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1.
The relationship between degree of glucose tolerance and cardiovascular disease has been studied in a cross-sectional population survey of 644 men born in 1913, randomly sampled and examined at the age of 67. The cohort was divided into different groups according to current diagnostic criteria for diabetes and impaired glucose tolerance. An almost 2-fold higher prevalence of hypertension, myocardial infarction, angina pectoris, and congestive heart failure was found in the group with impaired glucose tolerance compared to the group with a normal glucose tolerance. Fifty per cent of the men with impaired glucose tolerance were being treated with some drug for cardiovascular disease, usually diuretics for hypertension. Intermittent claudication showed a 2.5-fold higher prevalence among the diabetic patients. A computerized 12-lead exercise-ECG test, with a unique accuracy in measuring ST-segment changes, was performed in a subset of 135 men. This showed no association between ST-segment depression and different degrees of glucose tolerance, even when accounting for confounding factors such as treatment with beta-blocker agents or digoxin, pathological Q-waves, and differences in maximal heart rate.  相似文献   

2.

Objective

Inconsistent findings have reported the association between self-reported habitual snoring and risk of cardiovascular disease (CVD) and all-cause mortality. We conducted a meta-analysis to investigate whether self-reported habitual snoring was an independent predictor for CVD and all-cause mortality using prospective observational studies.

Methods

Electronic literature databases (PubMed, Medline, Embase, Cochrane Library, Wanfang database, and China National Knowledge Infrastructure) were searched for publications prior to September 2013. Only prospective studies evaluating baseline habitual snoring and subsequent risk of CVD and all-cause mortality were selected. Pooled adjust hazard risk (HR) and corresponding 95% confidence intervals (CI) were calculated for categorical risk estimates.

Results

Eight studies with 65,037 subjects were analyzed. Pooled adjust HR was 1.26 (95% CI 0.98–1.62) for CVD, 1.15 (95% CI 1.05–1.27) for coronary heart disease (CHD), and 1.26 (95% CI 1.11–1.43) for stroke comparing habitual snoring to non-snorers. Pooled adjust HR was 0.98 (95% CI 0.78–1.23) for all-cause mortality in a random effect model comparing habitual snoring to non-snorers. Habitual snoring appeared to increase greater stroke risk among men (HR 1.54; 95% CI: 1.09–2.17) than those in women (HR 1.22; 95% CI: 1.05–1.41).

Conclusions

Self-reported habitual snoring is a mild but statistically significant risk factor for stroke and CHD, but not for CVD and all-cause mortality. However, whether the risk is attributable to obstructive sleep apnea syndrome or snoring alone remains controversial.  相似文献   

3.
葡萄糖耐量低减与动脉粥样硬化   总被引:43,自引:1,他引:42  
目的 观察葡萄糖耐量低减 (IGT)与动脉粥样硬化 (AS)的关系。方法 在曾经有血糖异常升高 (但未达糖尿病标准 )、患有心血管疾病 (如冠心病、中风或高血压 )或其危险因素 (如血脂异常 )的人群进行 75g口服葡萄糖耐量试验 (OGTT)筛查IGT病人 ,并同时记录病史、体检。空腹血脂指标由自动生化分析完成。同时用B型超声检查双侧颈总动脉 ,观察内膜连续性、内膜 中层厚度 (IMT)、斑块等指标。结果 IGT组 (n =5 1)的内膜连续性比正常糖耐量 (NGT)组 (n =97)明显差 (P <0 .0 5 ) ,IGT组双侧平均IMT和动脉粥样硬化 (AS)积分均显著高于NGT组 (均P <0 .0 5 ) ,IGT的平均IMT异常增高的发病率显著高于NGT。但以上指标IGT与糖尿病组 (n =73 )差异无显著性。多元分析发现 ,IGT的AS指标增加效应经同时校正甘油三酯、胆固醇、冠心病史、中风史、吸烟、性别、体重指数仍具有显著意义 ;但是分别校正年龄、腰臀围比值、高密度脂蛋白胆固醇和高血压病史 ,三种AS指标有不同程度的减弱。结论 与NGT人群相比 ,IGT人群已经存在明显的AS表现 ,其程度与糖尿病类似。IGT的动脉粥样硬化现象独立于部分心血管危险因子和已经存在的心血管疾病。  相似文献   

