Li Shanshan, Yang Boyi, Shang Shasha, Jiang Wei
Department of Medical College, Jiangsu Vocational College of Medicine, Yancheng, China.
Jiangsu Engineering Research Centers for Cardiovascular and Cerebrovascular Disease and Cancer Prevention and Control, Yancheng, China.
Diabetes Obes Metab. 2025 Jan;27(1):92-101. doi: 10.1111/dom.15986. Epub 2024 Oct 1.
To explore the correlation between new-onset diabetes (NOD), hypertension and blood pressure management among elderly individuals in China.
A cohort analysis involved 1380 participants aged 60 years or older, initially free of diabetes in 2008, from the Chinese Longitudinal Healthy Longevity Survey. Follow-up assessments occurred every 2-3 years. The relationship between hypertension, blood pressure changes and NOD was analysed using multivariable-adjusted Cox regression.
By 2018, 102 participants developed diabetes, while 1278 remained without diabetes. The cumulative diabetes prevalence increased from 3.1% at 3 years to 7.4% at 10 years. Hypertension prevalence increased from 20.9% at baseline to 41.0% at 10 years, with higher rates in those diagnosed with diabetes during follow-up. Multivariate analysis identified age, gender, baseline hypertension and systolic blood pressure (SBP) as independent predictors of NOD. Hypertension combined with overweight/obesity significantly increased the risk of NOD (hazard ratio [HR] 2.837; 95% confidence interval [CI], 1.680-4.792). We evaluated participants' blood pressure management levels in 2008 and 2011, then tracked the onset of diabetes from 2011 to 2018. Compared with participants with an average SBP below 120 mmHg in 2008 and 2011, those with SBP of 140 mmHg or higher had an 8-fold higher risk of developing NOD (adjusted HR8.492, 95% CI 2.048-35.217, P = .003), the highest risk group. Participants with SBP of 130-139.9 mmHg also had a significantly increased risk (adjusted HR 5.065, 95% CI 1.186-21.633, P = .029), while those with SBP of 120-129.9 mmHg showed no significant difference (HR 2.730, 95% CI 0.597-12.481, P = .195). Consistently high SBP (≥ 130 mmHg) further increased NOD risk (adjusted HR 3.464, 95% CI 1.464-8.196, P = .005).
Significant predictors of NOD included age, gender, baseline hypertension and blood pressure management. Maintaining SBP consistently below 130 mmHg may be an effective strategy to reduce the incidence of NOD in the general elderly population.
探讨中国老年人新发糖尿病（NOD）、高血压与血压管理之间的相关性。
一项队列分析纳入了1380名年龄在60岁及以上的参与者，这些参与者在2008年时最初无糖尿病，来自中国老年健康长寿纵向调查。每2至3年进行一次随访评估。使用多变量调整的Cox回归分析高血压、血压变化与NOD之间的关系。
到2018年，102名参与者患糖尿病，而1278名仍未患糖尿病。糖尿病累积患病率从3年时的3.1%增至10年时的7.4%。高血压患病率从基线时的20.9%增至10年时的41.0%，随访期间诊断为糖尿病的人群患病率更高。多变量分析确定年龄、性别、基线高血压和收缩压（SBP）为NOD的独立预测因素。高血压合并超重/肥胖显著增加NOD风险（风险比[HR] 2.837；95%置信区间[CI]，1.680 - 4.792）。我们评估了参与者在2008年和2011年的血压管理水平，然后追踪了2011年至2018年糖尿病的发病情况。与2008年和2011年平均SBP低于120 mmHg的参与者相比，SBP为140 mmHg或更高的参与者发生NOD的风险高8倍（调整后HR 8.492，95% CI 2.048 - 35.217，P = .003），为风险最高组。SBP为130 - 139.9 mmHg的参与者风险也显著增加（调整后HR 5.065，95% CI 1.186 - 21.633，P = .029），而SBP为120 - 129.9 mmHg的参与者无显著差异（HR 2.730，95% CI 0.597 - 12.481，P = .195）。持续高SBP（≥130 mmHg）进一步增加NOD风险（调整后HR 3.464，95% CI 1.464 - 8.196，P = .005）。
NOD的显著预测因素包括年龄、性别、基线高血压和血压管理。将SBP持续维持在130 mmHg以下可能是降低普通老年人群中NOD发病率的有效策略。
