摘要
目的 探讨中国北方不同基线血压人群新发糖尿病（new on-set diabetes,NOD）的情况.方法 本研究采用前瞻性队列研究方法,以参加2006至2007年度开滦集团职工健康体检的101 510名职工中空腹血糖（FBG） ＜7.0 mmol/L、无糖尿病病史、未使用降糖药物者及基线血压和FBG资料完整的90 322名职工作为观察队列.排除未参加2008至2009年度、2010至2011年度体检以及FBG资料缺失者,排除各种原因死亡者及恶性肿瘤者,最终纳入统计分析的为51 631名.依据2006至2007年度收缩压、舒张压及是否服用降压药物将观察对象分为正常血压组（＜ 120/80 mmHg,1 mmHg=0.133 kPa）、正常高值组（120-139/80 - 89 mmHg）、高血压组（≥140/90 mmHg或服用降压药物）.新发糖尿病定义为：随访期间任意一次FBG≥7.0 mmol/L或有糖尿病病史或使用降糖药物.采用Kaplan-Meier法绘制生存曲线,log-rank法进行检验;用多因素COX风险回归模型分析不同血压人群NOD的情况.结果 （1）在平均4.04年的随访中,共3 917例发生糖尿病.正常血压组、正常高值组、高血压组糖尿病的发病率分别为（10.41、16.28和24.46）/千人年.男性为（12.70、17.34和26.79）/千人年,女性为（6.30、12.41和24.89）/千人年（P趋势＜0.01）.（2）影响NOD的多因素COX回归模型分析显示：校正了年龄、性别、体重指数、高敏C反应蛋白、高密度脂蛋白胆固醇、甘油三酯、总胆固醇、FBG、吸烟、饮酒、体育锻炼和糖尿病家族史后,与正常血压组比较,正常高值组和高血压组NOD的发病风险增加,HR值（95％ CI）分别为1.19（1.07 -1.33）、1.35（1.21 -1.50）.不同性别人群校正上述因素之后,血压对NOD的发病风险仍有明显统计学意义,尤其对女性影响更显著.结论 血压增高者未来发生糖尿病的风险增加,尤其在女性人群中风险增加更显著.
Objective To explore the relationship between baseline blood pressure and new-onset diabetes （NOD） in northern China.Methods Prospective cohort study method was used.A total of 101 510 workers took part in the health examination during 2006 to 2007.Of them 90 322 participants were enrolled from the observation population,with fasting blood glucose （FBG） ＜7.0 mmol/L,no history of diabetes,no treatment of hypoglycemic agents,and with complete baseline blood pressure and FBG data.Those,who did not participate in the health examination during 2008-2009 or 2010-2011,and had incomplete FBG data,or had cancer,or died were excluded.Finally,51 631 participants were included into the statistical analysis.According to the data collected during health examinations in 2006-2007,the participants were divided into three groups：normotensive （＜ 120/80mmHg,1 mmHg=0.133 kPa） prehypertensive （120-139/80-89 mmHg）,and hypertensive（≥ 140/90 mmHg or using antihypertensive agents）.The new-onset diabetes was defined as FBG ≥ 7.0 mmol/L,or having history of diabetes,or using hypoglycemic agents.Kaplan-Meier method was used to draw survival curve,and log-rank test to examine.The relationship between baseline blood pressure and NOD was estimated by multivariate Cox hazard regression model analysis.Results （1） During a median 4.04 year of follow-up,3 917 had NOD.The incidences（/ 1 000 person-years） of NOD in normotensive,prehypertensive,hypertensive groups were respectively 10.41,16.28,and 24.46,men 12.70,17.34,26.79,women 6.30,12.41,24.89,P for trend ＜0.01）.（2） Multivariate Cox regression model analysis showed that compared with normotensive group,the prehypertensive and hypertensive groups had an increased risk of NOD after adjusting for age,gender,body mass index,high-sensitivity C-reactive protein,high-density lipoprotein-cholesterol,triglyceride,total cholesterol,FBG,smoking,drinking,physical activity,and family history of diabetes.The corresponding hazard ratios （95％ CI） were 1.19 （1
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2014年第11期966-971,共6页
Chinese Journal of Endocrinology and Metabolism
关键词
基线血压
空腹血糖
新发糖尿病
Baseline blood pressure
Fasting blood glucose
New-onset diabetes
