糖尿病人群基线腰围水平与新发高血压的相关性

The relationship between baseline waist circumference and the new-onset hypertension in diabetic patients

目的探讨糖尿病人群基线腰围水平与新发高血压风险之间的关系。方法本研究采用前瞻性队列研究方法,以参加2006-2007年度开滦集团职工健康体检,收缩压〈140mm Hg且舒张压〈90mm Hg及既往无高血压病史,相关资料完整的2468例糖尿病人群作为观察队列。依据基线腰围四分位数将观察对象分为4组（第一分位组：腰围〈84cm;第二分位组：腰围84-〈89cm;第三分位组：腰围89-〈95cm;第四分位组：腰围≥95cm）,比较4组2010-2011年度健康体检时高血压的发病率,并用Cox比例风险回归模型分析基线腰围与新发高血压风险的关系。结果观察队列的平均随访时间为（47.2±5.1）月,有976例发生了高血压,发病率为39.5%。随着腰围的增加,高血压的发病率逐渐升高,腰围第一分位、第二分位、第三分位和第四分位组的发病率分别为30.3%、37.4%、42.2%和47.6%（趋势P值〈0.01）。影响新发高血压的Cox比例风险回归模型分析显示,腰围是新发高血压的独立危险因素,与第一分位组比较,第三分位组和第四分位组新发高血压的风险分别增加26.2%和46.8%。结论腰围≥89cm是糖尿病人群新发高血压的独立危险因素。

Objective To explore the relationship between baseline waist circumference and the new-onset hypertension in diabetic patients. Methods It was a prospective cohort study incorporating a total of 2468 diabetic patients who participated in health examination between 2006 and 2007. At enrollment, all patients, without history of hypertension, had systolic and diastolic blood pressure less than 140 and 90 mm Hg, respectively. The patients were categorized into quartiles of waist circumference （〈84, 84--89, 89--95 and ≥95 cm）. The incidence of hypertension in health examination between 2010 and 2011 was compared across quartiles, and multivariable Cox proportional hazard regression analysis was performed to quantify the relationship between waist circumference at baseline and the new-onset hypertension. Results The mean follow-up time was （47.2±5.1） months, and there were 976 cases of hypertension with the incidence rate of 39.5 %. With the increase of waist circumference, the incidence of hypertension increased gradually. The incidence rate of hypertension in the first, second, third and fourth quartile of waist circumference were 30.3%, 37.4%, 42.2% and 47.6%, respectively （P for trend 〈0.01）. Cox proportional regression analysis indicated that waist circumference was an independent risk factor for the new-onset hyper- tension, and the risk of developing hypertension were separately increased 26.2% and 46.8% in the third and fourth quartiles relative to the first quartile of waist circumference. Conclusion Waist circumferenceS89 cm may be an independent risk factor for the new-onset hypertension in diabetic patients.