Lou Yanmei, Zhang Yanyan, Zhao Ping, Qin Pei, Wang Changyi, Ma Jianping, Peng Xiaolin, Chen Hongen, Zhao Dan, Xu Shan, Wang Li, Zhang Ming, Hu Dongsheng, Hu Fulan
Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, People's Republic of China.
Department of Epidemiology and Health Statistics, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
Endocr Connect. 2022 Jan 20;11(1):e210464. doi: 10.1530/EC-21-0464.
We aimed to assess the association between fasting plasma glucose (FPG) change trajectory and incident hypertension among Chinese population. This cohort study included 11,791 adults aged 18-80 years without hypertension at first entry and who completed at least four follow-ups between 2009 and 2016. Logistic regression was used to estimate odds ratios (ORs) and 95% CIs for the association between FPG change trajectory and probability of hypertension. During a median follow-up of 5.10 years (total person-years 61,887.76), hypertension developed in 2177 participants. After adjusting for baseline potential confounders, the probability of hypertension increased with the increasing FPG change trajectory (adjusted OR (aOR) 1.22, 95% CI 1.07-1.40), bell-shape trajectory (aOR 1.15, 95% CI 1.02-1.30) and other-shape trajectory (aOR 1.13, 95% CI 1.02-1.25) which showed a higher variability of FPG compared to the decreasing group. In addition, the increasing FPG change trajectory was associated with a higher probability of hypertension compared with the decreasing group regardless of age and BMI but was only significant in males and in those with normal FPG at baseline. Our study indicates that the increasing FPG change trajectory determines the highest risk of hypertension, demonstrating the importance of maintaining low and stable levels of FPG, especially in males and in those with normal FPG.
我们旨在评估中国人群中空腹血糖(FPG)变化轨迹与高血压发病之间的关联。这项队列研究纳入了11791名年龄在18 - 80岁之间、首次入组时无高血压且在2009年至2016年期间至少完成了四次随访的成年人。采用逻辑回归来估计FPG变化轨迹与高血压发病概率之间关联的比值比(OR)和95%置信区间(CI)。在中位随访时间5.10年(总人年数61887.76)期间,2177名参与者患上了高血压。在对基线潜在混杂因素进行调整后,高血压的发病概率随着FPG变化轨迹的增加而升高(调整后的OR(aOR)为1.22,95%CI为1.07 - 1.40),呈钟形轨迹(aOR为1.15,95%CI为1.02 - 1.30)和其他形状轨迹(aOR为1.13,95%CI为1.02 - 1.25),与下降组相比,这些轨迹显示FPG的变异性更高。此外,无论年龄和体重指数如何,与下降组相比,FPG变化轨迹增加与高血压发病概率更高相关,但仅在男性和基线FPG正常者中具有统计学意义。我们的研究表明,FPG变化轨迹增加决定了高血压的最高风险,这表明维持FPG处于低水平且稳定的重要性,尤其是在男性和基线FPG正常者中。
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