4.
目的 探讨高血压合并糖耐量减低(IGT)对老年男性人群全因死亡风险的影响.方法 纳入2005年5月至2007年5月在解放军总医院第二医学中心行口服葡萄糖耐量试验检出的老年男性IGT患者和正常糖耐量(NGT)人群,根据基线时是否存在高血压病史和IGT分为4组:非高血压(NH)+正常糖耐量(NGT)组、高血压(H)+NGT...  相似文献   

5.
目的了解空腹血糖受损(IFG)患者糖耐量异常(IGT)情况及其影响因素。方法纳入空腹血糖为5.6~6.1 mmol/L的IFG患者337例,检测患者口服75克葡萄糖后2小时血糖等资料,分析患者IGT情况及其影响因素。结果纳入的337例IFG患者中46.6%(157/337)伴有IGT。口服葡萄糖耐量异常和正常组超重和肥胖率分别为75.0%和63.1%(P0.05);口服葡萄糖耐量异常组甘油三酯水平显著高于正常组,高密度脂蛋白胆固醇水平低于正常组,均有统计学差异(P0.05)。多因素Logistic回归分析结果显示,年龄、体重指数、甘油三酯水平是IFG患者葡萄糖耐量异常的影响因素,相对危险分别为:1.06(95%CI:1.03~1.08);1.11(95%CI:1.05~119);1.58(95%CI:1.23~2.09)。进一步对体重正常者发生糖耐量异常的影响因素进行分析,除年龄外,甘油三酯水平是空腹血糖受损患者糖耐量异常的影响因素,相对危险为2.10(95%CI:1.29~3.43)。结论空腹血糖受损患者约半数伴有糖耐量异常,体重指数和甘油三酯水平是空腹血糖受损患者糖耐量异常的影响因素。  相似文献   

6.
Aims/hypothesis. Impaired glucose tolerance is associated with metabolic alterations which increase cardiovascular disease risk. The contribution of hyperglycaemia to this increased risk is, however, not clear. Abdominal obesity is often observed in subjects with impaired glucose tolerance; our objective was therefore to find the contribution of visceral adipose tissue to the deterioration of the metabolic risk profile noted in subjects with impaired glucose tolerance. Methods. We studied 284 men with a normal glucose tolerance and 66 men with impaired glucose tolerance which was defined as a glycaemia between 7.8 and 11.1 mmol/l 2 h after a 75-g glucose load. Results. Men with impaired glucose tolerance had more visceral adipose tissue and higher concentrations of plasma glucose and insulin in the fasting state and following a 75-g oral glucose load than men with a normal glucose tolerance. They also had higher concentrations of plasma cholesterol, triglycerides, apolipoprotein B and lower concentrations of HDL-cholesterol as well as higher cholesterol:HDL-cholesterol ratios than men with a normal glucose tolerance. The two groups of men were then compared after a statistical adjustment for the amount of visceral adipose tissue. Although men with impaired glucose tolerance still had higher fasting plasma glucose and insulin concentrations after the adjustment for visceral adipose tissue, differences in all the variables of the lipid-lipoprotein profile were eliminated. Conclusion/interpretation. Visceral adipose tissue accumulation is an important factor in the deterioration of the plasma lipid-lipoprotein noted in men with impaired glucose tolerance. [Diabetologia 2000 43: 1126–1135] Received: 16 March 2000 and in revised from 8 June 2000  相似文献   

