空腹血糖变异性与2型糖尿病患者脑卒中发病风险的前瞻性队列研究

顾淑君; 覃玉; 俞浩; 官昊宇; 崔岚; 沈冲; 陆艳; 程亭亭; 张宁; 周金意; 苏健

doi:10.16462/j.cnki.zhjbkz.2024.07.006

空腹血糖变异性与2型糖尿病患者脑卒中发病风险的前瞻性队列研究

doi: 10.16462/j.cnki.zhjbkz.2024.07.006

顾淑君¹,
覃玉²,
俞浩²,
官昊宇³,
崔岚²,
沈冲³,
陆艳⁴,
程亭亭⁵,
张宁¹,
周金意²,
苏健^2, ,

1.
常熟市疾病预防控制中心慢性非传染病防制科, 常熟 215500
2.
江苏省疾病预防控制中心慢性非传染病防制所，南京 210009
3.
南京医科大学公共卫生学院流行病与卫生统计学系，南京 211166
4.
苏州市疾病预防控制中心慢性非传染病防制科，苏州 215004
5.
苏州高新区(虎丘区)疾病预防控制中心传防科，苏州 215011

基金项目:

江苏省卫健委2020年医学研究项目 M2020085

苏州市姑苏卫生人才项目 GSWS2020107

江苏省领军人才与创新团队项目 K201105

江苏省第五届“333工程”科研项目 BRA2020090

苏州市科技局民生科技-科技示范工程项目 SS202010

常熟市科技计划项目 CS201812

详细信息

通讯作者:
苏健，E-mail: sujiangx@163.com

中图分类号: R183.3
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出版历程
- 收稿日期: 2023-07-28
- 修回日期: 2024-01-09
- 网络出版日期: 2024-08-19
- 刊出日期: 2024-07-10

A prospective cohort study on the long-term fasting plasma glucose variability and risk of stroke among patients with type 2 diabetes mellitus

1.
Department of Non-communicable Disease Prevention, Changshu County Center for Disease Control and Prevention, Changshu 215500, China
2.
Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
3.
Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
4.
Department of Non-communicable Disease Prevention, Suzhou City Center for Disease Control and Prevention, Suzhou 215004, China
5.
Department of Infectious Disease Control Division, Suzhou Hi-Tech District (Huqiu District) Center for Disease Control and Prevention, Suzhou 215011, China

Funds:

Jiangsu Provincial Health Commission 2020 Medical Research Project Approval M2020085

