Zhang Junwen, Zhu Jiaquan, Ding Shiao, Bao Chunrong, Jiang Zhaolei, Tang Zi-Hui, Mei Ju
Department of Cardiothoracic Surgery, Xin Hua Hospital Affiated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Cardiology. 2015;132(1):58-64. doi: 10.1159/000381013. Epub 2015 Jun 6.
The purpose of this study was to evaluate the associations of fasting plasma glucose (FPG) and hypertension (HTN) with cardiovascular autonomic neuropathy (CAN) and to estimate the extent to which the synergistic effects of FPG and HTN affect outcomes in a Chinese population.
We conducted a large-scale, population-based study to analyze the association and interaction of the two factors with CAN in a sample of 2,092 Chinese people. Univariate and multiple linear regression (MLR) analyses were employed to detect these relationships. Interaction on an additive scale can be calculated by using the relative excess risk due to interaction, the proportion attributable to interaction (AP), and the synergy index (S).
After adjusting for confounding factors, MLR showed that FPG and HTN were independently associated with CAN (p < 0.001 for both). A significant synergistic effect of FPG and HTN on CAN was detected (p = 0.046, RETI = 0.733, 95% CI 0.059-1.450; AP = 0.167, 95% CI -0.033 to 0.367; S = 1.275, 95% CI 0.140-2.410).
Our findings suggest that FPG and HTN are independently associated with CAN, and they offer evidence to support the hypothesis that FPG and HTN have synergistic effects that influence the progression of CAN.
本研究旨在评估空腹血糖（FPG）和高血压（HTN）与心血管自主神经病变（CAN）之间的关联，并估计FPG和HTN的协同作用对中国人群预后的影响程度。
我们进行了一项大规模的基于人群的研究，以分析2092名中国人样本中这两个因素与CAN的关联和相互作用。采用单因素和多元线性回归（MLR）分析来检测这些关系。可以通过使用交互作用引起的相对超额风险、交互作用归因比例（AP）和协同指数（S）来计算相加尺度上的交互作用。
在调整混杂因素后，MLR显示FPG和HTN均与CAN独立相关（两者p均<0.001）。检测到FPG和HTN对CAN有显著的协同作用（p = 0.046，RETI = 0.733，95%CI 0.059 - 1.450；AP = 0.167，95%CI -0.033至0.367；S = 1.275，95%CI 0.140 - 2.410）。
我们的研究结果表明，FPG和HTN均与CAN独立相关，并且为支持FPG和HTN具有协同作用影响CAN进展这一假说提供了证据。