7.
Background and aimsAs a new simple anthropometric index, the weight-adjusted-waist index (WWI) appears to be superior to body mass index (BMI) and waist circumference (WC) in assessing both muscle and fat mass. We aimed to explore the association of WWI with all-cause and cardiovascular mortality in southern China.Methods and resultsA total of 12,447 participants (mean age, 59.0 ± 13.3 years; 40.6% men) in Jiangxi Province from the China Hypertension Survey study were included. WWI was defined as WC divided by the square root of weight. The outcome was all-cause and cardiovascular mortality. During a median follow-up of 5.6 years, 838 all-cause deaths occurred, with 390 cardiovascular deaths. Overall, there was a nonlinear positive relationship of WWI with all-cause and cardiovascular mortality. Accordingly, compared with participants in quartiles 1–3 (<11.2 cm/√kg), a significant higher risk of all-cause mortality (HR: 1.36, 95% CI: 1.17, 1.58) and cardiovascular mortality (HR: 1.43, 95% CI: 1.15, 1.77) were found in quartile 4 (≥11.2 cm/√kg). Further adjustment for BMI and WC did not substantially alter the results. No significant interactions were found in any of the subgroups (sex, age, area, physical activity, current smoking, current alcohol drinking, hypertension, and stroke).ConclusionHigher WWI levels (≥11.2 cm/√kg) were associated with increased the risk of all-cause and cardiovascular mortality in southern China. These findings, if confirmed by further studies, suggested that WWI may serve as a simple and effective anthropometric index in clinical practice.  相似文献   

8.
This report concerns the relationship between baseline levels of fasting blood glucose (FBG) in non-diabetics and the subsequent 17-year incidence of coronary heart disease (CHD), stroke and all-cause mortality. In 1963, 973 men aged 50 years were recruited from a general Swedish urban population for a prospective study of risk factors for CHD. Eight hundred and fifty-five (88%) men agreed to participate and have been observed for 17 years. The 832 men who had no history of myocardial infarction, stroke, diabetes mellitus or who had a fasting blood glucose below 7.0 mmol/l at baseline were selected for this analysis. CHD occurred in 106 men, 35 developed a stroke and 137 died during follow-up. When quintiles and deciles of the FBG distribution were considered, no trend of 17-year incidence of CHD, stroke or death was apparent. However, for men with an FBG above the 95th percentile (greater than 5.7 mmol/l) a non-significant trend towards increasing risk was indicated.  相似文献   

9.
Summary Impaired glucose tolerance (IGT) is associated with increased mortality due to ischaemic heart disease (IHD), but as it is not known whether this excess mortality can be reduced by preventing or delaying the development of non-insulin-dependent diabetes mellitus (NIDDM), a long-term NIDDM prevention trial of dietary counselling and physical exercise was launched at Malm?, Sweden, the 12-year follow-up of which is reported here. At 12-year follow-up of 6956 men who underwent health screening at 48 years of age, an IGT intervention group (n = 288) who participated in a long-term NIDDM prevention programme were compared with an IGT non-randomised routine treatment group (n = 135), a diabetic group (n = 144), and the remainder, the normal glucose tolerance (NGT) group (n = 6389). The variables studied included the levels of blood glucose, plasma insulin, blood pressure, blood lipids, lung function and maximum oxygen uptake. Subjects with IGT were characterised by overweight, poor vital capacity, hypertension, hypertriglyceridaemia and hyperinsulinaemia. The mortality rate in the IGT intervention group was similar to that in the NGT group (6.5 vs 6.2 per 1000 person years at risk) and lower than that in the IGT routine treatment group (6.5 vs 14.0, p = 0.009). In the two IGT groups taken together, intervention but not body mass index, systolic blood pressure, smoking, cholesterol or the 2-h glucose level predicted mortality. Systolic blood pressure was a predictor of IHD mortality among IGT subjects; and in the cohort as a whole, body mass index, systolic blood pressure, hypercholesterolaemica, diabetes and smoking were predictors of IHD mortality. The findings suggest that a long-term intervention programme, with an emphasis on lifestyle changes, including dietary counselling and physical exercise, will reduce mortality in subjects with IGT who are at an increased risk of both developing NIDDM and of premature death due to IHD and other causes. [Diabetologia (1998) 41: 1010–1016] Received: 20 June 1997 and in revised form: 24 April 1998  相似文献   

10.
Objective To assess the association between 1-year risk of all-cause and cardiovascular disease (CVD) mortality and ankle-brachial index (ABI) in Chinese patients who were at high CVD risk. Methods Totally 3733 patients with high CV risk had bilateral ABI measurements at baseline and were followed up for 1-1.5 years. Patients were divided to four groups: 1) coronary heart disease (CHD); 2) ischemic stroke (IS); 3) diabetes mellitus (DM); 4) very high risk group(VHR), low ABI was defined as 〈0.9. Results A total of 3179 patients were analyzed. The prevalence of low ABI was 28.1%. At 1 year, all-cause mortality was 8.7%, and 27.6% was attributable to CVD; mortality due to CV events was 4.8% and 1.5%. After adjusting other risk factors the hazard ratio of low ABI was 1.623 for all-cause mortality and 2.304 for CVD mortality. Similar in patient with and without low ABI, respectively were found in four groups.Conclusion ABI is a strong and independent predictor ofrnortality. Patients with a low ABI have a substantially increased risk of all-cause mortality and CVD mortality (J Geriatr Cardio12010; 7:17-20).  相似文献   