Gusu Health Talent Training Project of Suzhou GSWS2020107

Jiangsu Province Leading Talents and Innovation Team Program K201105

Jiangsu Provincial Fifth "333 Project" BRA2020090

Suzhou Science and Technology Plan Projects SS202010

Changshu Science and Technology Plan Projects CS201812

More Information

Corresponding author: SU Jian，E-mail: sujiangx@163.com

摘要

摘要: 目的探讨空腹血糖(fasting plasma glucose, FPG)长期变异性与2型糖尿病(type 2 diabetes mellitus, T2DM)患者脑卒中发病风险的关联。方法基于江苏省常熟市社区糖尿病患者队列人群，共6 247人纳入分析。≥3次FPG值计算FPG长期变异性指标，包括FPG标准差(standard deviation, SD)、变异系数(coefficient of variation, CV)、平均真实变异(average real variability, ARV)和独立于均值的变异系数(variability independent of mean, VIM)。利用Cox比例风险回归模型探索FPG长期变异性与T2DM患者脑卒中发病风险的关联，并根据年龄、性别以及糖尿病用药史进行分层分析。结果队列人群平均随访7.26年，共观察到脑卒中发病1 080人，发病密度为23.81/1 000人年。以FPG长期变异性指标三分位分组(T1~T3)，调整相关因素后，Cox比例风险回归模型分析显示，与T1组相比，FPG-SD、FPG-CV、FPG-ARV和FPG-VIM的T2、T3组发生脑卒中的风险均增加，并呈上升趋势(P_趋势＜ 0.01)。FPG-SD、FPG-CV、FPG-ARV和FPG-VIM每增加1个SD，脑卒中发生风险均增加，HR值(95% CI)分别为1.09(1.02~1.16)、1.09(1.03~1.16)、1.08(1.02~1.16)和1.10(1.03~1.16);缺血性脑卒中的发病风险均增加，HR值(95% CI)分别为1.11(1.03~1.19)，1.11(1.04~1.18)，1.08(1.00~1.15)，1.04(1.04~1.17);FPG-ARV每增加1个SD，出血性脑卒中的发病风险增加，HR值(95% CI)为1.25(1.03~1.53)。分层分析显示，在年龄≥65岁患者(FPG-CV除外)、女性和单用降糖药的T2DM患者中，FPG-SD、FPG-CV、FPG-ARV和FPG-VIM每增加1个SD，其脑卒中发病风险均增加(均P＜0.05)。结论 FPG长期变异性与T2DM患者脑卒中发病风险呈正相关，应降低FPG长期变异性。
- 空腹血糖变异性 /
- 2型糖尿病 /
- 脑卒中 /
- 队列研究
Abstract: Objective To investigate the association between long-term fasting plasma glucose (FPG) variability and stroke in patients with type 2 diabetes mellitus (T2DM). Methods The participants were from a community-based diabetes cohort established in Changshu from 2013 to 2014 (n=6 247). Long-term glucose variability was assessed using the standard deviation (SD), coefficient of variation (CV), average real variability (ARV), and variability independent of the mean (VIM) across FPG measurements obtained at the more than three visits. The risk of stroke in patients with T2DM was estimated using Cox proportional risk regression models for SD, CV, ARV, VIM and stratified analysis were conducted according to age, gender and history of diabetes medication. Results After an average 7.26 years of follow-up, there were 1 080 incident cases of stroke, giving a crude incidence rate of 23.81/1 000 person-years. The long-term fasting plasma glucose variability was grouped by tertiles (T1-T3). After adjustment, Cox regression analysis showed that compared with the T1 group, FPG-SD, FPG-CV, FPG-ARV and FPG-VIM in T2 and T3 groups were significantly increased the risks of stroke (P_trend ＜ 0.01). Per 1 standard deviation(SD) higher of FPG-SD, FPG-CV, FPG-ARV and FPG-VIM, the risk of stroke was significantly increased, the HR (95% CI) were 1.09(1.02-1.16), 1.09(1.03-1.16), 1.08(1.02-1.16) and 1.10(1.03-1.16) respectively. Per 1 SD higher of FPG-SD, FPG-CV, FPG-ARV and FPG-VIM, the risk of ischemic stroke was significantly increased, the HR (95% CI) were 1.11(1.03-1.19), 1.11(1.04-1.18), 1.08(1.00-1.15), 1.04(1.04-1.17), respectively. Per 1 SD higher of FPG-ARV, the risk of hemorrhagic stroke was significantly increased, the HR(95% CI) was 1.25(1.05-1.48). Stratified analysis showed that in the patients of ≥65 years of age (except FPG-CV), women and oral hypoglycemic agents, per 1 SD higher of FPG-SD, FPG-CV, FPG-ARV and FPG-VIM, the risk of ischemic stroke increased significantly (P ＜ 0.05). Conclusions Long-term FPG glycemic variability is positively associated with the risk of stroke in type 2 diabetes patients.
- Fasting plasma glucose variability /
- Type 2 diabetes mellitus /
- Stroke /
- Cohort study

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表 1 研究对象按FPG-SD三分位分组的基线特征

Table 1. Baseline characteristics of study participants grouped by FPG-SD tertile

