超重/肥胖人群的脉压与新发糖尿病的关联研究  

Association between pulse pressure and new-onset diabetes in overweight and obese people

作　　者：方伟 李尉键 蔡泽锋 郑梦伊 韩旭 陈冠之 吴炜强[4] 陈志超 吴寿岭[5] 陈有仁[4] Fang Wei;Li Weijiang;Cai Zefeng;Zheng Mengyi;Han Xu;Chen Guanzhi;Wu Weiqiang;Chen Zhichao;Wu Shouling;Chen Youren(Shantou University Medical College Shantou Guangdong,Shantou 515000,China;Graduate School,North China University of Science and Technology,Tangshan 063000,China;China Medical University,Shenyang 110122,China;Department of Cardiology,Second Affiliated Hospital of Shantou University Medical College,Shantou 515000,China;Department of Cardiology,Kailuan General Hospital,North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]汕头大学医学院,515000 [2]华北理工大学研究生院,唐山063000 [3]中国医科大学,沈阳110122 [4]汕头大学医学院第二附属医院心血管内科,515000 [5]河北联合大学附属医院开滦总医院心血管内科,唐山063000

出　　处：《中华内分泌代谢杂志》2021年第8期702-708,共7页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金(81870312)。

摘　　要：目的:探讨超重/肥胖人群中脉压(PP)与新发糖尿病的关联。方法:采用队列研究方法,选取开滦队列研究中参与2006至2007年度健康体检且符合纳入排除标准的超重、肥胖人群为研究对象,根据测量血压计算脉压并按脉压四分位数将其分为4组,采用Kaplan-Meier法计算不同脉压组别糖尿病累积发生率并用Log-Rank检验比较各组糖尿病累积发生率的差异;采用Cox比例风险模型估计不同脉压组别的糖尿病发病风险及95%置信区间。结果:经过平均8.45年随访,研究人群中共新发糖尿病8922例,Q1~Q4各分位组累积发病率分别为22.12%、24.48%、27.97%、33.44%,差异具有统计学意义(χ^(2)=368.16,P<0.01)。Cox比例风险模型分析显示,校正多种混杂因素后,与脉压Q1组相比,Q2~Q4组糖尿病发病风险分别为1.07(1.00~1.14)、1.13(1.05~1.21)、1.17(1.09~1.27)。动脉压分数(PPf)每增加一个标准差发生糖尿病事件的HR值为1.04(1.02~1.07)。此外,在超重、肥胖、正常血压、高血压未服药人群中,高脉压分组糖尿病发病风险均高于低脉压分组,差异具有统计学意义(P<0.01)。结论:脉压与糖尿病发病率呈正向关联,高脉压是超重/肥胖人群发生糖尿病的危险因素之一。Objective To investigate the association between pulse pressure(PP)and new-onset diabetes in overweight and obese people.Methods A prospective cohort study was conducted in overweight or obese participants selected from Kailuan Study who underwent 2006-2007 annual checkup and met the inclusion and exclusion criteria.PP was calculated by blood pressure and participants were divided into 4 groups according to PP quartile.The cumulative incidence of new-onset diabetes of different PP groups was calculated by Kaplan-Meier method and compare by Log-Rank test.The multivariate Cox proportional hazards model was used to analyze the association between different PP groups and new-onset diabetes.Results During an average follow-up of 8.45 years,8922 diabetes was identified.The cumulative incidence rate of the Q1,Q2,Q3,and Q4 groups were 22.12%,24.48%,27.97%,and 33.44%respectively,which were statistically different(χ^(2)=368.16,P<0.01).Cox proportional hazards regression analysis showed that after adjusting for multiple confounding factors,compared with Q1 group,the hazard ratio for diabetes in Q2,Q3,and Q4 groups were 1.07(1.00-1.14),1.13(1.05-1.21),and 1.17(1.09-1.27)respectively.And the HR of diabetes event in pulse pressure(per 1 SD increase)was 1.04(1.02-1.07).Similar results were found in participants who were over-weight,obese,with normal blood pressure or hypertensive without drugs use.Conclusion PP is positively correlated with the new-onset diabetes.High PP is one of the risk factors for developing diabetes in overweight and obese people.

关 键 词：脉压 新发糖尿病 超重肥胖人群 

分 类 号：R587.1[医药卫生—内分泌]