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目的探讨基线总胆固醇水平对糖尿病人群新发脑梗死事件的影响。方法采用前瞻性队列研究方法,以空腹血糖≥7.0 mmo/lL或<7.0 mmo/lL但已确诊为糖尿病,正在使用降糖药物的8 306例糖尿病人群作为观察队列,随访(48.01±3.14)个月,随访期间每半年收集一次新发脑梗死事件情况。分析基线总胆固醇水平对糖尿病人群新发脑梗死事件的影响。结果 (1)随着基线总胆固醇水平的增高,研究对象的空腹血糖、甘油三酯、收缩压和舒张压的水平逐渐增高(P<0.05)。(2)总胆固醇<4.46 mmo/lL组累积发生脑梗死事件率最低(2.2%,P<0.05)。校正年龄、性别、空腹血糖、收缩压、舒张压、甘油三酯、体重指数、吸烟和糖尿病病程因素,Cox比例风险回归分析表明,相对于总胆固醇<4.46 mmo/lL组,总胆固醇≥5.93 mmo/lL组发生脑梗死事件的相对危险(RR)增加1.90倍(95%CI 1.24～2.89,P<0.01)。结论糖尿病人群总胆固醇控制在4.46 mmo/lL以下发生脑梗死事件率最低。
Objective To investigate the effect of baseline total cholesterol level on new-onset cerebral infarction in diabetic population. Methods A prospective cohort study was conducted in 8 306 diabetics with fasting glucose ≥7.0 mmo / lL or <7.0 mmo / lL but diagnosed with diabetes. The follow-up was (48.01 ± 3.14) Month, during the follow-up period every six months to collect new cases of cerebral infarction. The impact of baseline total cholesterol level on new-onset cerebral infarction in diabetic population was analyzed. Results (1) The levels of fasting blood glucose, triglycerides, systolic and diastolic blood pressure increased gradually with the increase of baseline total cholesterol (P <0.05). (2) The cumulative incidence of cerebral infarction with total cholesterol <4.46 mmo / lL group was the lowest (2.2%, P <0.05). Cox proportional hazards regression analysis showed that total cholesterol ≥5.93 mmo, relative to total cholesterol <4.46 mmo / lL group, adjusted for age, gender, fasting blood glucose, systolic blood pressure, diastolic blood pressure, triglyceride, body mass index, smoking and diabetes course factors The relative risk (RR) of cerebral infarction in / lL group increased 1.90 times (95% CI 1.24-2.89, P <0.01). Conclusion The total incidence of cerebral infarction in patients with diabetes under 4.46 mmo / lL is the lowest.