特征 Feature	合计 ^① Total ^①	FPG-SD的三分位数FPG-SD tertile			$\begin{equation} \chi^2 \end{equation}$/F/H值value	P值 value
特征 Feature	合计 ^① Total ^①	T1^① (＜0.89 mmol/L)	T2^① (0.89~＜1.72 mmol/L)	T3^① (≥1.72 mmol/L)	$\begin{equation} \chi^2 \end{equation}$/F/H值value	P值 value
人数Number of people	6 247	2 082	2 083	2 082
年龄/岁Age/years	64.51±7.82	65.12±7.98	64.35±7.47	64.07±7.96	19.541	＜ 0.001
性别Gender					17.443	＜ 0.001
男性Male	2 144(34.56)	658(31.60)	702(33.70)	784(37.50)
女性Female	4 103(65.68)	1 424(34.71)	1 381(33.66)	1 298(31.63)
文化程度Education degree					6.040	0.049
未接受正规教育No formal education	2 353(37.67)	835(40.11)	779(37.40)	739(35.50)
小学Primary school	2 833(45.35)	892(42.84)	960(46.09)	981(47.12)
初中Junior high school	821(13.14)	279(13.40)	260(12.48)	282(13.54)
高中及以上Senior high school and above	240(3.84)	76(3.65)	84(4.03)	80(3.84)
家庭年收入/万元Annual household income/10 000 yuan					1.134	0.567
≤3	1 452(23.24)	482(23.15)	465(22.32)	505(24.26)
＞3~ ＜ 11	3 412(54.62)	1 154(55.43)	1 152(55.31)	1 106(53.12)
11~ ＜ 16	997(15.96)	314(15.08)	327(15.70)	356(17.10)
≥16	386(6.18)	132(6.34)	139(6.67)	115(5.52)
吸烟Smoking	1 447(23.16)	418(20.08)	467(22.42)	562(26.99)	28.946	＜ 0.001
饮酒Alcohol	1 152(18.54)	336(16.22)	389(18.78)	427(20.63)	13.462	0.001
体力活动水平/(MET-h·day^-1) Physical activity level/(MET-h·day^-1)	8.00(2.57, 16.00)	8.00(2.73, 16.00)	8.00(2.57, 16.00)	7.33(2.17, 14.57)	1.311	0.519
糖尿病病程/年Duration of diabetes/years	4.00(2.00, 7.00)	4.00(2.00, 7.00)	5.00(3.00, 9.00)	6.00(4.00, 12.00)	362.172	＜ 0.001
基线BMI /(kg·m^-2) Baseline BMI /(kg·m^-2)	24.72±3.21	24.64±3.21	24.86±3.20	24.67±3.22	6.601	0.037
基线FPG/(mmol·L^-1) Baseline FPG/(mmol·L^-1)	8.20(6.95, 9.82)	7.21(6.31, 8.13)	8.33(7.20, 9.44)	9.82(8.13, 12.16)	1 397.020	＜ 0.001
FPG-CV /%	0.15(0.09, 0.24)	0.08(0.05, 0.10)	0.15(0.13, 0.18)	0.27(0.23, 0.35)	5 056.838	＜ 0.001
FPG-ARV /(mmol·L^-1)	3.21(1.57, 5.14)	2.52(0.68, 4.34)	2.48(1.47, 4.50)	4.44(2.87, 6.44)	885.122	＜ 0.001
FPG-VIM /%	2.10(1.35, 3.19)	1.16(0.80, 1.54)	2.19(1.70, 2.82)	3.44(2.66, 4.40)	3 622.347	＜ 0.001
疾病史Diseases history					21.958	＜ 0.001
高血压Hypertension	3 905(65.99)	1 374(65.99)	1 306(62.07)	1 225>(62.51)
血脂异常Dyslipidemia	700(11.21)	226(10.85)	257(12.34)	217(10.42)	2.111	0.348
肾病Kidney disease	207(3.31)	79(3.79)	66(3.17)	62(2.98)	4.451	0.108
糖尿病用药史History of diabetes medication					604.840	＜ 0.001
未用药No medication	1 102(17.64)	695(33.38)	274(13.16)	133(6.39)
单用降糖药Antidiabetic drugs alone	4 197(67.18)	1 220(58.60)	1 535(73.69)	1 442(69.26)
单用胰岛素Insulin alone	630(10.08)	112(5.38)	184(8.83)	334(16.04)
联合用药Drug combination	318(5.10)	55(2.64)	90(4.32)	173(8.31)
注：FPG，空腹血糖；SD，标准差；MET，代谢当量；CV，变异系数；ARV，独立于均值的变异系数；VIM，平均真实变异。 ①以人数(占比/%)或x±s或M(P₂₅, P₇₅)表示。 Note: FPG，fasting plasma glucose; SD, standard deviation; MET, metabolic equivalent; CV, coefficient of variation; ARV, variability independent of mean; VIM, average real variability. ① Number of people (proportion/%) or x±s or M(P₂₅, P₇₅).

