的辨别力（C指数）。此外，我们的研究显示，FPG变化的最高四分位数与最低四分位数相比，将T2D风险提高到1.65（95CI 1.2至2.27），（p趋势=0.004）。在回归模型中加入了2-hPCG变化这个变量后，FPG变化的独立风险作用仍然存在。添加2-hPCG变化这个变量仅略微增加了包括FPG变化和WC基线值（0.73 VS.0.72）的模型的辨别力。将研究人群限于正常空腹血糖/葡萄糖耐量正常者，FP

9、G变化仍然是独立预测因子（HR 1.57,95CI 1.31-1.88）。Conclusions(结论)Two measurements of FPG obtained about 3years apart can help to identify populations at risk of incident T2D independently of important traditional risk factors and their changes,including 2-hPCG change.(大约3年间两次测量的FPG有助于识别T2D发生风险的人群，并且独立于重要的传统危险因素及其变化，包括2-hPCG变化。)前言材料和方法材料和方法材料和方法结果结果结果结果结果结果结果结果结果结果结果结果结果结果讨论讨论