健康体检人群血浆致动脉粥样硬化指数轨迹与高血压发病风险的相关性

Association between plasma atherogenic index trajectories and risk of hypertension in health examination population

目的探讨健康体检人群血浆致动脉粥样硬化指数(AIP)轨迹与高血压发病风险的相关性。方法本研究为回顾性队列研究,连续选取2012年1月至2022年12月大连医科大学附属第二医院健康管理中心先后进行≥3次健康体检的15389名受检者,收集其一般资料、人体测量指标及实验室指标。筛选基线入选时无高血压的研究人群,通过组基轨迹建模确定不同性别人群的AIP轨迹组,观察男性和女性各AIP轨迹组的基线特征和随访结束时的高血压发病率情况。使用Cox风险比例回归模型分析AIP轨迹与高血压发病风险的相关性。结果男性和女性受检者均识别出4个AIP轨迹组(低水平组、低增长组、中增长组和高增长组),其中低增长组高血压发病率最高(女性38.18%,男性40.92%)。调整所有混杂因素后,女性低增长组(HR=1.29,95%CI:1.02~1.63)、中增长组(HR=1.66,95%CI:1.23~2.23)和高增长组(HR=1.89,95%CI:1.26~2.85)高血压发病风险均与AIP轨迹升高呈正相关;男性仅高增长组高血压发病风险(HR=1.33,95%CI:1.01~1.74)与AIP轨迹升高呈正相关。结论健康体检人群AIP轨迹升高与高血压发病风险呈正相关。

Objective To investigate the relationship between plasma atherogenic index(AIP)trajectory and the risk of hypertension in health examination population.Methods In this retrospective cohort study,a total of 15389 subjects who had undergone health examinations at the Health Management Center of the Second Affiliated Hospital of Dalian Medical University three or more times from January 2012 to December 2022 were consecutively selected.The general data,anthropometric parameters and laboratory parameters were collected.The study population without hypertension at baseline inclusion was screened,and AIP trajectory groups of different genders were determined by group-based trajectory modeling.The baseline characteristics and the incidence of hypertension at the end of follow-up were observed in each AIP trajectory group of men and women.Cox proportional hazards regression models were used to analyze the association of AIP trajectories with the risk of hypertension.Results Four AIP trajectory groups(low level group,low gain group,medium gain group and high gain group)were identified in both male and female subjects,with the highest incidence of hypertension in the low gain group(38.18%in females and 40.92%in males).After adjusting for all confounders,the risk of hypertension was positively associated with increased AIP trajectories in the low(HR=1.29,95%CI:1.02-1.63),medium(HR=1.66,95%CI:1.23-2.23),and high(HR=1.89,95%CI:1.26-2.85)gain groups in women;the risk of hypertension was positively associated with increased AIP trajectories in only the high gain group in men(HR=1.33,95%CI:1.01-1.74).Conclusion Elevated AIP trajectory is positively correlated with the risk of hypertension in health examination population.