糖耐量受损转化为正常糖耐量或演变为糖尿病者血压均下降——来自大庆糖尿病研究的新发现  

Blood pressure reduction found in subjects after evolution of impaired glucose tolerance to normal glucose tolerance or diabetes ——New information from The Da-Qing IGT and Diabetes Study

作　　者：王瑶[1] 王金平[2] 李光伟[1] 杨文英[1] 姜亚云[2] 邢小燕[1] 张景玲[2] 萧建忠[1] 胡英华[2] Barbara V. Howard Peter H. Bennett 

机构地区：[1]卫生部中日友好医院内分泌代谢病中心,北京100029 [2]大庆市第一医院 [3]Medlantic Research Institute, Washington DC, USA [4]Phoenix Epidemiology and Clinical Research Branch, NIH, NIDDK, Arizona, USA

出　　处：《中华内分泌代谢杂志》2008年第3期268-271,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的分析大庆糖尿病预防研究中糖耐量受损（IGT）人群随访6年期间的糖耐量演变及其与血压变化的关联。方法大庆糖尿病预防研究中有334例IGT患者未曾服用任何降血压药物，其中264例基线血压≥130／80mmHg（1mmHg=0．133kPa）。随机分配在对照、饮食、运动及饮食加运动干预4个组，从1986年随访到1992年。根据研究结束时口服葡萄糖耐量试验（OGTT）2h血糖水平（2hPG）分为〈7．8、7．8～8．8、8．9～9．9、10．0～11．0、11．1～13．8、13．9～16．6和≥16．7mmol／L7个亚组，探讨各组血压水平的变化及其与血糖变化的关联。结果经多因素分析调整了年龄、性别、基线体重指数及随访期体重变化等因素的影响后，1986至1992年间各组的收缩压改变分别为-2．4、0．6、7．7、4．3、1．7、-2．9、和-6．9mmHg，舒张压变化为-3．2、3．0、3．3、1．7、-0．7、-1．3和-3．7mmHg。收缩压和舒张压在演变为糖耐量正常或糖尿病者比那些仍然保持为IGT且2hPG在8．9～9．9mmol／L者显著下降（均P〈0．05）。264例基线血压≥130／80mmHg者中血压变化更为显著。在上述各组，收缩压变化分别为-5．2、-2．6、5．2、2．3、-2．3、-4．2、-7．6mmHg，舒张压变化分别为-5．0、-3．7、1．5、-2．9、-4．3、-4．0和-6．0mmHg。结论大庆6年研究中IGT人群中血糖水平仍保持为IGT者血压有所升高。相反，IGT转化为正常糖耐量或糖尿病组血压明显下降。Objective To investigate the blood pressure change in relation to the evolution of impaired glucose tolerance （IGT）. Methods From 1986 to 1992, 334 subjects with IGT were randomized to placebo, diet, exercise and diet plus exercise intervention groups. No anti-hypertension drug was given to these enrolled subjects. Blood pressure was measured at the beginning and the end of the six-year prospective study. In this analysis these subjects were stratified to seven subgroups based on 2 h plasma glucose （2hPG） level during OGTT at the end of the study： 〈7.8,7.8 -8.8,8.9 -9.9,10.0-11.0,11.1-13.8,13.9-16.6 and ≥16.7 mmol/L. Blood pressure changes in relation to the evolution of glucose tolerance in these subgroups were compared by least square mean procedure. Results Changes of systolic blood pressure （SBP） in average in these seven groups were -2.4,0.6,7.7,4.3,1.7, -2.9 and -6.9 mm Hg （ 1 mm Hg =0. 133 kPa） , and changes of diastolic blood pressure （DBP） were -3.2, 3.0,3.3,1.7, - 0. 7, - 1.3 and - 3.7 mm Hg respectively after controlling for age, sex, BMI at baseline and A BMI during the follow-up period. In those subjects with IGT evolved into normal glucose tolerance（NGT） or diabetes, reductions in SBP and DBP were significantly greater than those who retained IGT with 2hPG between 8.9-9.9 mmol/L （ all P 〈 0. 05 ）. In 264 out of the 334 subjects with IGT and blood pressure ≥ 130/80 mm Hg at baseline, blood pressure changed more strikingly： changes of SBP in these groups were -5.2, -2.6, 5.2, 2.3, -2.3, -4.2, -7.6mmHg, andDBPwere -5.0, -3.7,1.5, -2.9, -4.3, - 4.0 and - 6.0 mm Hg respectively after the adjustment of age, sex, BMI, BMI variation. The reductions of SBP and DBP in subjects whose status of IGT was converted to NGT or diabetes were significantly greater than those with retained IGT and 2hPG between 8.9-9.9 mmol/L. Conclusion Blood pressure is increased in the subjects with IGT who retained in the IGT group during the six-year follow-up period in Da-Qing Study. On the

关 键 词：糖耐量受损 糖尿病 血压 

分 类 号：R587.1[医药卫生—内分泌]