不同血压水平与糖尿病前期的关联性

Associations between different levels of blood pressure and risk of prediabetes

目的探讨不同血压水平在不同性别、城乡居民中与糖尿病前期患病风险的关联性。方法2020年,在湖北省10个调查地区采用多阶段整群随机抽样方法调查21637名≥18岁常住居民。收集研究对象的问卷资料、身体测量指标和实验室检测指标,采用复杂加权和多因素logistic回归分析不同血压水平在不同性别、城乡居民中与糖尿病前期患病风险的关联性。结果共纳入16111名研究对象。糖尿病前期、单纯空腹血糖受损(IFG)、单纯糖耐量减低(IGT)和IFG合并IGT患病率(95%CI)分别为25.1%(14.4%~35.9%)、12.7%(3.2%~22.1%)、8.1%(6.3%~9.8%)和4.4%(2.3%~6.5%)。经多变量校正后,血压水平升高与糖尿病前期、单纯IFG、单纯IGT和IFG合并IGT患病风险上升均具有关联性(趋势性P<0.05)。在男性、城乡居民中,血压水平与糖尿病前期患病风险均呈正向剂量-反应关系(趋势性P<0.05),性别与血压水平的交互作用对糖尿病前期和单纯IGT患病有统计学意义(交互性P<0.05)。结论血压水平升高与糖尿病前期患病风险上升相关,关联性在男性中更强,城乡人群未见明显差异。应针对不同特征人群制定更为特色和有效的防控策略。

Objective To explore sex and rural-urban differences in the associations of different blood pressure levels with the risk of prediabetes.Methods We used a multi-stage stratified cluster random sampling method to investigate 21637 residents aged≥18 years from 10 survey areas in Hubei province in 2020.The data on questionnaire,physical measurements,and laboratory indicators of the participants were collected.The associations of different blood pressure levels with risk of prediabetes by sex and regions were analyzed using multivariate logistic regressions after complex weighting.Results A total of 16111 subjects were included.The prevalence(95%CI)of prediabetes,impaired fasting glucose(IFG),impaired glucose tolerance(IGT),and IFG complicated with IGT were 25.1%(14.4%-35.9%),12.7%(3.2%-22.1%),8.1%(6.3%-9.8%),and 4.4%(2.3%-6.5%),respectively.After multivariate adjustment,the risk of prediabetes,IFG,IGT,and IFG complicated with IGT increased with the increment of blood pressure(both P for trend<0.05).The positive dose-response relationships between blood pressure levels and risk of prediabetes were also significant among male,urban,and rural residents(both P for trend<0.05),and the interactions between sex and blood pressure showed significant associations for risk of prediabetes and IGT(both P for interaction<0.05).Conclusions Higher blood pressure levels were associated with an increased risk of prediabetes.The association with prediabetes was stronger in males,but no significant difference was found between urban and rural residents.More distinctive and effective prevention and control strategies should be developed for different populations.