正常高值血压合并糖调节受损患者的心血管危险因素  

Cardiovascular risk factors in prehypertensive patients with impaired glucose regulation

作　　者：刘继东[1] 侯新国[1] 宋君[1] 李文娟[1] 校娟[1] 肖芳[1] 王美建[1] 邓楠[1] 周晓莹[1] 陈丽[1] 

机构地区：[1]山东大学齐鲁医院内分泌科内分泌代谢病研究所,济南250012

出　　处：《山东大学学报（医学版）》2012年第7期1-4,9,共5页Journal of Shandong University:Health Sciences

基　　金：中华医学会糖尿病分会重点项目(07020470055);"十一五"国家科技支撑计划项目(2006BAI02B08);山东省科技攻关国际科技合作项目(2010GHZ20201);济南市科技局科技明星项目(20100318);山东大学自主创新基金(2009TS054);国家科技支撑计划(2009BAI80B04);山东省自然科学基金(Z2008C05)

摘　　要：目的探讨正常高值血压合并糖调节受损患者的临床特点及相关心血管危险因素。方法采用分层抽样方法,对山东省4个城市35～75岁的2 158名常住居民进行流行病学调查,其中正常高值血压865名。按受试者血压及血糖水平,分为单纯正常高值血压组(Ⅰ组,n=510)、正常高值血压合并糖调节受损组(Ⅱ组,n=278)、正常高值血压合并糖尿病组(Ⅲ组,n=77)。对3组患者的临床特点及合并心血管危险因素进行相关分析,应用Logistic回归分析,探讨正常高值血压人群发生糖调节受损的危险因素。结果 32.1%的正常高值血压人群出现糖调节受损。Ⅱ组年龄、体质量指数(body mass index,BMI)、腰围、甘油三酯(triglyceride,TG)、胆固醇(cholesterol,CHOL)、低密度脂蛋白(low density lipoprotein,LDL-C)均显著高于Ⅰ组(P<0.01)。Ⅲ组年龄、腰臀比(w aist-hip-ratio,WHR)、TG均显著高于Ⅰ组、Ⅱ组(P<0.05或P<0.01),腰围、CHOL、LDL-C显著高于Ⅰ组(P<0.01),HDL-C显著低于Ⅰ组、Ⅱ组(P<0.05)。Ⅱ组、Ⅲ组肥胖、高脂血症的检出率均显著增高(P<0.05),合并2个及以上心血管危险因素的比例上升(P<0.05或P<0.01),年龄(OR=1.04,95%CI:1.02～1.05)、BMI(OR=1.05,95%CI:1.01～1.10)、LDL-C(OR=1.22,95%CI:1.02～1.46)是糖调节受损发生的独立危险因素(P<0.05或P<0.01)。结论正常高值血压人群合并糖调节受损常伴发肥胖和高脂血症等心血管危险因素,正常高值血压人群随着年龄增加,BMI、LDL-C水平的升高,患糖调节受损的风险增加。Objective To investigate clinical characteristics and associated cardiovascular risk factors in prehypertensive patients with impaired glucose regulation（IGR）. Methods 2 158 residents aged 35-75 years old were enrolled by the cross-sectional and cluster sampling methods from 4 cities in Shandong, of which 865 subjects were prehypertensive. All the subjects were divided into three groups： the simple prehypertention group （group Ⅰ , n = 510） , the prehyperten- sion with impaired glucose regulation group （ group Ⅱ , n = 278 ） and the prehypertension with diabetes group （ group m, n =77）. The clinical characteristics and associated cardiovascular risk factors were compared among the threegroups. The risk factors of hyperglycemia were analyzed by binary logistic regression analysis. Results The preva- lence of ⅠGR was 32.1% in prehypertensive population. The values of age, BMI, waist circumference, CHOL, TG and LDL-C in group Ⅱ were higher compared with group Ⅰ （ P 〈 0.01 ）. Age, WHR and TG in group Ⅲ showed a higher level compared with groups Ⅰ and Ⅱ （ P 〈 0.05 or P 〈 0.01 ）. The values of waist circumference, CHOL, LDL-C in group Ⅱ were obviously higher compared with group Ⅰ （ P 〈 0.01 ）. The values of age, WHR and TG in group Ⅲ were obviously higher than those in group Ⅰ and Ⅱ （ P 〈 0.05 or P 〈 0.01 ）. The values of waist circumfer- ence, CHOL and LDL-C in group Ⅲ were higher than those in group Ⅰ （ P 〈0.01 ）. The value of HDL-C in the group Ⅲ was lower compared with groups Ⅰ and Ⅱ（ P 〈 0.05 ）. The detection rates of obesity and hyperlipidemia were higher in group Ⅱ and group Ⅲ （P 〈 0.05）. Patients in group Ⅱ and group In were more likely to have 2 or more cardiovascular risk factors than group Ⅰ （P〈0.05 or P〈0.01）. Age（OR = 1.04, 95%CI： 1.02-1.05）, BMⅠ（OR =1.05, 95%CI： 1.01-1.10 ） and LDL-C（ OR = 1.22, 95% CI： 1.02-1.46 ） proved to be the independent predictors for the impaired gl

关 键 词：正常高值血压 糖尿病 糖调节受损 心血管疾病 危险因素 

分 类 号：R587.1[医药卫生—内分泌]