郑州市成人高血压人群糖代谢异常流行现状与危险因素

Prevalence and risk factors of abnormal glucose metabolism in adults with hypertension in Zhengzhou

目的分析郑州市成人高血压人群糖代谢异常流行现状及其主要危险因素。方法选取郑州市城乡18岁以上常住居民(至少居住6个月以上),采用多阶段抽样方法抽取调查对象,符合纳排标准的共6 798人。通过现场问卷调查和体格测量获取调查对象的基本情况及身高、体重、腰围、血压;采集调查对象血样并检测其血糖、血脂水平;分析高血压患者糖代谢异常患病率及其分布特征和危险因素。结果高血压患者共1 985例,患病率29.20%,标化患病率26.53%。采集到血样的高血压患者有1 936例,年龄(55.8±13.6)岁,男性903例(46.64%),女性1 033例(53.36%);糖代谢异常1 050例(54.24%),其中空腹血糖受损率为4.44%、糖耐量减低率为22.21%、糖尿病为27.56%。采集到血样的非高血压者有4 748人,糖代谢异常1 123例(23.65%);高血压患者糖代谢异常患病率明显高于非高血压人群,差异有统计学意义(χ^2=586.264,P<0.001)。高血压患者糖代谢异常患病率女性58.57%高于男性49.28%(χ^2=16.743,P<0.001);城市57.68%高于农村51.67%(χ^2=6.984,P<0.001),随着年龄增长高血压患者糖代谢异常患病率呈明显的上升趋势;中心性肥胖者、血脂异常者、有糖尿病家族史者、不吸烟者、不饮酒者患病率更高,差异均有统计学意义(P均<0.05);糖代谢异常患病率随年龄的增加、体质指数的升高而升高,随文化程度的升高而降低,差异均有统计意义(P均<0.001)。多因素Logistic回归分析显示,高龄、肥胖、中心性肥胖、血脂异常、糖尿病家族史是高血压患者糖代谢异常的危险因素。结论郑州市城乡居民高血压患者糖代谢异常患病率较高,在高血压患者的管理中要强化糖代谢异常情况的发现与干预治疗,并注重其相关危险因素的预防,建议应进一步降低首诊测血压年龄及高血压、糖尿病患者健康管理对象的年龄。

ObjectiveThis study aims to analyze the prevalence, distribution, and risk factors of abnormal glucose metabolism in urban and rural adult hypertension patients in Zhengzhou. MethodsThe study was conducted on permanent residents aged 18 years and over (with at least 6 months of residence) in urban and rural areas of Zhengzhou. The survey subjects were chosen by the multi-stage sampling method. Basic information regarding the height, weight, waist circumference, and blood pressure of 6 798 people who met the standards of admission and discharge were obtained through an on-site questionnaire survey and physical examination. Blood samples were collected and blood glucose and lipid levels were detected. ResultsThere were 1 985 patients with hypertension, with a prevalence rate of 29.20% and the standardized prevalence rate was 26.53%. Blood samples were collected from 1 936 hypertensive patients (55.8±13.6 years), of whom 903 were male (46.64%) and 1 033 female (53.36%). Among 1 050 patients (54.24%) with abnormal glucose metabolism, the impaired fasting glucose rate was 4.44%, the decreased glucose tolerance rate was 22.21%, and the diabetes rate was 27.56%. Blood samples were collected from 4 748 non-hypertensive patients and 1 123 patients (23.65%) with abnormal glucose metabolism. The prevalence of abnormal glucose metabolism in hypertensive patients was significantly higher than that in non-hypertensive patients, and the difference was statistically significant (χ^2=586.264, P<0.001). The prevalence rate of abnormal glucose metabolism in hypertensive patients was higher in females, 58.57%, than in males, 49.28%(χ^2=16.743, P<0.001). Urban patients showed a higher abnormal glucose metabolism, 57.68%, than rural patients did, 51.67%(χ^2=6.984, P<0.001), and the prevalence of abnormal glucose metabolism in hypertensive patients showed a significant upward trend with an increase in age. Patients with central obesity, abnormal blood lipids, family diabetes history, non-smokers, and non-drinkers showed a higher prevalence of abnormal glucose metabolism, and the differences were statistically significant (P<0.05). The prevalence of abnormal glucose metabolism increased with age and body mass index, and decreased with increase in education level, with differences being statistically significant (P<0.001). Multivariate logistic regression analysis showed that age, obesity, centripetal obesity, dyslipidemia, and family history of diabetes were the main risk factors for abnormal glucose metabolism in patients with hypertension. ConclusionsThere is a relatively high prevalence of abnormal glucose metabolism in hypertension patients among the urban and rural residents of Zhengzhou. In the management of hypertension, the detection and intervention for reducing abnormal glucose metabolism should be strengthened and related risk factors must be prevented. The age for health management objectives among hypertension and diabetes patients should be further reduced.