论文部分内容阅读
目的研究不同饮酒量对男性糖尿病人群心脑血管事件的影响。方法采用前瞻性队列研究方法,以2006-07-2007-10参加开滦集团健康体检的6041例男性糖尿病人群作为观察队列,以不同饮酒量进行分组(饮酒量0g/d组,饮酒量≤25g/d组,饮酒量>25g/d组)。用寿命表法计算不同饮酒量组心脑血管事件(急性心肌梗死、心源性猝死、脑梗死、脑出血、心脑血管病因死亡)的累积发生率,并用Log-Rank检验比较不同饮酒量组心脑血管事件发生率的差异。采用多变量Cox比例风险回归模型分析影响心脑血管事件的因素。结果随着酒精摄入量增加,总胆固醇、低密度脂蛋白胆固醇、总胆红素水平增加,吸烟者比例增加(均P<0.01);与其他2组相比,饮酒量≤25g/d组平均年龄小,高血压患病率低,收缩压、舒张压、高密度脂蛋白胆固醇水平低;高中及以上教育水平、糖尿病病史、服用降糖及降压药物者比例高,体质量指数、三酰甘油、估计肾小球滤过率水平高(均P<0.05)。随访期间内发生总心脑血管事件291例,急性心肌梗死80例,心源性猝死8例,脑梗死172例,脑出血40例和心脑血管病因死亡58例。与饮酒量0g/d组和饮酒量>25g/d组相比,饮酒量≤25g/d组总心脑血管事件、急性心肌梗死、脑梗死和脑出血的发生率低,其中总心脑血管事件、急性心肌梗死和脑梗死发生率差异有统计学意义(均P<0.05)。多因素Cox比例风险回归模型结果显示,与饮酒量≤25g/d组相比,饮酒量0g/d组发生总心脑血管事件和脑梗死的RR分别为1.69(95%CI1.13～2.52,P<0.01)和1.71(95%CI1.02～2.86,P<0.05)。结论适量饮酒可以降低男性糖尿病人群总心脑血管事件和脑梗死的发生。
Objective To study the effect of different alcohol consumption on cardiovascular and cerebrovascular events in male patients with diabetes mellitus. Methods A prospective cohort study was conducted in 6041 male diabetic patients who participated in the Kailuan Group physical examination from July 2006 to July 2007 as observation cohorts and divided into groups according to different alcohol consumption (alcohol consumption 0g / d, alcohol consumption ≤25g / d group, alcohol consumption> 25g / d group). The cumulative incidence of cardiovascular events (acute myocardial infarction, sudden cardiac death, cerebral infarction, intracerebral hemorrhage, cardiovascular and cerebrovascular causes of death) in different alcohol consumption groups was calculated by the life table method. Log-Rank test was used to compare the different alcohol consumption groups Differences in the incidence of cardiovascular events. Multivariable Cox proportional hazards regression model was used to analyze the factors influencing cardiovascular and cerebrovascular events. Results With the increase of alcohol intake, the level of total cholesterol, low density lipoprotein cholesterol and total bilirubin increased, while the proportion of smokers increased (all P <0.01). Compared with the other two groups, the alcohol consumption was less than or equal to 25g / d The average age is small, the prevalence of hypertension is low, systolic blood pressure, diastolic blood pressure and high-density lipoprotein cholesterol are low. The education level of senior high school and above, the history of diabetes mellitus, the high proportion of people taking hypoglycemic drugs and antihypertensive drugs, body mass index, Acylglycerides, estimated glomerular filtration rate was high (both P <0.05). During the follow-up period, there were 291 cardiovascular and cerebrovascular events, 80 acute myocardial infarction, 8 sudden cardiac death, 172 cerebral infarction, 40 cerebral hemorrhage and 58 cardiovascular and cerebrovascular diseases. Compared with 0g / d alcohol consumption and alcohol consumption> 25g / d group, the incidence of total cardiovascular and cerebrovascular events, acute myocardial infarction, cerebral infarction and cerebral hemorrhage was less than 25g / d, and the total cardiovascular and cerebrovascular The incidence of events, acute myocardial infarction and cerebral infarction were significantly different (all P <0.05). The multivariate Cox proportional hazards regression model showed that RR of total cardiovascular events and cerebral infarction were 1.69 (95% CI, 1.25 to 2.52, P <0.01) and 1.71 (95% CI 1.02 ~ 2.86, P <0.05). Conclusion moderate drinking can reduce the incidence of total cardiovascular and cerebral infarction in male patients with diabetes mellitus.