目的:中国糖尿病学会发布《中国糖尿病新诊断标准》(2020年版)。我们旨在研究新的糖尿病诊断标准对心血管疾病(CVD)的预测价值。
方法:纳入2011年和2018年中国健康与退休纵向研究共5884人。比较基线特征和结果数据。通过Kaplan-Meier曲线确定了根据两个标准诊断的糖尿病与未来CVD之间的关联。Cox回归分析,和接收器操作特性分析。Delong的测试是为了比较2020年版诊断的糖尿病和上一版本诊断的糖尿病对未来CVD的预测价值。
结果:经过多变量调整后,2020版诊断的糖尿病和上一版诊断的糖尿病均与CVD相关(分别为HR1.607,95%CI1.221-2.115,P<0.001;HR1.244,95%CI1.060-1.460,P=0.007).Kaplan-Meier分析显示糖尿病患者有更多的心血管风险(log-rankP<0.001)。此外,在2020年版中诊断出的糖尿病显示了0.673的曲线下面积(AUC)用于预测CVD,而上一版诊断为糖尿病的AUC为0.638(DeLong检验P<0.01)。
结论:我国糖尿病诊断标准(2020年版)在预测心血管疾病方面的表现优于上一版。
OBJECTIVE: Chinese diabetes society has published the new diagnostic criteria for diabetes in China (2020 edition). We aimed to investigate the predictive value of new diabetes-diagnosed criteria for cardiovascular diseases (CVD).
METHODS: A total of 5884 individuals from the China Health and Retirement Longitudinal Study in 2011 and 2018 were enrolled. Baseline characteristics and outcome data were compared. The association between diabetes diagnosed by two criteria and future CVD was identified by Kaplan-Meier curves, Cox regression analyses, and receiver-operating characteristic analyses. Delong\'s test was conducted to compare the predictive value for future CVD between diabetes diagnosed by the 2020 edition and diabetes diagnosed by the previous version.
RESULTS: After multivariate adjustment, both diabetes diagnosed by the 2020 edition and diabetes diagnosed by the previous edition is associated with CVD (HR 1.607, 95% CI 1.221-2.115, P < 0.001; HR 1.244, 95% CI 1.060-1.460, P = 0.007, respectively). The Kaplan-Meier analysis indicated that diabetes patients have more cardiovascular risk (log-rank P<0.001). Moreover, diabetes diagnosed in the 2020 edition illustrated an area under the curve (AUC) of 0.673 for predicting CVD, while diabetes diagnosed in the previous edition showed an AUC of 0.638 (DeLong\'s test P<0.01).
CONCLUSIONS: Diabetes diagnosis criteria (2020 edition) in China had better performance in predicting cardiovascular diseases than the previous edition.