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肱踝脉搏波速度与2型糖尿病风险的关联:一项队列研究的结果

Association between brachial-ankle pulse wave velocity and risk of type 2 diabetes mellitus: results from a cohort study.

作者信息

Lou Yan-Mei, Liao Min-Qi, Wang Chang-Yi, Chen Hong-En, Peng Xiao-Lin, Zhao Dan, Gao Xu-Ping, Xu Shan, Wang Li, Ma Jian-Ping, Ping Zhao, Zeng Fang-Fang

机构信息

Department of Health Management, Beijing Xiao Tang Shan Hospital, Beijing, China.

Department of Epidemiology, Jinan University, Guangzhou, China.

出版信息

BMJ Open Diabetes Res Care. 2020 Jul;8(1). doi: 10.1136/bmjdrc-2020-001317.

Abstract

INTRODUCTION

Brachial-ankle pulse wave velocity (ba-PWV), as a simple and easily measured marker of arterial stiffness, has not been prospectively explored for its role in type 2 diabetes mellitus (T2DM) risk among the general population. This study aimed to explore the association between baseline ba-PWV value and new-onset T2DM among Chinese adults.

RESEARCH DESIGN AND METHODS

Using data from Xiaotangshan Hospital, we conducted a prospective cohort study among those who underwent annual or biennial health check-up examinations and who had their ba-PWV measured from 2009 to 2016. We explored the risk of new-onset T2DM across ba-PWV tertiles using Cox proportional-hazards regression analysis.

RESULTS

Of 6122 adults (68.9% male; mean age: 51.0 (SD 13.0) years) without T2DM and with ba-PWV measured at baseline, 599 participants developed T2DM during an average of 3.8 (SD 2.3) years of follow-up. After multivariable adjustment, ba-PWV was positively related to T2DM risk (p for trend=0.008). Compared with the lowest ba-PWV tertile, the HRs and their 95% CIs were 1.57 (1.18 to 2.10) for the second and 1.66 (1.24 to 2.22) for the third tertile. The risk across ba-PWV tertiles increased steadily from 1000 cm/s to 1400 cm/s and then reached a plateau. Subgroup analyses indicated a significantly higher risk among those aged <65 years and current smokers (p for interactions: <0.001 and 0.006).

CONCLUSIONS

Our findings suggest that ba-PWV might be a useful and independent predictor of new-onset T2DM with ba-PWV ranging between 1000 cm/s and 1400 cm/s, especially among younger individuals and current smokers.

摘要

引言

肱踝脉搏波速度(ba-PWV)作为一种简单且易于测量的动脉僵硬度指标,尚未在普通人群中对其在2型糖尿病(T2DM)风险中的作用进行前瞻性研究。本研究旨在探讨中国成年人基线ba-PWV值与新发T2DM之间的关联。

研究设计与方法

利用小汤山医院的数据,我们对2009年至2016年期间接受年度或两年一次健康检查且测量了ba-PWV的人群进行了一项前瞻性队列研究。我们使用Cox比例风险回归分析探讨了不同ba-PWV三分位数组中新发T2DM的风险。

结果

在6122名无T2DM且在基线时测量了ba-PWV的成年人中(男性占68.9%;平均年龄:51.0(标准差13.0)岁),599名参与者在平均3.8(标准差2.3)年的随访期间患上了T2DM。经过多变量调整后,ba-PWV与T2DM风险呈正相关(趋势p值 = 0.008)。与最低ba-PWV三分位数组相比,第二三分位数组的风险比(HR)及其95%置信区间(CI)为1.57(1.18至2.10),第三三分位数组为1.66(1.24至2.22)。ba-PWV三分位数组的风险从100厘米/秒稳步增加至140厘米/秒,然后达到平稳状态。亚组分析表明,年龄<65岁的人群和当前吸烟者的风险显著更高(交互作用p值:<0.001和0.006)。

结论

我们的研究结果表明,ba-PWV可能是新发T2DM的一个有用且独立的预测指标,ba-PWV范围在100厘米/秒至140厘米/秒之间,尤其是在较年轻个体和当前吸烟者中。

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