Gao Liu, Bai Lingling, Shi Min, Ni Jingxian, Lu Hongyan, Wu Yanan, Tu Jun, Ning Xianjia, Wang Jinghua, Li Yukun
Department of Endocrinology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Department of Neurology, Tianjin Medical University General Hospital, Heping District, Tianjin, China.
J Diabetes Investig. 2017 Nov;8(6):788-797. doi: 10.1111/jdi.12639. Epub 2017 Mar 22.
AIMS/INTRODUCTION: Carotid intima-media thickness (CIMT) is an established predictor of cardiovascular disease and stroke. We aimed to identify the association between CIMT and blood glucose, as well as the risk factors associated with increased CIMT in a low-income Chinese population.
Stroke-free and cardiovascular disease-free residents aged ≥45 years were recruited. B-mode ultrasonography was carried out to measure CIMT.
There were 2,643 participants (71.0%) in the normal group, 549 (14.7%) in the impaired fasting glucose group and 533 (14.3%) in the diabetes mellitus group. The determinants of increased CIMT were older age; male sex; low education; hypertension; smoking; high levels of systolic blood pressure, fasting blood glucose and low-density lipoprotein cholesterol; and low levels of diastolic blood pressure, triglycerides and high-density lipoprotein cholesterol, after adjusting for covariates. Age and hypertension were the common risk factors for increased CIMT in all three groups. Furthermore, male sex, smoking and high low-density lipoprotein cholesterol level were positively associated with the mean CIMT in the normal group; high triglycerides levels were negatively associated with the mean CIMT in the impaired fasting glucose group; and alcohol consumption was an independent risk factor for mean CIMT in the diabetes mellitus group. Hypertension was the greatest risk factor for increased CIMT.
These findings suggest that it is crucial to manage and control traditional risk factors in low-income populations in China in order to decelerate the recent dramatic increase in stroke incidence, and to reduce the burden of stroke.
目的/引言:颈动脉内膜中层厚度(CIMT)是心血管疾病和中风的既定预测指标。我们旨在确定中国低收入人群中CIMT与血糖之间的关联,以及与CIMT增加相关的危险因素。
招募年龄≥45岁且无中风和心血管疾病的居民。采用B型超声测量CIMT。
正常组有2643名参与者(71.0%),空腹血糖受损组有549名(14.7%),糖尿病组有533名(14.3%)。在调整协变量后,CIMT增加的决定因素包括年龄较大、男性、低教育程度、高血压、吸烟、收缩压、空腹血糖和低密度脂蛋白胆固醇水平较高,以及舒张压、甘油三酯和高密度脂蛋白胆固醇水平较低。年龄和高血压是所有三组中CIMT增加的常见危险因素。此外,男性、吸烟和低密度脂蛋白胆固醇水平高与正常组的平均CIMT呈正相关;甘油三酯水平高与空腹血糖受损组的平均CIMT呈负相关;饮酒是糖尿病组平均CIMT的独立危险因素。高血压是CIMT增加的最大危险因素。
这些发现表明,在中国低收入人群中管理和控制传统危险因素对于减缓近期中风发病率的急剧上升以及减轻中风负担至关重要。