Zhang Zhiqiang, Chen Hejun, Chen Lei, Liang Wenyan, Hu Tenglong, Sun Na, Zhao Yangyu, Wei Xiqing
Department of Cardiology, Clinical Medical College, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China.
Shandong Provincial Key Medical and Health Discipline of Cardiology, Affiliated Hospital of Jining Medical University, Jining, Shandong, China.
J Diabetes Investig. 2025 Jun;16(6):1081-1090. doi: 10.1111/jdi.70029. Epub 2025 Mar 24.
With lifestyle changes, the incidence of diabetes has been steadily increasing, and hypertension remains a significant risk factor impacting cardiovascular health. Understanding the potential effects of blood pressure on diabetes risk is, therefore, crucial. This study aims to comprehensively explore the relationship between blood pressure and diabetes risk.
A total of 211,809 individuals undergoing health check-ups were included in this analysis. Participants were divided into four groups based on the quartiles of systolic and diastolic blood pressure, with the primary outcome being the incidence of new-onset diabetes.
Over an average follow-up period of 3.1 years (±0.94 years), 3,000 men (1.42%) and 1,173 women (0.55%) were newly diagnosed with diabetes. Multivariable Cox regression analysis demonstrated that blood pressure is an independent predictor of new-onset diabetes (systolic blood pressure HR 1.07 per SD increase, 95% CI: 1.01-1.12, P for trend <0.001; diastolic blood pressure HR 1.11 per SD increase, 95% CI: 1.06-1.17, P for trend 0.001). The optimal cutoff for systolic blood pressure in predicting new-onset diabetes was found to be 123 mmHg (area under the curve 0.7014, sensitivity 0.65, specificity 0.64), which was superior to the predictive efficacy of diastolic blood pressure (area under the curve 0.6645, sensitivity 0.63, specificity 0.62). Subgroup analyses indicated that the risk of blood pressure-related diabetes was significantly higher in middle-aged individuals compared to older adults (P for interaction <0.05). Additionally, women showed a higher risk of systolic blood pressure-related diabetes than men, and normal-weight individuals exhibited a higher risk than those with obesity (P for interaction <0.05).
This cohort study within a Chinese population highlights that, after adjusting for other confounding factors, blood pressure is an independent risk factor for diabetes. This association is particularly pronounced among middle-aged individuals, women, and those of normal weight. Moreover, systolic blood pressure demonstrates superior predictive efficacy for diabetes compared to diastolic blood pressure.
随着生活方式的改变，糖尿病的发病率一直在稳步上升，高血压仍然是影响心血管健康的一个重要风险因素。因此，了解血压对糖尿病风险的潜在影响至关重要。本研究旨在全面探讨血压与糖尿病风险之间的关系。
本分析纳入了总共211,809名接受健康检查的个体。参与者根据收缩压和舒张压的四分位数分为四组，主要结局是新发糖尿病的发病率。
在平均3.1年（±0.94年）的随访期内，3000名男性（1.42%）和1173名女性（0.55%）被新诊断为糖尿病。多变量Cox回归分析表明，血压是新发糖尿病的独立预测因素（收缩压每增加1个标准差，风险比为1.07，95%置信区间：1.01 - 1.12，趋势P值<0.001；舒张压每增加1个标准差，风险比为1.11，95%置信区间：1.06 - 1.17，趋势P值为0.001）。发现预测新发糖尿病的收缩压最佳临界值为123 mmHg（曲线下面积为0.7014，敏感性为0.65，特异性为0.64），其预测效能优于舒张压（曲线下面积为0.6645，敏感性为0.63，特异性为0.62）。亚组分析表明，与老年人相比，中年个体中与血压相关的糖尿病风险显著更高（交互作用P值<0.05）。此外，如果收缩压相关的糖尿病女性高于男性，正常体重个体的风险高于肥胖个体（交互作用P值<0.05）。
这项在中国人群中的队列研究强调，在调整其他混杂因素后，血压是糖尿病的独立危险因素。这种关联在中年个体、女性和正常体重者中尤为明显。此外，与舒张压相比，收缩压对糖尿病的预测效能更高。