11.
Background and aimLongitudinal evidence on change in serum (SUA) with risk of cardiovascular disease (CVD) and all-cause mortality is limited, as many prior studies focused on baseline SUA. Further, the optimal threshold range of SUA change is unclear.Methods and resultsA total of 63,127 participants without history of CVD were enrolled. Change in SUA was determined by the difference of SUA levels between 2006 and 2010, which divided by baseline SUA was percent change in SUA. Multivariable Cox proportional hazards models were used to calculated the hazard ratios (HRs) and 95% confidence intervals (CIs). Our analysis also included restricted cubic spline model and three-piecewise Cox proportion hazards model to address the non-linearity between percent change in SUA and outcomes. During a median follow-up of 7.04 years, 3341 CVD and 3238 deaths occurred. We did not observed a significant association between changes in SUA and CVD. However, changes in SUA at extreme were associated with higher risk of all-cause mortality, the HRs (95% CIs) were 1.15 (1.02–1.29) and 1.20 (1.06–1.35) in the first and fifth quintile group, compared with the third quintile group. We further found a U-shaped association between percent change in SUA and all-cause mortality, and the optimal range was within 20%.ConclusionsChanges in SUA at extreme were risk factors for all-cause mortality, but not for CVD in the general population. The findings are relevant for role of SUA in the management of CVD risk and may contribute to improve identification of patients at higher risk.  相似文献   

12.
13.
《Primary Care Diabetes》2020,14(1):40-46
AimPrevious studies have shown that individuals with impaired glucose tolerance (IGT) have lower self-rated health than normoglycaemic individuals. The aim of this study was to examine differences in self-rated health between individuals with IGT and those with impaired fasting glucose (IFG) and to consider the potentially mediating effect of physical activity.MethodsIn 2002–2005, a total of 2816 individuals were randomly selected for a population-based study in Sweden. All participants performed an oral glucose tolerance test (OGTT). Fasting venous blood samples were drawn, and questionnaires concerning lifestyles were completed. Self-rated health (SRH) and leisure time physical activity (LTPA) were reported on a five-graded and four-graded scale, respectively. A total of 213 individuals with IGT and 129 with IFG were detected.ResultsIGT, but not IFG, was associated with low self-rated health. The difference in self-rated health was seen particularly in men when adjusted for age and BMI (OR = 2.13, CI: 1.13–4.02, p = 0.020). The results became insignificant when including physical activity in the model (OR = 1.8, CI: 0.91–3.58, p = 0.094).ConclusionThe low self-rated health adds further weight to the risk profile in men with IGT and stresses the importance of early detection and lifestyle interventions.  相似文献   

14.
Background and aimsStudies have shown inconsistent results about the association between serum uric acid (SUA) levels and mortality in hemodialysis patients. We performed this meta-analysis to determine whether higher SUA values comprised a risk factor of cardiovascular or all-cause mortality in maintenance hemodialysis patients.Methods and resultsPubmed, Embase and the Cochrane library were searched up to August 31, 2020 for the longitudinal studies that investigated the association between the elevated SUA and cardiovascular or all-cause mortality risk in maintenance hemodialysis patients. Pooled adjusted hazard ratios (HR) and corresponding 95% confidence interval (CI) were calculated using a random-effects model. We included 10 studies with an overall sample of 264,571 patients with hemodialysis in this meta-analysis. Patients with the highest SUA were associated with a decreased risk of cardiovascular mortality (HR = 0.72, 95% CI 0.59–0.87) compared with patients with the lowest SUA after adjustment for potential confounders in a random effects model. Moreover, for each increase of 1 mg/dl of SUA, the overall risks of all-cause and cardiovascular mortality decreased by 6% and 9%, respectively (HR = 0.94, 95% CI 0.90–0.99; HR = 0.91, 95% CI 0.89–0.94).ConclusionElevated SUA levels are strongly and independently associated with lower risk of cardiovascular mortality in maintenance hemodialysis patients. More designed studies, especially randomized controlled trials, should be conducted to determine whether high SUA levels is an independent risk factor of all-cause mortality in hemodialysis patients.  相似文献   

