估算的脉搏波传导速度对新发糖尿病的影响  

Effect of Estimated Pulse Wave Velocity on New-onset Diabetes

作　　者：季春鹏[1] 韩冰 王硕 母静 吴寿岭[1] 汪国栋 JI Chunpeng;HAN Bing;WANG Shuo;MU Jing;WU Shouling;WANG Guodong(Department of Cardiology,Kailuan General Hospital,Tangshan 063000,China;Health Care Center,Kailuan Medical Group,Tangshan 063000,China)

机构地区：[1]开滦总医院心内科,唐山063000 [2]开滦员工健康保障中心,唐山063000

出　　处：《中国循环杂志》2024年第10期1016-1021,共6页Chinese Circulation Journal

摘　　要：目的:探讨估算的脉搏波传导速度(ePWV)对新发糖尿病的影响。方法:以参加2006年7月至2007年10月健康体检、既往无糖尿病病史且资料完整的82 440例开滦集团公司职工为观察队列,平均随访(13.19±3.73)年。将研究人群按ePWV四分位数分为四组:Q_1组(ePWV<12.35 m/s,n=20 610)、Q_(2)组(12.35 m/s≤ePWV<13.74 m/s,n=20 610)、Q_3组(13.74 m/s≤ePWV<15.16 m/s,n=20 611)和Q_4组(ePWV≥15.16 m/s,n=20 609),计算各组糖尿病的发病密度。采用ROC曲线分析ePWV对新发糖尿病的预测价值。在校正传统心血管危险因素(包括性别、吸烟、饮酒、体育锻炼、文化程度、心血管疾病家族史、心肌梗死史、脑卒中史、体重指数、总胆固醇、空腹血糖、血尿酸和高敏C反应蛋白)后,采用多因素Cox回归模型分析ePWV对新发糖尿病的影响。结果:ePWV预测新发糖尿病的ROC曲线的AUC为0.60,最佳截断值为12.78 m/s。随着ePWV四分位数的递增,糖尿病的发病密度呈递增趋势,分别为5.84/千人年、12.04/千人年、15.70/千人年和16.87/千人年。在校正性别、基线空腹血糖、吸烟、饮酒等传统心血管危险因素后,ePWV每增加1 m/s,糖尿病的发生风险增加9%(HR=1.09,95%CI:1.08~1.11,P<0.01)。进一步分析显示,无论有无心血管危险因素、男性还是女性、年龄<51岁还是≥51岁,ePWV均与糖尿病的发生存在显著关联,HR(95%CI)分别为1.07(1.05~1.08)和1.21(1.08~1.36),1.07(1.06~1.09)和1.17(1.15~1.20),1.22(1.19~1.24)和1.06(1.04~1.07)。结论:ePWV对新发糖尿病具有一定的预测价值,是新发糖尿病的独立危险因素。Objectives:To evaluate the association between estimated pulse wave velocity(ePWV)and risk of new-onset diabetes.Methods:A total of 82440 employees without prior diabetes who participated in the health examination from July 2006 to October 2007 were selected as the observation cohort,participants were followed-up for a mean of(13.19±3.73)years.The study population was divided into four groups according to the ePWV quartiles:group Q1(ePWV<12.35 m/s,n=20610),group Q_(2)(12.35 m/s≤ePWV<13.74 m/s,n=20610),group Q3(13.74 m/s≤ePWV<15.16 m/s,n=20611),and group Q4(ePWV≥15.16 m/s,n=20609).ROC curve was used to analyze the predictive value of ePWV for new-onset diabetes.The incidence density of diabetes in each group was calculated.After adjustment for the traditional cardiovascular risk factors(including sex,smoking,drinking,exercise,education level,family history of cardiovascular disease,history of myocardial infarction,history of stroke,body mass index,total cholesterol,fasting blood glucose,uric acid and high-sensitivity C-reactive protein),multivariate Cox regression models were used to evaluate the association between ePWV and risk of new-onset diabetes.Results:The area under the ROC curve of ePWV was 0.60 in the prediction of new-onset diabetes,and the optimal cutoff value was 12.78 m/s.With the increase of ePWV quartile,the incidence density of diabetes showed an increasing trend,which was 5.84/ 1 000 person years, 12.04/ 1 000 person years, 15.70/ 1 000 person years and 16.87/ 1 000 person years,respectively. After adjusting for the traditional cardiovascular risk factors, the risk of new onset diabetes increased by 9%(HR=1.09, 95%CI : 1.08-1.11, P<0.01) for each 1 m/s increase in ePWV. Subgroup analysis showed that higher ePWV wassignificantly associated with increased risk of new-onset diabetes regardless of presence or absence of cardiovascular riskfactors, male or female, and age < 51 years or age ≥ 51 years, with the HR (95%CI ) values of 1.07 (1.05-1.08) and 1.21 (1.08-1.36), 1.07 (1.06-1.09) and 1

关 键 词：估算的脉搏波传导速度 臂踝脉搏波传导速度 糖尿病 危险因素 

分 类 号：R54[医药卫生—心血管疾病]