高血压发病年龄与糖尿病的关联研究

Association of hypertension onset age with diabetes

目的探讨高血压发病年龄与糖尿病的关联,为降低心血管事件风险提供依据。方法2016—2020年上海市长宁区和宝山区开展国家心血管病高危人群早期筛查与综合干预项目,选择35~75岁常住居民为研究对象,通过问卷调查、体格检查和实验室检测收集人口学信息、既往疾病史、高血压发病年龄、血压和空腹血糖等资料。高血压发病年龄按<45岁、45~<55岁、55~<65岁和≥65岁分组,以正常血压为对照组,采用多因素logistic回归模型分析高血压发病年龄与糖尿病前期、糖尿病的关联。结果纳入居民25228人,其中男性8753人,占34.70%;女性16475人,占65.30%。高血压11051例,占43.80%;高血压发病年龄<45岁、45~<55岁、55~<65岁和≥65岁分别为1779、3274、3781和2217例;正常血压14177人。糖尿病前期6056例,占24.01%;糖尿病2849例,占11.29%。多因素logistic回归分析结果显示,调整性别、婚姻状况和文化程度等变量,与正常血压组比较,高血压发病年龄<45岁(OR=1.345,95%CI:1.164~1.553)、45~<55岁(OR=1.365,95%CI:1.212~1.536)和55~<65岁组(OR=1.376,95%CI:1.239~1.527)糖尿病前期风险较高;高血压发病年龄<45岁(OR=2.302,95%CI:1.906~2.775)、45~<55岁(OR=2.349,95%CI:2.016~2.734)、55~<65岁(OR=1.909,95%CI:1.667~2.184)和≥65岁组(OR=1.315,95%CI:1.131~1.526)糖尿病风险较高。结论高血压发病年龄与糖尿病前期、糖尿病存在统计学关联。

Objective To examine the association of hypertension onset age with diabetes,so as to provide insights into reducing the the risk of cardiovascular events.Methods Permanent residents aged 35 to 75 years were selected through the program of early screening and comprehensive intervention for the high-risk cardiovascular disease popula⁃tion in Changning District and Baoshan District,Shanghai Municipality from 2016 to 2020.Demographic information,dis⁃ease history,hypertension onset age,blood pressure and fasting blood glucose were collected through questionnaire sur⁃veys,physical examination and laboratory tests.The residents were divided into four groups based on the onset age of hypertension:<45,45-<55,55-<65 and≥65 years old,and the residents with normal blood pressure were selected as control.The association of hypertension onset age with prediabetes and diabetes were identified using a multivariable logistic regression model.Results A total of 25228 residents were recruited,including 8753 males(34.70%)and 16475 females(65.30%).The prevalence of hypertension was 43.80%.There were 1779,3274,3781 and 2217 cases with hypertension onset age of<45,45-<55,55-<65 and≥65 years old,respectively,and 14177 residents with normal blood pressure.The prevalence of prediabetes and diabetes were 24.01%and 11.29%,respectively.Multivariable logistic regression analysis showed that after adjusting for confounding factors such as gender,marital status and educa⁃tional level,compared with the normal blood pressure group,the risk of prediabetes was higher in the hypertension on⁃set age groups of<45(OR=1.345,95%CI:1.164-1.553),45-<55(OR=1.365,95%CI:1.212-1.536)and 55-<65 years old(OR=1.376,95%CI:1.239-1.527),and the risk of diabetes was higher in the hypertension onset age groups of<45(OR=2.302,95%CI:1.906-2.775),45-<55(OR=2.349,95%CI:2.016-2.734),55-<65(OR=1.909,95%CI:1.667-2.184)and≥65 years old(OR=1.315,95%CI:1.131-1.526).Conclusion There are statistically significant associations be⁃tween hypertension onset age with prediabetes and diabetes.