非糖尿病中老年人群空腹血糖与无症状颈动脉斑块相关性研究

Relationship between fasting blood glucose and asymptomatic carotid plaque in middle-aged and elderly population without diabetes

目的探索在非糖尿病中老年人群中,空腹血糖对无症状颈动脉斑块的影响。方法研究人群为2015年9月至2017年9月期间参与中国国家卒中高危人群筛查和干预(China National Stroke Screen Survey,CNSSS)项目,来自北京市昌平区北七家社区卫生服务中心和北京市顺义区空港医院筛查点的40岁及以上非城镇居民。入组标准为既往无脑血管疾病及相关神经功能缺损症状体征且无糖尿病者。共有3531人纳入本项研究,行颈动脉超声检查评估是否存在颈动脉斑块,采用多因素Logistic回归分析空腹血糖与颈动脉斑块之间的关系。结果研究人群的平均年龄(58.06±9.55)岁,男性1470例(占41.6%),女性2061例(占58.4%)。其中1318例(占37.3%)受试者存在颈动脉斑块。多因素调整后,空腹血糖仍与无症状颈动脉斑块相关(OR=1.16,95%CI:1.01~1.31,P=0.035)。结论本研究发现无糖尿病的中老年社区人群中,空腹血糖是无症状颈动脉斑块的独立危险因素。监测并积极控制血糖对预防颈动脉粥样硬化的发生及进展有着重要意义。

Objective To explore the effect of fasting blood glucose on asymptomatic carotid plaque in middle-aged and elderly population without diabetes.Method Participants aged≥40 years who participated in the China National Stroke Screen Survey(CNSSS)program,from two rural communities(Beiqijia community,Changping District,Beijing and Konggang community,Shunyi District,Beijing),were enrolled in this study from September 2015 to September 2017.The inclusion criteria were no history of cerebrovascular diseases,no neurological deficits,and no diabetes.Finally,a total number of 3531 subjects were enrolled in this study.Carotid plaques were measured by using doppler ultrasound.Logistic regression analysis was used to assess the association between fasting blood glucose and the presence of asymptomatic carotid plaques.Result The mean age was(58.06±9.55)years.Male subjects were 1470(41.6%),while female subjects were 2061(58.4%).Carotid plaques were detected in 1318(37.3%)subjects.In multivariate logistic regression analysis,after adjusting for potential confounders,fasting blood glucose was still a significant risk factor for asymptomatic carotid plaques(OR=1.16,95%CI:1.01-1.31,P=0.035).Conclusion Our study indicates that fasting blood glucose may be an independent risk factor for asymptomatic carotid plaque in middle-aged and elderly population without diabetes.Monitoring and effective control of glucose is important for the prevention and management of asymptomatic carotid atherosclerosis.