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表 2 FPG长期变异性指标与T2DM患者脑卒中风险的Cox回归分析

Table 2. Cox regression analysis of long-term FPG variability and stroke among patients with T2DM

变异指标 Variation index	随访人年 Person-years of follow-up	发病人数 Number of the infected	发病密度(/1 000人年) Incidence density/1 000 person-years	HR值value (95% CI)
变异指标 Variation index	随访人年 Person-years of follow-up	发病人数 Number of the infected	发病密度(/1 000人年) Incidence density/1 000 person-years	模型1 Model 1	模型2 Model 2	模型3 Model 3
FPG-SD
T1(＜ 0.89 mmol/L)	15 358.80	304	19.79	1.00	1.00	1.00
T2(0.89~ ＜ 1.72 mmol/L)	15 070.42	372	24.68	1.39(1.12~1.52)	1.26(1.08~1.47)	1.24(1.06~1.46)
T3(≥1.72 mmol/L)	14 949.56	404	27.02	1.46(1.25~1.69)	1.34(1.15~1.56)	1.28(1.07~1.52)
P_趋势值^①P_trend value^①				＜ 0.01	＜ 0.01	＜ 0.01
每增加1个SD Each increment of 1 SD				1.14(1.08~1.20)	1.11(1.05~1.17)	1.09(1.02~1.16)
FPG-CV
T1(＜ 0.11%)	15 302.68	305	19.93	1.00	1.00	1.00
T2(0.11%~ ＜ 0.20%)	15 154.56	362	23.89	1.24(1.07~1.45)	1.20(1.03~1.40)	1.18(1.01~1.38)
T3(≥0.20%)	14 921.54	413	27.68	1.45(1.25~1.69)	1.36(1.16~1.58)	1.29(1.09~1.51)
P_趋势值^①P_trend value^①				＜ 0.01	＜ 0.01	＜ 0.01
每增加1个SD Each increment of 1 SD				1.15(1.09~1.21)	1.12(1.05~1.18)	1.09(1.03~1.16)
FPG-ARV
T1(＜ 2.12 mmol/L)	15 580.96	289	18.55	1.00	1.00	1.00
T2(2.12~ ＜ 4.43 mmol/L)	15 081.39	361	23.94	1.17(1.00~1.36)	1.13(0.98~1.32)	1.09(0.93~1.28)
T3(≥4.43 mmol/L)	14 716.46	430	29.22	1.42(1.22~1.65)	1.33(1.14~1.56)	1.26(1.07~1.48)
P_趋势值^①P_trend value^①				＜ 0.01	＜ 0.01	0.01
每增加1个SD Each increment of 1 SD				1.14(1.07~1.21)	1.11(1.04~1.18)	1.08(1.02~1.16)
FPG-VIM
T1(＜ 1.59%)	15 296.71	312	20.40	1.00	1.00	1.00
T2(1.59%~ ＜ 2.76%)	15 243.40	364	23.88	1.19(1.02~1.38)	1.16(1.00~1.35)	1.16(0.99~1.35)
T3(≥2.76%)	14 838.66	404	27.23	1.35(1.17~1.57)	1.28(1.10~1.49)	1.25(1.07~1.45)
P_趋势值^①P_trend value^①				＜ 0.01	＜ 0.01	＜ 0.01
每增加1个SD Each increment of 1 SD				1.14(1.07~1.20)	1.11(1.05~1.18)	1.10(1.03~1.16)
注：1. FPG，空腹血糖；T2DM，2型糖尿病；CVD，心血管病；SD，标准差；CV，变异系数；ARV，平均真实变异；VIM，独立于均值的变异系数。 2. T1~T3为以FPG长期变异性指标的三分位数进行分组；模型1调整年龄、性别、文化程度和家庭年收入；模型2在模型1的基础上调整吸烟、饮酒、体力活动水平、BMI和糖尿病病程；模型3在模型2的基础上调整基线FPG(对FPG-VIM变异指标不调整基线FPG)、糖尿病用药史以及高血压、血脂异常和肾病疾病史。 ① FPG长期变异性指标按照三分位数进行分组，将每组中位数以连续性变量的形式纳入回归模型计算P_趋势值。 Note: 1. FPG, fasting plasma glucose; T2DM, type 2 diabetes mellitus; CVD, cardiovascular disease; SD, standard deviation; CV, coefficient of variation; ARV, average real variability; VIM, variability independent of mean. 2. The long-term fasting plasma glucose variability was grouped by tertiles (T1-T3). Model 1 was adjusted for age, gender, education degree and annual household income. Model 2 was adjusted for smoking, alcohol, physical activity level, BMI and duration of diabetes on the basis of model 1; On the basis of model 2, model 3 was adjusted for baseline FPG (without adjusting baseline FPG for FPG-VIM) history of diabetes medication, and history of hypertension, dyslipidemia, and kidney disease. ① The long-term fasting plasma glucose variability was grouped by tertiles, and the median of each group was included in the regression model as a continuous variable to calculate the P_trend value.

