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糖尿病患者每天运动1小时死亡风险减半  

2013-03-02 01:34:39|  分类: 医学进展新干线 |  标签: |举报 |字号 订阅

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日本厚生劳动省的研究小组在25日的欧洲糖尿病学会会刊《糖尿病学》(Diabetes)上报告说,大规模流行病学调查发现,糖尿病患者每天运动1小时左右,可使死亡风险和脑卒中发病风险降低约一半。

研究人员跟踪调查这些患者长达8年,根据运动量将患者分为几组,并把他们的运动量与脑卒中、心肌梗塞等合并症的发生率和死亡率进行比较。其中,运动量最多的一组相当于每天以时速6公里的较快速度步行约70分钟,或相当于游泳30至40分钟,而最少的一组,除了工作和日常生活的活动外,几乎不运动。

结果发现,运动量最多的一组患者因心肌梗塞等合并症而死亡的风险是运动量最少一组的约47%,患脑卒中的风险只有后者的约57%。

《糖尿病护理》发表论文摘要(英文)

Predicting Macro- and Microvascular Complications in Type 2 Diabetes The Japan Diabetes Complications Study/the Japanese Elderly Diabetes Intervention Trial risk engine

OBJECTIVE To develop and validate a risk engine that calculates the risks of macro- and microvascular complications in type 2 diabetes. RESEARCH DESIGN AND METHODS We analyzed pooled data from two clinical trials on 1,748 Japanese type 2 diabetic patients without diabetes complications other than mild diabetic retinopathy with a median follow-up of 7.2 years. End points were coronary heart disease (CHD), stroke, noncardiovascular mortality, overt nephropathy defined by persistent proteinuria, and progression of retinopathy. We fit a multistate Cox regression model to derive an algorithm for prediction. The predictive accuracy of the calculated 5-year risks was cross-validated. RESULTS Sex, age, HbA1c, years after diagnosis, BMI, systolic blood pressure, non-HDL cholesterol, albumin-to-creatinine ratio, atrial fibrillation, current smoker, and leisure-time physical activity were risk factors for macro- and microvascular complications and were incorporated into the risk engine. The observed-to-predicted (O/P) ratios for each event were between 0.93 and 1.08, and Hosmer-Lemeshow tests showed no significant deviations between observed and predicted events. In contrast, the UK Prospective Diabetes Study (UKPDS) risk engine overestimated CHD risk (O/P ratios: 0.30 for CHD and 0.72 for stroke). C statistics in our Japanese patients were high for CHD, noncardiovascular mortality, and overt nephropathy (0.725, 0.696, and 0.767) but moderate for stroke and progression of retinopathy (0.636 and 0.614). By combining macro- and microvascular risks, the classification of low- and high-risk patients was improved by a net reclassification improvement of 5.7% (P = 0.02). CONCLUSIONS The risk engine accurately predicts macro- and microvascular complications and would provide helpful information in risk classification and health economic simulations.

作 者:Shiro Tanaka, Sachiko Tanaka, Satoshi Iimuro, Hidetoshi Yama****a, Shigehiro Katayama
期刊名称: Diabetes Care 
期卷页:February 12, 2013
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