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社区高血压患者中非糖尿病性糖代谢状态与主动脉僵硬度的关联

Association of Nondiabetic Glucometabolic Status and Aortic Stiffness in Community Hypertension Patients.

作者信息

Zhou Dan, Yan Mengqi, Tang Songtao, Feng Yingqing

机构信息

Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China.

Department of Internal Medicine, Community Health Center of Liaobu Community, Dongguan, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2022 Feb 25;15:591-600. doi: 10.2147/DMSO.S356488. eCollection 2022.

Abstract

BACKGROUND

Diabetes is most commonly associated with aortic stiffness, but the importance of nondiabetic glucometabolic status for aortic stiffness (AS) in hypertension patients is unclear.

METHODS

We included 1065 hypertension patients without diabetes in a cohort study. Carotid-femoral pulse wave velocity (cfPWV) >10 m/s can broadly be defined as AS. Pearson correlation analysis and multiple regression analysis are used to reveal the relationship between elevated fasting blood glucose (FBG) and AS.

RESULTS

The 1065 hypertension patients (mean age 60 years) included 48% male, 22% smokers, 94.3% with anti-hypertensive drugs, 17.9% with AS, 80% with abdominal obesity, 42% with elevated triglycerides (TG), and 27% with elevated FBG. The mean values for office systolic blood pressure (SBP)/diastolic blood pressure (DBP) and central SBP/DBP were 130/85mmHg and 132/86mmHg. Mean cfPWV was 8.7m/s. Multiple regression analysis revealed that age, office SBP, and elevated FBG were independently related to AS in the whole hypertension. Elevated FBG had 1.6-fold risk of AS in hypertension patients compared with below the cutoff. In subgroup analysis, elevated FBG increased 2.68-fold risk for AS in those without metabolic syndrome (MS), not in MS. The area under curve (AUC) of office SBP was higher than central SBP for AS in receiver operating characteristic (ROC) analysis.

CONCLUSION

We found that elevated FBG was an independent risk factor for AS in hypertension patients without MS, although there was a high proportion of abdominal obesity. Office SBP was better than central SBP to assess AS in community hypertension.

摘要

背景

糖尿病最常与主动脉僵硬度相关,但非糖尿病糖代谢状态对高血压患者主动脉僵硬度(AS)的重要性尚不清楚。

方法

我们纳入了1065例无糖尿病的高血压患者进行队列研究。颈股脉搏波速度(cfPWV)>10 m/s可大致定义为AS。采用Pearson相关分析和多元回归分析来揭示空腹血糖(FBG)升高与AS之间的关系。

结果

1065例高血压患者(平均年龄60岁)中,男性占48%,吸烟者占22%,服用抗高血压药物者占94.3%,AS患者占17.9%,腹型肥胖者占80%,甘油三酯(TG)升高者占42%,FBG升高者占27%。诊室收缩压(SBP)/舒张压(DBP)和中心SBP/DBP的平均值分别为130/85mmHg和132/86mmHg。平均cfPWV为8.7m/s。多元回归分析显示,年龄、诊室SBP和FBG升高在整个高血压患者中与AS独立相关。与低于临界值相比,高血压患者中FBG升高患AS的风险增加1.6倍。在亚组分析中,FBG升高使无代谢综合征(MS)者患AS的风险增加2.68倍,而MS患者则无此情况。在接受者操作特征(ROC)分析中,诊室SBP评估AS的曲线下面积(AUC)高于中心SBP。

结论

我们发现,在无MS的高血压患者中,尽管腹型肥胖比例较高,但FBG升高是AS的独立危险因素。在社区高血压患者中,诊室SBP比中心SBP更适合评估AS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b28e/8887139/eb5cf32a8136/DMSO-15-591-g0001.jpg

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