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表 3 FPG长期变异性指标每增加1个SD与T2DM患者脑卒中亚型风险的Cox回归分析

Table 3. Cox regression analysis of each 1 SD increase in FPG long-term variability and stroke subtypes among patients with T2DM

脑卒中亚型 Stroke subtype	发病例数 Number of cases	HR值value (95%CI)
脑卒中亚型 Stroke subtype	发病例数 Number of cases	FPG-SD	FPG-CV	FPG-ARV	FPG-VIM
缺血性脑卒中Ischemic stroke	918	1.11(1.03~1.19)	1.11(1.04~1.18)	1.08(1.00~1.15)	1.10(1.04~1.17)
出血性脑卒中Hemorrhagic stroke	102	0.85(0.66~1.10)	0.88(0.70~1.10)	1.25(1.03~1.53)	0.96(0.79~1.17)
注：1. FPG，空腹血糖；T2DM，2型糖尿病；SD，标准差；CV，变异系数；ARV，平均真实变异；VIM，独立于均值的变异系数。 2.表中HR值(95% CI)采用FPG长期变异性指标每增加1个SD进行计算；模型调整年龄、性别、文化程度和家庭年收入、吸烟、饮酒、体力活动水平、BMI和糖尿病病程、基线FPG(对FPG-VIM变异指标不调整基线FPG)、糖尿病用药史以及高血压、血脂异常和肾病疾病史。 Notes: 1. FPG, fasting plasma glucose; T2DM, type 2 diabetes mellitus; SD, standard deviation; CV, coefficient of variation; ARV, average real variability; VIM, variability independent of mean. 2. TheHR(95%CI)in the table were calculated using an increase of 1 SD in the FPG long-term variability indicator. The model was adjusted for age, gender, education degree and annual household income, smoking, alcohol, physical activity level, BMI, duration of diabetes, baseline FPG (without adjusting baseline FPG for FPG-VIM), history of diabetes medication, hypertension, dyslipidemia and kidney disease.

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表 4 FPG长期变异性指标每增加1个SD与T2DM患者脑卒中风险的分层分析

Table 4. Stratified analysis of each 1 SD increase in FPG long-term variability and stroke among patients with T2DM

