辽宁省农村地区高血压人群糖代谢异常对脑卒中发病影响流行病学调查

The Epidemiologic Study of Abnormal Glucose Metabolism and Its Effects of Incidence of Stroke in Rural Population with Hypertension in Liaoning Province

目的调查辽宁省阜新农村地区35～75岁高血压人群伴有糖代谢异常的流行病学特征,探讨血糖增高对脑卒中发病的影响,为心血管病危险因素人群干预提供科学依据。方法按分层整群随机抽样方法,对阜新农村35～75岁常驻(≥5年)6 516名高血压人群中随机抽取2 499人,按空腹血糖检测结果分为空腹血糖正常组(NFG)与空腹血糖增高组(IFG+DM),随访1年,记录新发脑卒中,观察发病情况,分析血糖增高对脑卒中发病的影响。结果 2 499人随访一年总脑卒中发病率为2.0%(50例),其中NFG组为1.5%(27例),IFG+DM组为3.2%(23例);Cox回归分析显示,女性空腹血糖增高使总脑卒中、非致死性脑卒中发病的相对危险升高(RR=2.234和RR=2.410),男性未达到统计学水平(RR=1.645和RR=1.648)。结论辽宁阜新农村地区高血压人群中空腹血糖增高是女性脑卒中发病的独立危险因素之一,应引起卫生部门重视,综合评估,全面治疗。

Aim To obtain the epidemiologic data of abnormal glucose metabolism in rural hypertensive population aged from 35 to 75 years old in Fuxin of Liaoning province; And to explore effects of hyperglycemia to incidence of stroke among rural adult groups with hypertension for providing the scientific basis for the comprehensive intervention of risk factors . Methods By stratified random sampling method, From the crowd of 6 516 Fuxin 35 - 75-year-old rural Permanent residents （ t〉 5 ） with hypertension 2 499 were randomly selected, fasting blood glucose test results they were divided into normal fasting blood glucose （NFG） group and higher fasting glucose （ IFG ＋ DM） group. In the follow-up of 1 year, we recorded the new sick stroke and observed the incidence to analyze the effects of hyperglycemia on stroke. Results During 1-year follow-up, 50 cases of stroke events emerged in 2 499 persons, 1.5% （27 cases） in NFG group,3.2% （23 cases） in IFG ＋ DM group. After adjusting for multiple risk factors, the relative risk of higher fasting glucose to incidence of stroke was 2. 234 and 2. 410 for women, significantly higher than that of the group with normal fasting glucose, which was 1. 645 and 1. 648 for men though higher than in normal group but was not statistically significant. The prevalence of impaired fasting blood glucose （IFG） was 25.3 %. The prevalence of diabetes mellitus （DM） was 9. 6% , which was lower in male than in female and the prevalence increased with age in female and male. The prevalence of DM increased with level of hypertension. Multiple logistic regression analysis revealed age, obesity were risk factors. Conclusions Higher fasting glucose is an important risk factor for stroke of women in the countryside of Fuxin county, Liaoning province.