Shen M Y, Zhang L, Zhu S Z, Pan J J, Tang Y M, Li Q, Zhou M G, He T J
Department of Disease Surveillance, Institute of Chronic Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Dec 10;43(12):1939-1944. doi: 10.3760/cma.j.cn112338-20220505-00379.
To explore sex and rural-urban differences in the associations of different blood pressure levels with the risk of prediabetes. We used a multi-stage stratified cluster random sampling method to investigate 21 637 residents aged ≥18 years from 10 survey areas in Hubei province in 2020. The data on questionnaire, physical measurements, and laboratory indicators of the participants were collected. The associations of different blood pressure levels with risk of prediabetes by sex and regions were analyzed using multivariate logistic regressions after complex weighting. A total of 16 111 subjects were included. The prevalence (95%) of prediabetes, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and IFG complicated with IGT were 25.1% (14.4%-35.9%), 12.7% (3.2%-22.1%), 8.1% (6.3%-9.8%), and 4.4% (2.3%-6.5%), respectively. After multivariate adjustment, the risk of prediabetes, IFG, IGT, and IFG complicated with IGT increased with the increment of blood pressure (both for trend <0.05). The positive dose-response relationships between blood pressure levels and risk of prediabetes were also significant among male, urban, and rural residents (both for trend <0.05), and the interactions between sex and blood pressure showed significant associations for risk of prediabetes and IGT (both for interaction <0.05). Higher blood pressure levels were associated with an increased risk of prediabetes. The association with prediabetes was stronger in males, but no significant difference was found between urban and rural residents. More distinctive and effective prevention and control strategies should be developed for different populations.
探讨不同血压水平与糖尿病前期风险之间关联的性别和城乡差异。我们采用多阶段分层整群随机抽样方法，于2020年对湖北省10个调查地区的21637名18岁及以上居民进行了调查。收集了参与者的问卷、体格测量和实验室指标数据。在进行复杂加权后，使用多变量逻辑回归分析了不同血压水平与按性别和地区划分的糖尿病前期风险之间的关联。共纳入16111名受试者。糖尿病前期、空腹血糖受损（IFG）、糖耐量受损（IGT）以及IFG合并IGT的患病率（95%）分别为25.1%（14.4%-35.9%）、12.7%（3.2%-22.1%）、8.1%（6.3%-9.8%）和4.4%（2.3%-6.5%）。多变量调整后，糖尿病前期、IFG、IGT以及IFG合并IGT的风险均随血压升高而增加（趋势检验均P<0.05）。血压水平与糖尿病前期风险之间的正剂量反应关系在男性、城市居民和农村居民中也均显著（趋势检验均P<0.05），并且性别与血压之间的交互作用在糖尿病前期和IGT风险方面显示出显著关联（交互作用检验均P<0.05）。较高的血压水平与糖尿病前期风险增加相关。这种关联在男性中更强，但城乡居民之间未发现显著差异。应针对不同人群制定更具针对性和有效的防控策略。
