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空腹血糖和餐后2小时血糖预测高血压:REACTION研究报告

Fasting Blood Glucose and 2-h Postprandial Blood Glucose Predict Hypertension: A Report from the REACTION Study.

作者信息

Si Yingkui, Wang Anping, Yang Yunshuang, Liu Hongzhou, Gu Shi, Mu Yiming, Lyu Zhaohui

机构信息

Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.

Department of Endocrinology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China.

出版信息

Diabetes Ther. 2021 Apr;12(4):1117-1128. doi: 10.1007/s13300-021-01019-9. Epub 2021 Mar 4.

Abstract

INTRODUCTION

Although diabetes is associated with hypertension, whether high blood glucose levels promote hypertension remains controversial. In this study we compared the predictive power of fasting plasma glucose (FPG), 2-h postprandial blood glucose (2hPG), and glycated hemoglobin (HbA1c) for the development of hypertension.

METHODS

This study was a substudy of the REACTION study, an ongoing longitudinal cohort study investigating the relationship of prediabetes and type 2 diabetes with the risk of cancer in an urban Northern Chinese population in Beijing. Logistic regression analysis was used to calculate odds ratios (ORs) after adjustment for risk factors for hypertension, including age, sex, body mass index, and triglycerides.

RESULTS

Among the 3437 participants, 497 developed hypertension during the 4-year follow-up. The logistic regression analysis showed that elevated FPG and 2hPG levels (FPG: OR 1.529; 95% confidence interval [CI] 1.348-1.735; 2hPG: OR 1.144; 95% CI 1.100-1.191), but not HbA1c, were independent risk factors for the development of hypertension. In the highest quartile of FPG and 2hPG levels, the multivariable-corrected ORs were 2.115 (95% CI 1.612-2.777) and 2.346 (95% CI 1.787-3.080), respectively, compared with the lowest quartile. The adjusted models showed no significant correlations between quartile HbA1c levels and the development of hypertension.

CONCLUSION

Higher FPG and 2hPG levels, but not HbA1c levels, are independent risk factors for developing hypertension in an urban Northern Chinese population.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01206869.

摘要

引言

尽管糖尿病与高血压相关,但高血糖水平是否会引发高血压仍存在争议。在本研究中,我们比较了空腹血糖(FPG)、餐后2小时血糖(2hPG)和糖化血红蛋白(HbA1c)对高血压发病的预测能力。

方法

本研究是REACTION研究的一个子研究,REACTION研究是一项正在进行的纵向队列研究,旨在调查中国北方城市人群中糖尿病前期和2型糖尿病与癌症风险之间的关系。采用逻辑回归分析计算调整高血压危险因素(包括年龄、性别、体重指数和甘油三酯)后的比值比(OR)。

结果

在3437名参与者中,497人在4年随访期间患高血压。逻辑回归分析显示,FPG和2hPG水平升高(FPG:OR 1.529;95%置信区间[CI] 1.348 - 1.735;2hPG:OR 1.144;95% CI 1.100 - 1.191)是高血压发病的独立危险因素,而HbA1c不是。在FPG和2hPG水平的最高四分位数中,与最低四分位数相比,多变量校正后的OR分别为2.115(95% CI 1.612 - 2.777)和2.346(95% CI 1.787 - 3.080)。调整后的模型显示四分位数HbA1c水平与高血压发病之间无显著相关性。

结论

在中国北方城市人群中,较高的FPG和2hPG水平是患高血压的独立危险因素,而HbA1c水平不是。

试验注册

ClinicalTrials.gov NCT01206869。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02e1/7994488/4cdc55fd0cac/13300_2021_1019_Fig1_HTML.jpg

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