糖代谢与中国常州汉族人群动脉僵硬的关系  

Association between glucose metabolism and arterial stiffness in Chinese Han population in Changzhou

作　　者：陈诗 孙红燕 朱金华 施鸿飞 沈斌 张荣艳 柯炜 彭浩[5] CHEN Shi;SUN Hong-yan;ZHU Jin-hua;SHI Hong-fei;SHEN Bin;ZHANG Rong-yan;KE Wei;PENG Hao(Suzhou Vocational Health College,Suzhou 215009,China)

机构地区：[1]苏州卫生职业技术学院,江苏苏州215009 [2]常州市天宁区疾病预防控制中心,江苏常州213000 [3]苏州市吴江区疾病预防控制中心,江苏苏州215200 [4]南京医科大学附属苏州医院苏州市立医院心血管内科,江苏苏州251000 [5]苏州大学医学部公共卫生学院流行病学教研室,江苏苏州215006

出　　处：《中国实用内科杂志》2021年第5期407-411,共5页Chinese Journal of Practical Internal Medicine

基　　金：十三五国家重点研发计划(2017YFC1307600)。

摘　　要：目的已有大量研究证实血糖升高与动脉僵硬有关,但关于糖化血红蛋白(HbA1c)与动脉僵硬度关系的研究有限。文章意在大样本的中国成人中探讨糖代谢与动脉僵硬的关系。方法利用天宁队列的基线资料分析糖代谢与动脉僵硬的关系,即于2018年在常州市天宁区随机选择5168位常住居民,检测空腹血糖和HbA1c,用颈股脉搏波传导速度(cfPWV)评价动脉僵硬度。应用分位数回归模型分析空腹血糖和HbA1c与cfPWV的关系,调整年龄、性别、受教育程度、吸烟、饮酒、体力活动、睡眠质量、BMI、血脂和血压。结果随着空腹血糖(β=0.14,P<0.001)和HbA1c(β=0.07,P=0.008)水平的升高,cfPWV的平均水平呈现明显增加趋势。经性别、年龄、睡眠评分和体力活动等因素调整后,空腹血糖每升高1 mmol/L,动脉僵硬(cfPWV≥8.84 m/s)患病风险增加9%(OR=1.09,P<0.001);同样,HbA1c每增加1%,动脉僵硬患病风险增加6%(OR=1.06,P=0.048)。结论空腹血糖和HbA1c水平与中国成人动脉僵硬度正相关,糖代谢异常可能加速动脉僵硬,但因果关系尚不明确。Objective Accumulating evidence has demonstrated the role of glucose increase in arterial stiffness,but the association between hemoglobin A1 c(HbA1c)and arterial stiffness is not well studied. This study aims to explore the association between glucose metabolism and arterial stiffness in a large sample of Chinese adults. Methods The baseline data of Tianing Cohort was used to analyze the association between glucose metabolism and arterial stiffness. Fasting glucose and HbA1c were examined in 5168 adults who were randomly selected from the residents in Tianning District of Changzhou city in 2018. Arterial stiffness was assessed by carotid-femoral pulse wave velocity(cfPWV). Quantile regression model was constructed to examine the associations of fasting glucose and HbA1c with cfPWV. Results The median level of cfPWV was significantly increased with the increasing of quintiles of fasting glucose(β=0.14,P<0.001)and HbA1c(β=0.07,P=0.008),respectively. After adjusting for factors such as gender,age,sleep score and physical activity,Per 1-mmol/L increment of fasting glucose was associated with a 9% higher risk of having arterial stiffness(cfPWV≥8.84 m/s,OR=1.09,P<0.001).Similarly,per 1% increment of HbA1c was associated with a 6% higher risk of having arterial stiffness(OR=1.06,P=0.048).Conclusion Fasting glucose and HbA1c levels are positively associated with arterial stiffness in Chinese adults,but the causality is uncertain.

关 键 词：糖代谢 动脉僵硬度 空腹血糖 糖化血红蛋白 颈股脉搏波传导速度 

分 类 号：R543.5[医药卫生—心血管疾病]