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空腹血糖升高与高血压对心脑血管疾病的关系及相互作用

[Relationship and interactions between elevated fasting glucose and hypertension for cardiocerebral vascular disease].

作者信息

Zhan Yi-qiang, Yu Jin-ming, Hu Da-yi, Mao Yong, Ding Rong-jing, Sun Yi-hong, Zhang Li-jun, Fu Yuan-yuan, Li She-chang, Zhang Fen

机构信息

School of Public Health, Fudan University, Shanghai, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2012 Jan;40(1):57-61.

Abstract

OBJECTIVE

To explore the relationship and interaction of elevated fasting glucose and hypertension on cardiocerebral vascular disease.

METHODS

10 054 males and females were recruited for our cross-sectional study during May 2007 to August 2007. Unconditional logistic regression was used to analysis the relationship between fasting glucose and hypertension on cardiocerebral vascular disease. A product of fasting glucose and hypertension was added to the logistic regression model to evaluate the multiplicative interaction and relative excess risk of interaction (RERI), attributable proportion (AP) of interaction and synergy index (S) was applied to evaluate the additive interaction of the two factors. Bootstrap was used to calculate 95% confidence intervals (CI) of RERI, AP and S.

RESULTS

After adjusting age, gender, smoking, drinking, body mass index (BMI) and region, the product of fasting glucose and hypertension was not statistically significant, which means there was no multiplicative interaction between the two. But the additive indexes RERI, AP and S with 95%CI of diabetes and hypertension were 0.64 (0.03, 1.25), 0.27 (0.01, 0.47) and 1.83 (1.02, 5.13) respectively, which means significant additive interaction was shown between the two on cardiovascular disease but not no stroke. And there were no additive interaction between impaired fasting glucose on cardiovascular disease or stroke.

CONCLUSIONS

Hypertension was independently related to cardiovascular disease and stroke in Beijing citizens, and diabetes were independently related to stroke. There was additive interaction between diabetes and hypertension on cardiovascular disease.

摘要

目的

探讨空腹血糖升高与高血压在心血管疾病中的关系及相互作用。

方法

2007年5月至2007年8月,招募了10054名男性和女性参与我们的横断面研究。采用无条件逻辑回归分析空腹血糖与高血压在心血管疾病中的关系。将空腹血糖与高血压的乘积纳入逻辑回归模型,以评估相乘交互作用,并应用交互作用的相对超额危险度(RERI)、归因比例(AP)和协同指数(S)来评估这两个因素的相加交互作用。采用Bootstrap法计算RERI、AP和S的95%置信区间(CI)。

结果

在调整年龄、性别、吸烟、饮酒、体重指数(BMI)和地区后,空腹血糖与高血压的乘积无统计学意义,这意味着两者之间不存在相乘交互作用。但糖尿病与高血压的相加指数RERI、AP和S及其95%CI分别为0.64(0.03,1.25)、0.27(0.01,0.47)和1.83(1.02,5.13),这意味着两者在心血管疾病上存在显著的相加交互作用,但在中风方面不存在。空腹血糖受损在心血管疾病或中风方面不存在相加交互作用。

结论

在北京居民中,高血压与心血管疾病及中风独立相关,糖尿病与中风独立相关。糖尿病与高血压在心血管疾病上存在相加交互作用。

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