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脉压与糖尿病前期风险的非线性关系:一项中国二次回顾性队列研究。

Non-linear relationship between pulse pressure and the risk of pre-diabetes: a secondary retrospective Chinese cohort study.

机构信息

Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, Guangdong, China.

Department of Emergency, Shenzhen Second People's Hospital, Shenzhen, Guangdong Province, China.

出版信息

BMJ Open. 2024 Mar 23;14(3):e080018. doi: 10.1136/bmjopen-2023-080018.

Abstract

OBJECTIVE

Previous research has shown that pulse pressure (PP) has a significant role in the start and development of type 2 diabetes mellitus. However, there is little proof that PP and pre-diabetes mellitus (Pre-DM) are related. Our study aimed to investigate the relationship between PP and incident pre-DM in a substantial cohort of Chinese participants.

DESIGN

The 'DATADRYAD' database (www.Datadryad.org) was used to retrieve the data for this secondary retrospective cohort analysis.

PARTICIPANTS

Data from 182 672 Chinese individuals who participated in the medical examination programme were recorded in this retrospective cohort study between 2010 and 2016 across 32 sites and 11 cities in China.

SETTING

PP assessed at baseline and incident pre-DM during follow-up were the target-independent and dependent variables. The association between PP and pre-DM was investigated using Cox proportional hazards regression.

PRIMARY OUTCOME MEASURES

The outcome was incident pre-DM. Impaired fasting glucose levels (fasting blood glucose between 5.6 and 6.9 mmol/L) were used to define pre-DM.

RESULTS

After controlling for confounding variables, PP was positively correlated with incident pre-DM among Chinese adults (HR 1.009, 95% CI 1.007 to 1.010). Additionally, at a PP inflection point of 29 mm Hg, a non-linear connection between the PP and incident pre-DM was discovered. Increased PP was an independent risk factor for developing pre-DM when PP was greater than 29 mm Hg. However, their association was not significant when PP was less than 29 mm Hg. According to subgroup analyses, females, never-smokers and non-obesity correlated more significantly with PP and pre-DM.

CONCLUSION

We discovered that higher PP independently correlated with pre-DM risk in this study of Chinese participants. The connection between PP and incident pre-DM was also non-linear. High PP levels were related to a higher risk of pre-DM when PP was above 29 mm Hg.

ARTICLE FOCUS

Our study investigated the relationship between PP and incident pre-DM in a secondary retrospective cohort of Chinese participants.

摘要

目的

先前的研究表明,脉压(PP)在 2 型糖尿病的发生和发展中具有重要作用。然而,PP 与糖尿病前期(Pre-DM)之间的关系证据较少。本研究旨在调查在中国大量参与者中,PP 与新发 Pre-DM 之间的关系。

设计

本二次回顾性队列分析使用“DATADRYAD”数据库(www.Datadryad.org)检索数据。

参与者

本回顾性队列研究纳入了 2010 年至 2016 年期间在中国 11 个城市 32 个地点参加体检计划的 182672 名中国个体的数据。

设置

基线时的 PP 和随访期间的新发 Pre-DM 为目标独立和目标依赖变量。使用 Cox 比例风险回归分析 PP 与 Pre-DM 之间的关系。

主要结局测量

结局为新发 Pre-DM。空腹血糖受损(空腹血糖 5.6 至 6.9mmol/L 之间)用于定义 Pre-DM。

结果

在控制混杂变量后,PP 与中国成年人新发 Pre-DM 呈正相关(HR 1.009,95%CI 1.007 至 1.010)。此外,在 PP 拐点为 29mmHg 时,发现 PP 与新发 Pre-DM 之间存在非线性关系。当 PP 大于 29mmHg 时,PP 升高是发生 Pre-DM 的独立危险因素。然而,当 PP 小于 29mmHg 时,两者之间的相关性不显著。根据亚组分析,女性、从不吸烟者和非肥胖者与 PP 和 Pre-DM 的相关性更显著。

结论

我们发现,在这项中国参与者的二次回顾性队列研究中,较高的 PP 独立与 Pre-DM 风险相关。PP 与新发 Pre-DM 之间的关系也是非线性的。当 PP 高于 29mmHg 时,PP 水平较高与 Pre-DM 风险增加相关。

文章重点

本研究调查了在中国二次回顾性队列中,PP 与新发 Pre-DM 之间的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/470b/10961532/b6117302476f/bmjopen-2023-080018f01.jpg

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