Sun Jia-Yi, Wang Wei, Liu Jing, Wang Miao, Liu Jun, Qi Yue, Qin Lan-Ping, Zhao Dong
Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Institute of Beijing Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2012 Jul;33(7):649-53.
To investigate the association between fasting blood glucose levels and the prevalence of carotid plaque in a community-based population of Beijing and to further explore the association between fasting glucose levels concomitant wand other cardiovascular risk factors as well as the prevalence of carotid plaque.
This study was a part of the Chinese Multi-provincial Cohort Study conducted in the communities of Beijing University in 2007. All the members aged 50 - 79 years from the community were recruited, with 1046 of them qualified as without missing data. Case of diabetes was defined if the fasting glucose level was greater than 7.0 mmol/L or on anti-diabetic drugs.
The mean level of fasting glucose was 5.89 mmol/L, and the prevalence of carotid plaque was 56.3%. For the reference on normal levels of fasting glucose, the risk on carotid plaque had an increase along with the increase of fasting glucose levels only under the univariate and multivariate analyses, after adjusting for age. However, the risk on carotid plaque in women was increased when there was an increase on the levels of fasting glucose. Specifically, for the reference on normal levels of fasting glucose, after adjusting for other cardiovascular risk factors, the odds of developing a carotid plaque was more than two folds in diabetic women. When combining the groups of risk factors (normal and abnormal) among the three groups of fasting glucose and assigning the normal level of risk factors concomitant with normal fasting glucose as a reference for both genders, the risk of developing a carotid plaque in diabetic women with abnormal level of risk factors ranked the highest, with statistical significance. When the diabetic patients combined with a decreased levels of HDL but increased levels of LDL, blood pressure, waist circumference, there appeared 2.8-(P = 0.014), 2.7-(P = 0.010), 2.4-(P = 0.013) and 2.1-times (P = 0.031) higher risks of developing carotid plaque than those in the reference group, respectively.
In this study, the prevalence of carotid plaque driven by increased fasting glucose was different on gender but the difference was only statistically significant in women. There also appeared a joint association of fasting glucose combined with other cardiovascular risk factors on the risk of developing a carotid plaque.
探讨北京市社区人群空腹血糖水平与颈动脉斑块患病率之间的关联，并进一步探索空腹血糖水平与其他心血管危险因素及颈动脉斑块患病率之间的关联。
本研究是2007年在北京大学社区进行的中国多省队列研究的一部分。招募了该社区所有年龄在50 - 79岁的成员，其中1046人数据无缺失且符合条件。空腹血糖水平大于7.0 mmol/L或正在接受抗糖尿病药物治疗的病例被定义为糖尿病患者。
空腹血糖平均水平为5.89 mmol/L，颈动脉斑块患病率为56.3%。以空腹血糖正常水平为参照，仅在单因素和多因素分析中，调整年龄后，颈动脉斑块风险随空腹血糖水平升高而增加。然而，女性空腹血糖水平升高时，颈动脉斑块风险增加。具体而言，以空腹血糖正常水平为参照，调整其他心血管危险因素后，糖尿病女性发生颈动脉斑块的几率是正常女性的两倍多。当将空腹血糖三组中的危险因素（正常和异常）组合，并将空腹血糖正常时危险因素正常水平作为男女双方的参照时，危险因素异常的糖尿病女性发生颈动脉斑块的风险最高，具有统计学意义。当糖尿病患者合并高密度脂蛋白水平降低但低密度脂蛋白、血压、腰围水平升高时，发生颈动脉斑块的风险分别比参照组高2.8倍（P = 0.014）、2.7倍（P = 0.010）、2.4倍（P = 0.013）和2.1倍（P = 0.031）。
在本研究中，空腹血糖升高导致的颈动脉斑块患病率在性别上存在差异，但仅在女性中差异具有统计学意义。空腹血糖与其他心血管危险因素在发生颈动脉斑块风险上也存在联合关联。