15.
Summary Since second-generation (Nisei) Japanese Americans are prone to develop the insulin resistance syndrome, younger third-generation (Sansei) Japanese Americans from a cross-sectional 10 % volunteer sample of Sansei men (n=115) and women (n=115) 34 years or older in King County, Washington with normal glucose tolerance or IGT were examined for metabolic and adipose risk factors associated with this syndrome. After an overnight 10-h fast, blood samples were taken for measurement of glucose, insulin, C-peptide, lipids, and lipoproteins, followed by a 3-h 75-g oral glucose tolerance test with blood samples taken for glucose, insulin, and C-peptide measurement. BMI (kg/m2), skinfolds, and body fat areas (by computed tomography) were measured. IGT was diagnosed in 19 % of the men and 31 % of the women. Men with IGT had more adiposity, both overall and in thoracic and visceral sites, had higher fasting plasma insulin and C-peptide, and tended to have higher fasting triglyceride and lower HDL cholesterol than men with normal glucose tolerance. Women with IGT had more thoracic subcutaneous fat and intra-abdominal fat and lower fasting HDL cholesterol than women with normal glucose tolerance, and tended to have higher fasting triglyceride and LDL cholesterol. Women with IGT also had higher fasting plasma insulin than women with normal glucose tolerance but tended to be less hyperinsulinaemic than men. Differences in fasting insulin, C-peptide, and lipids were best predicted by intra-abdominal fat. Thus metabolic (higher fasting insulin and a tendency to higher triglyceride and lower HDL cholesterol) and adipose (visceral adiposity) risk factors associated with the insulin resistance syndrome are identifiable among Sansei men and women with IGT, who may therefore be at increased risk of future development of NIDDM and CHD. [Diabetologia (1994) 37: 524–532] Received: 9 July 1993 and in revised form: 14 December 1993  相似文献   

16.
Increasing evidence demonstrates that inflammation is associated with many pathophysiologic processes and mortality in older adults. Increase in total white blood cell (WBC) counts is recognized as an important cellular marker of systemic inflammation. However, relationships of total WBC and individual differential counts with mortality in older adults, particularly in older women, have not been adequately evaluated. To address this important question, we obtained baseline total WBC and differential counts and 5-year all-cause mortality of 624 community-dwelling women age 65–101 in the Women's Health and Aging Study cohort, excluding those with WBC counts above the normal range. Using Kaplan–Meier survival and Cox proportional hazard regression analyses, and adjusting for age, race, body mass index, smoking, and education, we identified that baseline higher total WBC, higher neutrophil, or lower lymphocyte counts were independently associated with increased mortality. No significant associations of eosinophil, monocyte, or basophil counts with mortality were observed. These results suggest that beyond acute bacterial infection, changes in counts of baseline total WBC and its specific subpopulations predict increased mortality in older women. They provide a basis for further investigation into the role of leukocytes in age-related inflammation and its associated adverse outcomes in older adults.  相似文献   

17.

Objective

Serum uric acid (SUA) levels have been used to predict cardiovascular and all-cause mortality event, but the data have yielded conflicting results. We investigated whether SUA was an independent predictor for cardiovascular or all-cause mortality with prospective studies by meta-analysis.

Methods

Pubmed and Embase were searched without language restrictions for publications available till April 2013. Only prospective studies on cardiovascular or all-cause mortality related to SUA levels were included. Pooled adjust relative risk (RR) and corresponding 95% confidence intervals (CI) were calculated separately for the highest vs. lowest category or the lowest vs. middle category.

