Chen Ying, Zhang Haiyu, Pan Yanbing, Zhang Yanzi, Yang Yuxuan, Liu Lu, Jia Qiuting, Wang Yongle, Kong Yihui
Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, China.
Am J Med Sci. 2025 Jan;369(1):14-23. doi: 10.1016/j.amjms.2024.08.021. Epub 2024 Aug 24.
Prediabetes and diabetes are common and serious public health problems, and high blood glucose can lead to serious cardiovascular complications. The purpose of this article was to explore the link between CVH levels and the incidence of prediabetes and diabetes in people over 20 years old, and whether serum vitamin D status could alter this relationship.
Data from six consecutive cycles of the NHANES database from 2007 to 2018 were combined and eligible participants were aged ≥20 years. After excluding missing data, a total of 19,992 subjects were enrolled in the study. Significant risk factors for prediabetes and diabetes were analyzed using univariate and multivariate logistic regression. Exploring the interaction of VD and CVH on prediabetes and diabetes based on multifactorial regression analysis.
The prevalence of prediabetes among all participants was 36.15% and the prevalence of diabetes was 16.39%. CVH and vitamin D levels are influential factors in prediabetes and diabetes, and are negatively associated with the risk of developing prediabetes and diabetes. Compared with normoglycemia, poorer CVH and vitamin D deficiency only had a synergistic multiplicative interaction on the development of diabetes, and no significant interaction was observed for the development of prediabetes. Compared with prediabetes, poorer CVH and vitamin D deficiency still had a synergistic additive interaction on the development of diabetes.
Although the cross-sectional study only determines the association and does not prove causality, the current results can be used to prompt people to improve their lifestyle and risk factors to prevent prediabetes or diabetes through higher CVH and adequate Vitamin D.
糖尿病前期和糖尿病是常见且严重的公共卫生问题，高血糖会导致严重的心血管并发症。本文旨在探讨20岁以上人群心血管健康水平（CVH）与糖尿病前期和糖尿病发病率之间的联系，以及血清维生素D水平是否会改变这种关系。
合并2007年至2018年美国国家健康与营养检查调查（NHANES）数据库连续六个周期的数据，符合条件的参与者年龄≥20岁。排除缺失数据后，共有19992名受试者纳入研究。使用单因素和多因素逻辑回归分析糖尿病前期和糖尿病的显著危险因素。基于多因素回归分析探讨维生素D（VD）和CVH对糖尿病前期和糖尿病的相互作用。
所有参与者中糖尿病前期的患病率为36.15%，糖尿病的患病率为16.39%。CVH和维生素D水平是糖尿病前期和糖尿病的影响因素，与发生糖尿病前期和糖尿病的风险呈负相关。与血糖正常者相比，较差的CVH和维生素D缺乏仅在糖尿病发生方面存在协同相乘相互作用，而在糖尿病前期发生方面未观察到显著相互作用。与糖尿病前期相比，较差的CVH和维生素D缺乏在糖尿病发生方面仍存在协同相加相互作用。
尽管横断面研究仅确定关联而不能证明因果关系，但目前的结果可用于促使人们改善生活方式和危险因素，通过提高CVH和充足的维生素D来预防糖尿病前期或糖尿病。
