南京市老年体检人群空腹血糖轨迹与新发心血管病的关联  

Association between fasting blood glucose trajectories and new-onset cardiovascular diseases in the elderly health check-up population in Nanjing

作　　者：陈荃 杜金玲 洪忻[1,2] CHEN Quan;DU Jinling;HONG Xin(Nanjing Center for Disease Control and Prevention,Nanjing Medical University,Nanjing 210003,China;School of Public Health,Nanjing Medical University,Nanjing 211166,China)

机构地区：[1]南京医科大学附属南京市疾病预防控制中心,南京210003 [2]南京医科大学公共卫生学院,南京211166

出　　处：《中华疾病控制杂志》2024年第3期277-283,共7页Chinese Journal of Disease Control & Prevention

基　　金：江苏省卫生健康委2022年度医学科研项目(M2022028)。

摘　　要：目的探讨南京市老年人群(≥65岁)空腹血糖(fasting plasma glucose,FPG)轨迹和新发心血管病(cardiovascular disease,CVD)结局事件的关联。方法从南京市老年健康体检人群中选取符合纳入标准者作为研究对象,共计7079人纳入研究队列,采用群组化轨迹模型(group-based trajectory modeling,GBTM)构建2018―2020年FPG指标(FPG取其对数使其服从正态分布)随年份变化的轨迹并分组,随访该人群2021年CVD的发病情况,应用Cox回归模型分析不同轨迹组和新发CVD的关联。结果该人群的FPG轨迹最终分为低水平组(5635,79.6%)、中水平组(1201,17.0%)和高水平组(243,3.4%)。随访期间共有CVD结局事件70例,其中低水平组、中水平组和高水平组新发病例数分别占该组人数的0.83%、1.42%、2.47%,发病率随着FPG轨迹水平升高而增加(趋势χ^(2)=8.750,P=0.003),差异有统计学意义(χ^(2)=9.050,P=0.011)。Cox回归模型分析结果显示,高水平组的CVD发病风险是低水平组的2.96倍(95%CI:1.27~6.92)。结论老年人群较高水平的FPG轨迹和较高的CVD发病风险相关,FPG值偏高会增加CVD的发病风险,应及时干预,以实现早期预防CVD的目的。Objective To investigate the association between fasting blood glucose trajectory and the incidence of cardiovascular disease among the elderly population aged 65 years and above in Nanjing.Methods A total of 7079 participants were included from the Nanjing elderly health checkup cohort who met the inclusion criteria.The trajectory of fasting plasma glucose(FPG)index(FPG was taken as its logarithm to make it obey normal distribution)was constructed by group-based trajectory model(GBTM)over the years from 2018 to 2020.And we followed up the incidence of cardiovascular disease in 2021.A Cox regression model was used to analyze the association between distinct trajectory groups and the incidence of cardiovascular disease.Results The FPG trajectory was finally divided into low-level group(5635,79.6%),medium-level group(1201,17.0%)and high-level group(243,3.4%).A total of 70 cases of cardiovascular disease were newly reported during the follow-up period,with the low,medium,and high level groups accounting for 0.83%,1.42%,and 2.47%of the new cases in the group,respectively.The incidence of cardiovascular disease increased with increasing FPG levels(trendχ^(2)=8.750,P=0.003),and the difference was statistically significant(χ^(2)=9.050,P=0.011).The Cox regression model showed that the risk of cardiovascular disease in the high-level group was 2.96 times higher than that in the low-level group(95%CI:1.27-6.92).Conclusions Long-term high levels of FPG increase the risk of cardiovascular disease in the elderly,so timely intervention and early prevention are warranted.

关 键 词：老年人群 空腹血糖 轨迹 心血管病 队列研究 

分 类 号：R181.1[医药卫生—流行病学]