老年原发性高血压患者2型糖尿病和血糖调节受损的风险：一项10年队列研究

[Risks of type 2 diabetes mellitus and impaired glucose regulation among elderly patients with essential hypertension: a 10-years cohort study].

作者信息

Li Yu-peng, Shao Ying-hong, Tian Hui, Fang Fu-sheng, Sun Ban-ruo, Xiao Jing, Pei Yu, Yan Shuang-tong, Han Xiao-fei, Li Chen-xi

机构信息

Department of Geriatric Endocrinology, PLA General Hospital, Beijing, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2012 Jan 10;92(2):102-5.

PMID:22490691

Abstract

OBJECTIVE

To explore the incidence of type 2 diabetes mellitus (T2DM) and impaired glucose regulation (IGR) among elderly patients with and without hypertension during a follow-up period of 10 years.

METHODS

The subjects were elderly patients (> 60 years old) undergoing annual health examinations at our hospital. And the previously diagnosed T2DM and IGR patients were excluded. And the incidence and risk factors were analyzed by Kaplan-Meier method and COX's proportional hazard.

RESULTS

Among a total of 1136 subjects, 582 were enrolled. They were divided into essential hypertension group (HT, n = 384) and non-essential hypertension group (NHT, n = 198) (including new-onset 67 subjects). During a 10-year follow-up, the incidence of new-onset diabetes was 27.6% in HT group and 18.7% in NHT group (HR = 1.48; 95%CI: (1.07 - 2.04), P < 0.05). And the incidence density of T2DM were 33.8‰ and 20.6‰ respectively in two groups. There was no difference in the prevalence of IGR among HT and NHT groups and no difference was found in the prevalence of T2DM or IGR among new-onset HT and NHT groups. The independent risk factors of T2DM was dyslipidemia (HR = 1.459; 95%CI: 1.027 - 2.072, P < 0.05) and hypertension (HR = 1.516; 95%CI: 1.039 - 2.212, P < 0.05) based upon the COX's proportional hazard analysis. Dyslipidemia (HR = 1.545; 95%CI: 1.087 - 2.195, P < 0.05) and hypertension (HR = 1.524; 95%CI: 1.044 - 2.224, P < 0.05) were also independent risk factors of abnormal glycometabolism (T2DM and IGR). Kaplan-Meier analysis indicated that the accumulative incidence of DM and abnormal glycometabolism was different between the HT and NHT groups.

CONCLUSION

The DM risk is 1.516 folds higher in elderly patients with HT than in those without. According to multivariate analysis, hypertension and dyslipidemia are independent risk factors of T2DM and abnormal glycometabolism (T2DM and IGR).

摘要

目的

探讨10年随访期间老年高血压患者和非高血压患者2型糖尿病（T2DM）及糖调节受损（IGR）的发生率。

方法

研究对象为我院接受年度健康体检的老年患者（年龄>60岁），排除既往诊断为T2DM和IGR的患者。采用Kaplan-Meier法和COX比例风险模型分析发生率及危险因素。

结果

1136名受试者中，582名被纳入研究。分为原发性高血压组（HT组，n = 384）和非原发性高血压组（NHT组，n = 198）（包括67名新发病例）。10年随访期间，HT组新发糖尿病发生率为27.6%，NHT组为18.7%（HR = 1.48；95%CI：(1.07 - 2.04)，P < 0.05）。两组T2DM的发病密度分别为33.8‰和20.6‰。HT组和NHT组IGR患病率无差异，新发病的HT组和NHT组T2DM或IGR患病率也无差异。根据COX比例风险分析，T2DM的独立危险因素为血脂异常（HR = 1.459；95%CI：1.027 - 2.072，P < 0.05）和高血压（HR = 1.516；95%CI：1.039 - 2.212，P < 0.05）。血脂异常（HR = 1.545；95%CI：1.087 - 2.195，P < 0.05）和高血压（HR = 1.524；95%CI：1.044 - 2.224，P < 0.05）也是糖代谢异常（T2DM和IGR）的独立危险因素。Kaplan-Meier分析表明，HT组和NHT组糖尿病和糖代谢异常的累积发生率不同。