北京市50～79岁社区人群血糖水平与颈动脉斑块关系的相关性研究

Association between glucose level and carotid plaque among 50-79 year olds from the communities

目的分析北京市社区人群空腹血糖（FB6）水平与颈动脉斑块患病危险的关系，探讨不同血糖水平合并其他危险因素，与颈动脉斑块患病危险之间的关系。方法研究人群来自“中国多省市心血管病危险因素前瞻性队列研究（CMCS）”。2007年对北京大学社区随访人群中依然存活的人群进行危险因素复查，对两次调查资料完整，且年龄50～79岁的1046人进行分析。FBG~〉7．0mmol／L或正在服用降糖药物定义为糖尿病。结果研究人群FBG平均水平为5．89mmol／L，颈动脉斑块患病率为56．3％。以FBG正常组为参照，仅在单因素和调整年龄时，随着FBG水平的增加，颈动脉斑块的患病危险增加。分性别分析，在调整了其他危险因素后，女性颈动脉斑块患病危险是参照组的2．2倍。将各危险因素异常和正常的两分组与FBG水平的三分组进行组合，男女两性均以各危险因素正常且合并FBG正常组为参照。在调整了其他危险因素后，女性各危险因素异常合并糖尿病组的颈动脉斑块患病危险最高，具有统计学意义，高密度脂蛋白胆固醇降低、低密度脂蛋白胆固醇升高、血压升高、腰围增大合并有糖尿病组的颈动脉斑块患病危险分别是参照组的2．8倍（P=0．014）、2．7倍（P=0．010）、2．4倍（P=0．013）、2．1倍（P=0．031）。结论FBG水平的增加与颈动脉粥样硬化患病危险间的关系在男女两性不一致，糖尿病与颈动脉粥样硬化患病危险间的关系仅存在于女性，FBG水平和其他心血管病危险因素组合后与颈动脉粥样硬化患病危险问存在联合作用。

Objective To investigate the association between fasting blood glucose levels and the prevalence of carotid plaque in a community-based population of Beijing and to further explore the association between fasting glucose levels concomitant wand other cardiovascular risk factors as well as the prevalence of carotid plaque. Methods This study was a part of the Chinese Multi-provincial Cohort Study conducted in the communities of Beijing University in 2007. All the members aged 50-79 years from the community were recruited, with 1046 of them qualified as without missing data. Case of diabetes was defined if the fasting glucose level was greater than 7.0 mmol/L or on anti- diabetic drugs. Results The mean level of fasting glucose was 5.89 mmol/L, and the prevalence of carotid plaque was 56.3%. For the reference on normal levels of fasting glucose, the risk on carotid plaque had an increase along with the increase of fasting glucose levels only under the univariate and multivariate analyses, after adjusting for age. However, the risk on carotid plaque in women was increased when there was an increase on the levels of fasting glucose. Specifically, for the reference on normal levels of fasting glucose, after adjusting for other cardiovascular risk factors, the odds of developing a carotid plaque was more than two folds in diabetic women. When combining the groups of risk factors （normal and abnormal） among the three groups of fasting glucose and assigning the normal level of risk factors concomitant with normal fasting glucose as a reference for both genders, the risk of developing a carotid plaque in diabetic women with abnormal level of risk factors ranked the highest, with statistical significance. When the diabetic patients combined with a decreased levels of HDL but increased levels of LDL, blood pressure, waist circumference, there appeared 2.8- （P= 0.014）, 2.7- （P=0.010）, 2.4- （P=0.013） and 2.1- times （P=0.031） higher risks of developing carotid plaque than those in the reference group, respectively. Conclusion In this study, the prevalence of carotid plaque driven by increased fasting glucose was different on gender but the difference was only statistically significant in women. There also appeared a joint association of fasting glucose combined with other cardiovascular risk factors on the risk of developing a carotid plaque.