变量 Variable	FPG-SD		FPG-CV		FPG-ARV		FPG-VIM
变量 Variable	HR值value (95%CI)	P值value	HR值value (95%CI)	P值value	HR值value (95%CI)	P值value	HR值value (95%CI)	P值value
年龄/岁Age/years
＜ 65	1.09(0.98~1.20)	0.923	1.10(1.00~1.21)	0.654	1.14(1.04~1.26)	0.061	1.12(1.02~1.22)	0.438
≥65	1.09(1.00~1.19)		1.08(0.99~1.17)		1.03(0.99~1.07)		1.08(1.00~1.17)
性别Gender
男性Male	1.09(0.99~1.20)	0.425	1.09(0.99~1.20)	0.508	1.04(0.94~1.15)	0.763	1.11(1.02~1.22)	0.711
女性Female	1.09(1.00~1.19)		1.09(1.01~1.18)		1.12(1.03~1.21)		1.09(1.01~1.18)
糖尿病用药史History of diabetes medication
未用药No medication	1.21(0.91~1.62)	0.432	1.11(0.88~1.40)	0.692	1.13(0.92~1.39)	0.077	1.09(0.90~1.33)	0.954
单用降糖药Antidiabetic drugs alone	1.12(1.04~1.22)		1.11(1.03~1.20)		1.13(1.04~1.22)		1.10(1.03~1.19)
单用胰岛素Insulin alone	0.99(0.86~1.15)		1.02(0.88~1.18)		0.84(0.70~1.00)		1.07(0.93~1.23)
联合用药Drug combination	1.16(0.92~1.45)		1.18(0.94~1.49)		1.15(0.91~1.46)		1.20(0.96~1.49)
注：1. FPG，空腹血糖；SD，标准差；T2DM，2型糖尿病；CVD，心血管病；CV，变异系数；ARV，平均真实变异；VIM，独立于均值的变异系数。 2. 表中HR值(95% CI)采用FPG长期变异性指标每增加1个SD进行计算，模型调整年龄、性别、文化程度、家庭年收入、吸烟、饮酒、体力活动水平、BMI、糖尿病病程、基线FPG(对FPG-VIM变异指标不调整基线FPG)、糖尿病用药史以及高血压、血脂异常、肾病疾病史。 Note: 1. FPG, fasting plasma glucose; SD, standard deviation; T2DM, type 2 diabetes mellitus; CVD, cardiovascular disease; CV, coefficient of variation; ARV, average real variability; VIM, variability independent of mean. 2. The HR(95% CI) in the table were calculated using an increase of 1 SD in the FPG long-term variability indicator. The model was adjusted for age, gender, education degree and annual household income, smoking, alcohol, physical activity level, BMI, duration of diabetes, baseline FPG (without adjusting baseline FPG for FPG-VIM), history of diabetes medication, hypertension, dyslipidemia and kidney disease.

