累积脉压差水平与代谢综合征发生风险的相关性

Association of cumulative pulse pressure levels with the risk of metabolic syndrome

目的探索累积脉压差(cumPP)水平与代谢综合征(MetS)潜在的相关性,为MetS的健康管理提供思路。方法选取郑州市体检人群中符合入选标准的3968例受试者组成研究队列,根据基线cumPP水平的三分位数将数据分为3组,采用Cox比例风险回归模型分析不同cumPP水平与新发MetS的关系。结果在2.16年的中位随访期内MetS的发生风险随cumPP的增加而增加(2.5%、4.3%和4.6%,P趋势<0.001);Spearman秩相关分析显示cumPP与腰围、收缩压、舒张压、空腹血糖均呈显著正相关(均P<0.05)。Cox回归校正模型显示,总人群和男性中Q 2和Q 3组MetS发病风险均比Q 1组高(均P<0.05),女性无统计学意义;其中总人群的模型3校正了多种混杂因素,提示Q 3组发生MetS风险是Q 1组的1.654倍(95%CI 1.272~2.151);男性Q 3组发生MetS风险是Q 1组的1.665倍(95%CI 1.245~2.227);女性无统计学意义。基于Cox多因素分析绘制的列线图,可以查到1、2和3年MetS发生率分别为0.18%、3.97%和7.39%。此外,剂量反应曲线提示总人群中随着cumPP的升高,发生MetS的风险逐渐增大。根据基线收缩压水平的亚组分析显示,无论收缩压是否异常,较高cumPP水平均与较高的MetS发病风险相关。结论cumPP水平升高与新发MetS的发生具有显著相关性,将脉压差长期控制在合适的水平对管理MetS有意义。

ObjectiveTo explore the potential correlation between cumulative pulse pressure(cumPP)level and metabolic syndrome(MetS),and to provide insights for MetS management.MethodsA total of 3968 subjects who underwent health checkup were selected to form a research cohort,and the data were categorized into three groups based on the tertiles of cumPP levels.Cox proportional hazards regression model was employed to analyze the association between different cumPP levels and the incidence of new-onset MetS.ResultsThe risk of MetS increased with the increased tiers of the cumPP levels(2.5%,4.3%,and 4.6%,P trend<0.001)during the median follow-up period of 2.16 years.Spearman rank correlation analysis showed that cumPP was positively correlated with waist circumference,systolic blood pressure,diastolic blood pressure and fasting plasma glucose(all P<0.05).The Cox proportional hazards regression adjusted model showed that the risk of MetS in Q 2 and Q 3 was higher than that in Q 1 in the total population,and the same results were observed in males(all P<0.05),while there was no statistical significance in females.Model 3 of the total population adjusted for a variety of confounding factors displayed a higher risk of MetS in Q 3 compared with that in Q 1[1.654(95%CI 1.272-2.151)].When stratified by sex,and the risk of MetS in Q 3 was 1.665 times higher than that in Q 1(95%CI 1.245-2.227),while there was no statistically significant risk in female.According to the visual nomogram of independent risk factors screened by multivariate analysis based on Cox proportional hazards regression model,the incidence of MetS at 1 year,2 years,and 3 years was 0.18%,3.97%and 7.39%,respectively.In addition,the dose-response curve was plotted according to cumPP,suggesting that the risk of MetS gradually increased with the increase of cumPP in the total population.Subgroup analyses based on baseline systolic blood pressure levels showed that higher cumPP levels were associated with a higher risk of developing MetS,regardless of whether systolic blood pressure was abnormal.ConclusionsElevated cumPP levels is significantly related to the incidence of new-onset MetS.Maintaining pulse pressure within an appropriate range over long term is crucial for the management of MetS.