肱踝脉搏波速度和体重指数对糖尿病合并高血压发生风险的独立和联合作用  

Independent and joint effect of brachial.ankle pulse wave velocity and body mass index level on incident diabetes with hypertension

作　　者：王杰 裴育[1] 陈康[1] 闫文华[1] 王安平[1] 李一君[1] 谷伟君 王海滨[1] 安平[1] 金昕晔[1] 宁光[2] 母义明[1] Wang Jie;Pei Yu;Chen Kang;Yan Wenhua;Wang Anping;Li Yijun;Gu Weijun;Wang Haibing;An Ping;Jin Xinye;Ning Guang;Mu Yiming(Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China)

机构地区：[1]解放军总医院内分泌科,北京100853 [2]上海交通大学医学院附属瑞金医院内分泌代谢病科、上海市内分泌代谢病临床医学中心、上海市内分泌代谢病研究所

出　　处：《中华内分泌代谢杂志》2018年第4期287-294,共8页Chinese Journal of Endocrinology and Metabolism

基　　金：国家科技部创新药物研究开发技术平台建设（2011ZX09307-001-08）;中华内分泌学会,卫生部内分泌代谢病重点实验室（1994DP131044）;国家科技部重点新药创制项目（2012ZX09303006-001）;国家高技术研究发展计划（863计划）（2011AA020107）;国家自然科学基金项目（81300717）

摘　　要：目的探讨体重指数（BMI）和肱踝脉搏波速度（brachial—ankle pulse wave velocity，baPWV）预测糖尿病合并高血压发生风险的联合效应。方法用累积发生风险Kaplan—Meier曲线和Cox回归模型预测分析baPWV和BMI水平对糖尿病合并高血压发生风险的联合效应。结果本项研究总共纳入2222名受试者，以baPWV低四分位数（Q1-Q3）为参照组，baPWV位于最高四分位数（04）对新发糖尿病合并高血压的风险比（HR）值在未校正模型、模型Ⅰ和模型Ⅱ分别为4．16（95％CI 2．14，8．09）、2．52（95％CI1．10，5．78）和2．45（95％CI1．05，5．70）。基线baPWV（Q4）和BMI（≥25kg／m2）水平共同预测糖尿病合并高血压发生风险，在未校正模型、模型Ⅰ和模型Ⅱ中的HR值分别为11．50（95％C14．5，29．9）、4．20（95％CI1．4，13．1）和4．30（95％CI1．4，13．3），均有统计学意义（P〈0．05）。结论baPWV与BMI水平共同预测糖尿病合并高血压发生风险的效应优于独立效应，BMI≥25kg／m^2且baPWV在较高水平的人群发生糖尿病合并高血压的风险显著增加。Objective To investigate whether brachial-ankle pulse wave velocity （baPWV）, independently and jointly with the level of body mass index （BMI） , affect the risk of incident diabetes with hypertension. Methods The effects of baPWV and BMI level on incident diabetes with hypertension were evaluated using Kaplan-Meier curves （ log-rank test） and multi logistical regression models after adjustment for various confounding factors. Results A total of 2 222 participants were recruited in this study. Higher baPWV （Q4） was associated with a greater risk of incident diabetes with hypertension simultaneously compared with baPWV in the lower quartiles （ Q1-Q3 ）, with HR 4.16 （95% CI2.14, 8.09） in the crude model, 2.52 （95% CI1.10, 5.78） in model Ⅰ, and 2.45 （95% CI1.05, 5.70） in model Ⅱ. The highest risk of diabetes with hypertension simultaneously was in the group with high baPWV and B MI ≥ 25 kg/m^2, with HR 11.50 （95 % CI 4.5,29.9） in the crude model, 4.20 （95 % CI 1.4, 13.1 ） in model Ⅰ, and 4.30 （95% CI 1.4, 13.3） in model Ⅱ. Conclusions The joint effect of baPWV and BMI level on incident diabetes with hypertension simultaneously is a better predictor than their independent effect. The risk of incident diabetes with hypertension markedly increases in the subjects with BMI ≥25 kg/m： and higher baPWV.

关 键 词：糖尿病合并高血压 肱踝脉搏波速度 体重指数 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]