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特征 Feature	合计 ^① Total ^①	FPG-SD的三分位数FPG-SD tertile			$\begin{equation} \chi^2 \end{equation}$/F/H值value	P值 value
特征 Feature	合计 ^① Total ^①	T1^① (＜0.89 mmol/L)	T2^① (0.89~＜1.72 mmol/L)	T3^① (≥1.72 mmol/L)	$\begin{equation} \chi^2 \end{equation}$/F/H值value	P值 value
人数Number of people	6 247	2 082	2 083	2 082
年龄/岁Age/years	64.51±7.82	65.12±7.98	64.35±7.47	64.07±7.96	19.541	＜ 0.001
性别Gender					17.443	＜ 0.001
男性Male	2 144(34.56)	658(31.60)	702(33.70)	784(37.50)
女性Female	4 103(65.68)	1 424(34.71)	1 381(33.66)	1 298(31.63)
文化程度Education degree					6.040	0.049
未接受正规教育No formal education	2 353(37.67)	835(40.11)	779(37.40)	739(35.50)
小学Primary school	2 833(45.35)	892(42.84)	960(46.09)	981(47.12)
初中Junior high school	821(13.14)	279(13.40)	260(12.48)	282(13.54)
高中及以上Senior high school and above	240(3.84)	76(3.65)	84(4.03)	80(3.84)
家庭年收入/万元Annual household income/10 000 yuan					1.134	0.567
≤3	1 452(23.24)	482(23.15)	465(22.32)	505(24.26)
＞3~ ＜ 11	3 412(54.62)	1 154(55.43)	1 152(55.31)	1 106(53.12)
11~ ＜ 16	997(15.96)	314(15.08)	327(15.70)	356(17.10)
≥16	386(6.18)	132(6.34)	139(6.67)	115(5.52)
吸烟Smoking	1 447(23.16)	418(20.08)	467(22.42)	562(26.99)	28.946	＜ 0.001
饮酒Alcohol	1 152(18.54)	336(16.22)	389(18.78)	427(20.63)	13.462	0.001
体力活动水平/(MET-h·day^-1) Physical activity level/(MET-h·day^-1)	8.00(2.57, 16.00)	8.00(2.73, 16.00)	8.00(2.57, 16.00)	7.33(2.17, 14.57)	1.311	0.519
糖尿病病程/年Duration of diabetes/years	4.00(2.00, 7.00)	4.00(2.00, 7.00)	5.00(3.00, 9.00)	6.00(4.00, 12.00)	362.172	＜ 0.001
基线BMI /(kg·m^-2) Baseline BMI /(kg·m^-2)	24.72±3.21	24.64±3.21	24.86±3.20	24.67±3.22	6.601	0.037
基线FPG/(mmol·L^-1) Baseline FPG/(mmol·L^-1)	8.20(6.95, 9.82)	7.21(6.31, 8.13)	8.33(7.20, 9.44)	9.82(8.13, 12.16)	1 397.020	＜ 0.001
FPG-CV /%	0.15(0.09, 0.24)	0.08(0.05, 0.10)	0.15(0.13, 0.18)	0.27(0.23, 0.35)	5 056.838	＜ 0.001
FPG-ARV /(mmol·L^-1)	3.21(1.57, 5.14)	2.52(0.68, 4.34)	2.48(1.47, 4.50)	4.44(2.87, 6.44)	885.122	＜ 0.001
FPG-VIM /%	2.10(1.35, 3.19)	1.16(0.80, 1.54)	2.19(1.70, 2.82)	3.44(2.66, 4.40)	3 622.347	＜ 0.001
疾病史Diseases history					21.958	＜ 0.001
高血压Hypertension	3 905(65.99)	1 374(65.99)	1 306(62.07)	1 225>(62.51)
血脂异常Dyslipidemia	700(11.21)	226(10.85)	257(12.34)	217(10.42)	2.111	0.348
肾病Kidney disease	207(3.31)	79(3.79)	66(3.17)	62(2.98)	4.451	0.108
糖尿病用药史History of diabetes medication					604.840	＜ 0.001
未用药No medication	1 102(17.64)	695(33.38)	274(13.16)	133(6.39)
单用降糖药Antidiabetic drugs alone	4 197(67.18)	1 220(58.60)	1 535(73.69)	1 442(69.26)
单用胰岛素Insulin alone	630(10.08)	112(5.38)	184(8.83)	334(16.04)
联合用药Drug combination	318(5.10)	55(2.64)	90(4.32)	173(8.31)
注：FPG，空腹血糖；SD，标准差；MET，代谢当量；CV，变异系数；ARV，独立于均值的变异系数；VIM，平均真实变异。 ①以人数(占比/%)或x±s或M(P₂₅, P₇₅)表示。 Note: FPG，fasting plasma glucose; SD, standard deviation; MET, metabolic equivalent; CV, coefficient of variation; ARV, variability independent of mean; VIM, average real variability. ① Number of people (proportion/%) or x±s or M(P₂₅, P₇₅).

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空腹血糖变异性与2型糖尿病患者脑卒中发病风险的前瞻性队列研究

doi: 10.16462/j.cnki.zhjbkz.2024.07.006

通讯作者:
苏健，E-mail: sujiangx@163.com

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A prospective cohort study on the long-term fasting plasma glucose variability and risk of stroke among patients with type 2 diabetes mellitus

Corresponding author: SU Jian，E-mail: sujiangx@163.com

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空腹血糖变异性与2型糖尿病患者脑卒中发病风险的前瞻性队列研究

doi: 10.16462/j.cnki.zhjbkz.2024.07.006

通讯作者: 苏健，E-mail: sujiangx@163.com

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A prospective cohort study on the long-term fasting plasma glucose variability and risk of stroke among patients with type 2 diabetes mellitus

Corresponding author: SU Jian，E-mail: sujiangx@163.com

计量

出版历程

目录

通讯作者:
苏健，E-mail: sujiangx@163.com