中国全科医学2025，Vol.28Issue(31)：3924-3931,8.DOI:10.12114/j.issn.1007-9572.2025.0019
空腹血糖水平与全因死亡和特定原因死亡风险的前瞻性队列研究
Associations of Fasting Blood Glucose with All-cause Mortality and Specific-cause Mortality in a Prospective Cohort Study
摘要
Abstract
Background There are inconsistencies in the conclusions about the relationship between fasting blood glucose(FBG)and all-cause and specific-cause mortality among adults in previous studies,so it is necessary to be further explored.Objective To analyze the association between FBG level and the risk of all-cause mortality,cardiovascular disease mortality and cancer-related mortality in adults,providing dependable theoretical basis for the prevention and control of priority diseases.Methods This is a prospective cohort study,and the cohort was established in November 2010.A total of 9 280 residents aged 18 years or older who had lived at least 6 months per year in 12 counties(cities and districts)of Guizhou Province were selected for baseline survey.All participants in the baseline survey were followed up in 2020 and 2023,respectively.Participants were assigned into four groups based on their baseline FBG level:low fasting glucose(LFG),normal fasting glucose(NFG),impaired fasting glucose(IFG),diabetes(DM),the number of participants in each group is 437,6 210,2 035,427,respectively.COX proportional hazard models were used to estimate hazard ratio(HR)and corresponding 95%confidence interval(95%CI)for evaluating the association between FBG and risk of all-cause mortality,specific-cause mortality.Restricted cubic spline analysis was performed to analysis the dose-response relationship.Subgroup analysis was carried out with different characteristic including sex,age and BMI.Results A total of 9 109 subjects were included in this study,and 589 deaths occurred during a median follow-up period of 11.69 years.COX proportional hazard regression analysis showed that after adjusting for related confounding factors,the risk of all-cause mortality increased by 10%for every 1-unit increase in FBG(HR=1.10,95%CI=1.06-1.15),especially,comparing with NFG,with DM significant increased the risk of all-cause mortality(HR=1.59,95%CI=1.18-2.17)and cancer-related mortality(HR=2.16,95%CI=1.03-4.49),respectively.Restricted cubic spline analysis showed a linear dose-response relationship between FBG and the risk of all-cause mortality and cancer-related mortality.Subgroup analysis showed that the all-cause mortality was increasing in female(HR=2.01,95%CI=1.27-3.20),≥45 years old(HR=1.57,95%CI=1.13-2.16),BMI<24.0 kg/m2(HR=1.45,95%CI=1.11-2.43),BMI≥24.0 kg/m2(HR=1.67,95%CI=1.01-2.76)with DM,cancer-related mortality was increased only in female(HR=2.39,95%CI=1.11-5.14),≥45 years old(HR=6.62,95%CI=1.61-9.76),BMI<24.0 kg/m2(HR=2.69,95%CI=1.11-6.52)with DM.Conclusion FBG level was linearly positively correlated with mortality,DM increased the risk of all-cause mortality and cancer-related mortality,effective measures should be taken to control blood glucose at an ideal level.关键词
全因死亡/特定原因死亡/空腹血糖/前瞻性研究/队列研究Key words
All-cause mortality/Specific-cause mortality/Fasting blood glucose/Prospective study/Cohort study分类
医药卫生引用本文复制引用
张骥,周婕,李凌,吴延莉,吉维,刘涛..空腹血糖水平与全因死亡和特定原因死亡风险的前瞻性队列研究[J].中国全科医学,2025,28(31):3924-3931,8.基金项目
贵州省科技计划项目(黔科合支撑[2018]2819) （黔科合支撑[2018]2819）
贵州省卫生健康委省级重点建设学科项目 （）
