Sun Ke-xin, Liu Zhi-ke, Cao Ya-ying, Juan Juan, Xiang Xiao, Yang Cheng, Huang Shao-ping, Liu Xiao-fen, Li Na, Tang Xun, Li Jin, Wu Tao, Chen Da-fang, Hu Yong-hua
Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.
Fangshan District Center for Disease Control and Prevention, Beijing 102401, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2015 Jun 18;47(3):431-6.
To explore the correlation between glycemic control of type 2 diabetes mellitus (T2DM) patients and brachial-ankle pulse velocity (baPWV).
A community-based cross-sectional study was conducted in Beijing, China. Every subject underwent physical examinations, glycated hemoglobin (HbA1c), blood lipid and baPWV measurements and completed a standardized questionnaire. T2DM patients were divided into well controlled and poorly controlled groups according to HbA1c levels. The correlation between glycemic control of T2DM patients and baPWV was analyzed.
In this study, 1 341 subjects were recruited, including 733 T2DM patients and 608 non-diabetes subjects. Compared with non-diabetes subjects, abnormal baPWV (baPWV≥1 700 cm/s) rate for T2DM patients was higher (40.8% vs. 26.8%, P<0.001). With HbA1c<6.5% or <7.0% as the aim of glycemic control in T2DM patients, the abnormal baPWV rates for non-diabetes subjects, well controlled and poorly controlled T2DM patients were significantly different (non-diabetes vs. HbA1c<6.5% T2DM vs. HbA1c≥6.5% T2DM: 26.8% vs. 32.8% vs. 42.6%, P<0.001; non-diabetes vs. HbA1c<7.0% T2DM vs. HbA1c≥7.0% T2DM: 26.8% vs. 36.1% vs. 43.4%, P<0.001). After being adjusted for gender, age, smoking status, diabetes mellitus family history, T2DM duration, cardiovascular diseases (CVD), waist hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), total triglycerides (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C), the Logistic regression models suggested that glycemic control status of T2DM patients was associated with abnormal baPWV. Compared with non-diabetes subjects, the ORs for abnormal baPWV in HbA1c<6.5% T2DM patients and HbA1c≥6.5% T2DM patients were 0.927(95%CI 0.560-1.537) and 1.826 (95%CI 1.287-2.591). Compared with non-diabetes subjects, the ORs for abnormal baPWV in HbA1c<7.0% T2DM patients and HbA1c≥7.0% T2DM patients were 1.210 (95%CI 0.808-1.811) and 1.898 (95%CI 1.313-2.745).
The glycemic control status of T2DM patients from communities is significantly associated with baPWV. Poor glycemic control is a risk factor for abnormal baPWV. Keeping HbA1c under control might lower the risk of cardiovascular diseases in T2DM patients.
探讨2型糖尿病(T2DM)患者血糖控制与臂踝脉搏波速度(baPWV)之间的相关性。
在中国北京进行了一项基于社区的横断面研究。每位受试者均接受了体格检查、糖化血红蛋白(HbA1c)、血脂和baPWV测量,并完成了一份标准化问卷。根据HbA1c水平将T2DM患者分为血糖控制良好组和控制不佳组。分析了T2DM患者血糖控制与baPWV之间的相关性。
本研究共招募了1341名受试者,其中包括733名T2DM患者和608名非糖尿病受试者。与非糖尿病受试者相比,T2DM患者baPWV异常(baPWV≥1700 cm/s)率更高(40.8% 对26.8%,P<0.001)。以HbA1c<6.5%或<7.0%作为T2DM患者血糖控制目标,非糖尿病受试者、血糖控制良好和控制不佳的T2DM患者的baPWV异常率有显著差异(非糖尿病对HbA1c<6.5%的T2DM对HbA1c≥6.5%的T2DM:26.8%对32.8%对42.6%,P<0.001;非糖尿病对HbA1c<7.0%的T2DM对HbA1c≥7.0%的T2DM:26.8%对36.1%对43.4%,P<0.001)。在对性别、年龄、吸烟状况、糖尿病家族史、T2DM病程、心血管疾病(CVD)、腰臀比(WHR)、收缩压(SBP)、舒张压(DBP)、总甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)进行校正后,Logistic回归模型表明T2DM患者的血糖控制状况与baPWV异常有关。与非糖尿病受试者相比,HbA1c<6.5%的T2DM患者和HbA1c≥6.5%的T2DM患者baPWV异常的比值比(OR)分别为0.927(95%可信区间0.560-1.537)和1.826(95%可信区间1.287-2.591)。与非糖尿病受试者相比,HbA1c<7.0%的T2DM患者和HbA1c≥7.0%的T2DM患者baPWV异常的OR分别为1.210(95%可信区间0.808-1.811)和1.898(95%可信区间1.313-2.745)。
社区T2DM患者的血糖控制状况与baPWV显著相关。血糖控制不佳是baPWV异常的危险因素。控制HbA1c水平可能降低T2DM患者心血管疾病的风险。