高脉压与中国中年女性患2型糖尿病的风险相关。

High pulse pressure is related to risk of type 2 diabetes mellitus in Chinese middle-aged females.

作者信息

Zhang Lu, Wang Bingyuan, Wang Chongjian, Li Linlin, Ren Yongcheng, Zhang Hongyan, Yang Xiangyu, Zhao Yang, Han Chengyi, Zhou Junmei, Luo Xinping, Hu Dongsheng

机构信息

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China; The affiliated Luohu Hospital of Shenzhen University Health Sciences Center, China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, China.

出版信息

Int J Cardiol. 2016 Oct 1;220:467-71. doi: 10.1016/j.ijcard.2016.06.233. Epub 2016 Jun 27.

DOI:10.1016/j.ijcard.2016.06.233

PMID:27390971

Abstract

BACKGROUND

To examine the association of risk of incident type 2 diabetes mellitus (T2DM) with high pulse pressure (PP) by sex.

METHODS

We performed a prospective cohort study of 12,272 eligible participants (4664 males and 7608 females) without diabetes at baseline. Participants were classified as having normal PP (20-60mmHg) and high PP (>60mmHg) at baseline. The analysis was further stratified by sex, quartiles of age and high PP categories.

RESULTS

During 6years of follow-up, T2DM developed in 775 participants and the incidence was 10.57/1000person-years. With PP 70 to 76mmHg, the multivariable adjusted hazard ratio (HR) (95% confidence interval) for incident T2DM in females was 1.722 (1.093-2.714) after adjustment for baseline age, smoking, alcohol intake, physical activity level and family history of T2DM, and 1.634 (1.037-2.575) after adjustment for the above factors and body mass index, waist circumference, blood lipid levels and fasting plasma glucose (FPG) category. After stratification by quartiles of age, for females aged 52 to 59, the multivariable adjusted HRs (95% CI) for high PP as compared to normal PP were 2.263 (1.517-3.377) and 2.140 (1.426-3.210) in different models. During follow-up, levels of FPG, fasting plasma insulin and homeostatic model assessment of insulin resistance index (HOMA-IR) were higher in females with higher than normal PP group, but β-cell function was impaired in the high PP group (P<0.05).

CONCLUSION

High PP may be related to incident T2DM among female in China, especially women 52 to 59years old.

摘要

背景

按性别研究高脉压（PP）与2型糖尿病（T2DM）发病风险的关联。

方法

我们对12272名基线时无糖尿病的符合条件参与者（4664名男性和7608名女性）进行了一项前瞻性队列研究。参与者在基线时被分类为具有正常PP（20 - 60mmHg）和高PP（>60mmHg）。分析进一步按性别、年龄四分位数和高PP类别进行分层。

结果

在6年的随访期间，775名参与者发生了T2DM，发病率为10.57/1000人年。对于PP为70至76mmHg，在调整了基线年龄、吸烟、饮酒、身体活动水平和T2DM家族史后，女性发生T2DM的多变量调整风险比（HR）（95%置信区间）为1.722（1.093 - 2.714），在调整了上述因素以及体重指数、腰围、血脂水平和空腹血糖（FPG）类别后为1.634（1.037 - 2.575）。按年龄四分位数分层后，对于年龄在52至59岁的女性，在不同模型中，与正常PP相比，高PP的多变量调整HR（95%CI）分别为2.263（1.517 - 3.377）和2.140（1.426 - 3.210）。在随访期间，PP高于正常组的女性的FPG、空腹血浆胰岛素和胰岛素抵抗指数稳态模型评估（HOMA - IR）水平较高，但高PP组的β细胞功能受损（P<0.05）。