Diabetes Care：空腹血糖受损增加缺血性心脏病发病风险

空腹血糖受损（IFG）与心血管疾病（CVD）或者缺血性心脏病（IHD）发病风险的关系可因性别和种族而不同。为了评价韩国男性和女性人群中IFG与CVD或IHD发病风险的关系。来自韩国首尔峨山医疗中心的Sun Ha Jee教授及其团队进行了一项研究，该研究发现IFG与IHD及缺血性脑卒中的发病风险增加相关。该研究结果在线发表在2013年2月的《糖尿病治疗》（Diabetes Care）杂志上。
该研究中，共有来自韩国17个医疗中心的408,022位受试者参与了此项研究，受试者在各中心接受健康检查并随访了10年。与CVD或IHD事件相关的数据均从韩国健康保险数据库中获得。IFG被分为1级（空腹血糖100-109mg/dl）或2级（空腹血糖110-125mg/dl）。
该研究结果表明，糖尿病患者CVD的发病率（每100,000人年）为2,203。年龄校正后的CVD风险比（HRs）及其95%可信区间分别为：1级IFG患者为1.17（95% CI 1.13-1.20）；2级IFG患者为1.30（1.24-1.35）；糖尿病患者为1.81（1.75-1.86）。男性和女性发病风险的增加程度相近。无论是男性还是女性人群中的IFG和糖尿病患者，年龄校正后的IHD和缺血性脑卒中的发病风险均显著增加。在校正其它多种传统的心血管危险因素（高血压、血脂异常、吸烟、肥胖、CVD家族史）后，各类别人群中CVD的总体发病风险均有明显下降。然而，在2级IFG男性患者中IHD和缺血性脑卒中发病的HRs仍有显著增加，在女性患者中未显示出这一趋势。
该研究发现，在韩国男性人群中，2级IFG与IHD及缺血性脑卒中的发病风险增加相关，此相关性独立于其它传统的危险因素之外，但在女性人群中未发现此现象。

Impaired fasting glucose and risk of cardiovascular disease in Korean men and women: the Korean Heart Study.
OBJECTIVE
The relationship between impaired fasting glucose (IFG) and risk of cardiovascular disease (CVD) or ischemic heart disease (IHD) varies widely according to sex and ethnicity. We evaluated the relationship between IFG and CVD or IHD among Korean men and women.
RESEARCH DESIGN AND METHODS
A total of 408,022 individuals who underwent voluntary private health examinations in 17 centers in South Korea were followed for 10 years. Data regarding CVD or IHD events were obtained from the Korean National Health Insurance database. IFG was categorized as grade 1 (fasting glucose 100-109 mg/dL) or grade 2 (110-125 mg/dL).
RESULTS
Incidence rates of CVD (per 100,000 person-years) were 2,203 for diabetes. Age-adjusted hazard ratios (HRs) for CVD were 1.17 (95% CI 1.13-1.20) for grade 1 IFG, 1.30 (1.24-1.35) for grade 2 IFG, and 1.81 (1.75-1.86) for diabetes. The increased risk for women was similar to that of men. Age-adjusted HRs for IHD and ischemic stroke were also significantly increased for men and women with IFG and diabetes. After multivariate adjustment of conventional risk factors (hypertension, dyslipidemia, smoking, obesity, and family history of CVD), the overall risk of CVD was greatly attenuated in all categories. However, the HRs for IHD and ischemic stroke remained significantly increased in men for grade 2 IFG but not in women.
CONCLUSIONS
In Korea, grade 2 IFG is associated with increased risk of IHD and ischemic stroke, independent of other conventional risk factors, in men but not in women.