Categories: 健康

Survival Benefit from Overweight in Patients with Type 2 Diabetes? 2型糖尿病患者超重益于生存?

A prospective cohort study in England found that overweight patients with type 2 diabetes were associated with a lower mortality risk, but not obese patients. However, both overweight and obese patients were more likely to be hospitalized for cardiovascular reasons. The study included 10 568 patients with the median age of 63 years and a median follow up of 10.6 years, and 54% of patients were men. Information on all-cause mortality and cardiovascular morbidity was collected. Cox regression survival analysis was done and adjusted for cardiovascular risk factors and comorbid conditions (such as cancer, chronic kidney disease, and lung disease). Overweight or obese patients (BMI >25 kg/m2) had a higher rate of cardiac events (such as the acute coronary syndrome and heart failure) than those of normal weight (BMI, 18.5 to 24.9 kg/m2). Overall mortality during follow-up was 35%. However, being overweight (BMI, 25 to 29.9 kg/m2) was associated with a lower mortality risk, whereas obese patients (BMI >30 kg/m2) had a mortality risk similar to that of normal-weight patients. Underweight patients had the worst prognosis. There was no information on medications and causes of death. It is controversial for the survival benefits from overweight that if there is a paradox, a reverse causation or other cause such as medications. Source: http://annals.org/英国一项前瞻性群组研究发现,超重的2型糖尿病患者死亡风险较低,而非肥胖患者。然而,无论是超重和肥胖的患者因心血管病住院的可能性更大。该研究共纳入10 568例2型糖尿病患者,平均年龄63岁,平均随访10.6岁,其中54%的患者为男性。收集了全因死亡率和心血管病发病率。 实施了Cox回归生存分析,并校正心血管危险因素和合并症(如癌症,慢性肾脏疾病,和肺疾病)。超重或肥胖患者(BMI> 25公斤/平米)比正常体重(BMI,18.5至24.9公斤/平米)患者有较高的心脏事件(如急性冠状动脉综合征和心衰)。在随访期间总死亡率为35%。然而,超重患者(BMI,25至29.9公斤/平米)死亡的风险较低,而肥胖患者(体重指数> 30公斤/平米)的死亡风险类似于正常体重的患者。低体重患者预后最差。无用药和死亡原因的信息。至于上述超重有益于生存到底是一个悖论,是反向因果关系或有其它原因,如药物等是有争议的。来源:http://annals.org/

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