Results

For the highest SUA, eleven studies with 172,123 participants were identified and analyzed. Elevated SUA increased risk of all-cause mortality (RR 1.24; 95% CI 1.09–1.42) and cardiovascular mortality (RR 1.37; 95% CI 1.19–1.57). Subgroup analyses showed that elevated SUA significantly increase the risk of all-cause mortality among men (RR 1.23; 95% CI 1.08–1.42), but not in women (RR 1.05; 95% CI 0.79–1.39). Risk of cardiovascular mortality appeared to be more pronounced among women (RR 1.35; 95% CI 1.06–1.72). The association between extremely low SUA and mortality was reported in three studies; we did not perform a pooled analysis because of high degree of heterogeneity in these studies.

Conclusions

Baseline SUA level is an independent predictor for future cardiovascular mortality. Elevated SUA appears to significantly increase the risk of all-cause mortality in men, but not in women. Whether low SUA levels are predictors of mortality is still inconclusive.  相似文献   

18.
葡萄糖耐量受损(IGT)与冠心病关系密切,显著地影响冠心病的发病和转归。本文介绍餐后血糖定义及状态、监测及适应证、IGT的检出率与相关因素、对心血管系统的危害、干预措施和效果。  相似文献   

19.
目的 探讨空腹血糖受损(IFG)、糖耐量受损(IGT)人群发生糖尿病的危险性及其影响因素. 方法对2003年4~6月朝阳市市区居民1 062人糖尿病普查中IFG、IGT患者79人于2006年4~6月进行随访调查.测量身高、体重、腰围、血压,做过夜空腹75g葡萄糖耐量试验,同时测定血总胆固醇(TC),甘油三酯(TG),高密度脂蛋白胆固醇(HDL-C).结果 随访的65人中22人发生糖尿病.其中孤立性IFG(I-IFG)糖尿病转变率为10.8%,孤立性IGT(I-IGT)为9.2%, IFG/IGT为10.4%.在不同的年龄组,随着年龄增长糖代谢异常、高血压、肥胖、脂代谢异常有增加趋势,在40岁以上人群糖代谢异常的患病率有明显增加趋势.进行单因素相关分析结果发现血糖升高可能与增龄、糖尿病(DM)家族史、劳动强度、腰围指数(WC)增加、收缩压(SBP)增加、血脂异常等相关.进行Logistic回归分析,高龄、血压升高、中心性肥胖、体力活动强度减弱均为糖尿病危险因素.结论 I-IGT、IGT/IFG人群糖尿病累计发病率明显高于I-IFG人群.增龄、向心性肥胖、高血压、体力活动减少是糖代谢异常的重要危险因素,因此控制血压、体重,增加体力活动,对糖尿病预防具有重要意义.  相似文献   

20.
目的 探讨糖尿病前期冠脉病变的特点及危险因素。方法  193例冠心病患者根据 1997年美国糖尿病学会诊断标准分为单纯冠心病组 12 2例 ,冠心病合并糖耐量异常组 39例 ,冠心病合并糖尿病组 32例 ,所有研究对象均行冠脉造影和口服 75 g葡萄糖耐量实验 ,检测血糖、胰岛素、血脂、血压、BUN、Cr。冠脉病变程度应用 CAG分析 ,冠脉狭窄程度根据 AHA分类标准评价 ,冠脉病变的危险因素应用多元逐步直线回归分析。结果  (1)冠心病合并糖耐量异常组多支冠脉病变的发生率明显高于单纯冠心病组 (6 6 .5 % vs 35 .1% ,P <0 .0 5 )。冠脉狭窄程度 (8.9± 3.6 vs 6 .5± 3.9,P<0 .0 5 )及钙化的程度明显高于单纯冠心病组 (6 .6± 6 .1vs 3.9± 4 .1,P <0 .0 5 ) ,冠脉远端的病变发生率明显高于单纯冠心病组 (40 .8% vs 13.1% ,P <0 .0 5 )。 (2 )冠心病合并糖耐量异常组与冠心病合并糖尿病组相比 ,多支冠脉病变的发生率、冠脉粥样硬化及钙化的程度及冠脉远端的病变发生率差异性不明显。(3)血脂、胰岛素、血压、肥胖与冠脉粥样硬化程度有明显相关性。结论 与糖尿病患者相似 ,糖耐量异常患者多支冠脉病变的发生率明显升高 ,病变多呈弥漫性狭窄 ,远端血管病变发生率较高 ,程度严重 ,血脂、胰岛素、血压、肥胖为发生冠脉  相似文献   

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