成都地区社区居民高血压前期与糖脂代谢的关系

Relationship between prehypertension and glucose and lipid metabolism among the community residents in Chengdu area

目的探讨成都地区社区居民高血压前期和糖脂代谢紊乱之间的关系。方法2008年4月至11月应用分层整群抽样方法，选取成都市3个社区的40岁及以上居民，进行问卷调查和体格检查，给予口服葡萄糖耐量试验，并检测血糖、血脂等生化指标。在5123名40岁及以上中老年人群中，正常血压者1486名，平均年龄（52±10）岁；高血压前期者1636名，平均年龄（55±10）岁。比较两组人群的糖脂代谢情况，并进一步分析高血压前期与相关因素的关系。计量资料以均数±标准差表示，两组间比较采用t检验，计数资料比较采用）（。检验，相关因素分析采用logistic回归分析。结果成都地区中老年人群高血压前期总体患病率为31．93％，标化患病率为32．70％，其中男性为35．56％，女性为29．69％。高血压前期组／正常血压组在单纯空腹血糖受损、单纯糖耐量异常、空腹血糖受损合并糖耐量异常以及糖尿病的患病率分别为3．42％／2．22％、18．46％／14．47％、2．69％／1．55％和15．71％／8．41％，两组间比较差异均有统计学意义（X^2=4．064、8．978、4．833、38．613，均P〈0．05）。高血压前期组／正常血压组在高胆固醇血症、高甘油三酯血症、高低密度脂蛋白胆固醇（LDL．C）和低高密度脂蛋白胆固醇（HDL-C）的患病率分别为5．38％／3．30％、17．1l％／9．62％、2．69％／1．68％和11．74％／6．93％，两组问比较差异均有统计学意义（X^2=8．041、37．313、4．219、21．009，均P〈0．05）。logistic回归分析显示，年龄、性别、BMI、腰臀比、餐后血糖、总胆固醇、甘油三酯和HDL-C均与高血压前期相关（OR=1．03、0．60、1．10、6．92、1．04、1．19、1．10、0．68，均P〈0．05），其中女性和HDL-C升高是高血压前期的保护因素，年龄和性别是不可控因素。结论成都地区社区中老年人群高血压前期的患病率高，中老年高血压前期人群更易合并糖尿病和血脂紊乱，高血压前期与糖脂代谢关系密切。

Objective To study the relationship between the prehypertension and disorders of glucose and lipid metabolism among the community residents in Chengdu area. Methods A cross-sectional population-based survey for chronic diseases in Chengdu was performed from April to November in 2008. Using cluster random sampling method, three communities were selected in Chengdu area. All the participants completed a detailed questionnaire and underwent anthropometric measurements. A total of 1486 normotensive subjects and 1636 prehypertensive subjects among the 5123 individuals aged 40 years and above were included in this study. The glucose and lipid metabolism profiles in normotensive group and prehypertension group were determined and compared. The relation between prehypertension and other related clinicopathological factors was also investigated. Chi-squared tests for categorical variables, t-tests for continuous variables and logistic regression analysis for related risk factors were performed in this study. Results The total prevalence of prehypertension among the community residents aged 40 years and over in Chengdu area was 31.93%, the standard prevalence was 32. 70%, it was 35.56% in male and 29. 69% in female. The prevalence of isolated impaired fasting glucose, isolated impaired glucose tolerance, impaired fasting glucose combined impaired glucose tolerance and diabetes were 3.42%/2. 22%, 18.46%/14. 47% , 2. 69%/1.55% and 15.71%/8.41% in prehypertensive/ normotensive subjects respectively ; there were significant differences in all the above-mentioned four parameters between the two groups （ X^2 = 4. 064, 8. 978, 4. 833, 38. 613, respectively; all P 〈 0.05 ） . The prevalence of hypercholesterolemia, hypertriglyceridemia, high low density lipoprotein-cholesterol （LDL-C） and low high density lipoprotein- cholesterol （HDL-C） were 5.38%/3.30%, 17. 11%/9.62%, 2. 69%/1.68% and 11.74%/6. 93% in prehypertensive/normotensive subjects respectively; there were significant differences in all the above- mentioned four parameters between the two groups （ X^2 = 8. 041, 37. 313, 4. 219, 21. 009, all P 〈 0.05 ）. Logistic regression analysis showed that age, gender, body mass index, waist to hip ratio, elevated postprandial blood glucose, elevated triglycerides, total cholesterol and HDL-C were correlated with prehypertension（ OR = 1.03,0. 60,1.10,6. 92,1.04,1.10,1.19,0. 68, all P 〈 0. 05 ）. Female and elevated HDL-C were negatively correlated with prehypertension （ all P 〈 0. 05 ）. Age and gender were nonmodifiable factors. Conclusions Prehypertension is highly prevalent among middle-aged and elderly in the communities in Chengdu area. The prehypertensive subjects are more susceptible to diabetes and dyslipidemia.