| 糖化血红蛋白、空腹及服糖后2小时胰岛素水平与高血压发病风险的前瞻性研究 |
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| 引用本文： | 王艺颖,余杨文,吴延莉,苏旭,周婕,赵否曦,李雪娇,刘涛.糖化血红蛋白、空腹及服糖后2小时胰岛素水平与高血压发病风险的前瞻性研究[J].现代预防医学,2022,0(9):1547-1553. |
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| 作者姓名： | 王艺颖 余杨文 吴延莉 苏旭 周婕 赵否曦 李雪娇 刘涛 |
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| 作者单位： | 1.贵州省疾病预防控制中心,贵州 贵阳 550004; 2.贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室 |
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| 摘 要： | 目的 探讨糖化血红蛋白(Glycosylated hemoglobin,HbA1c)、空腹胰岛素(Fasting insulin,INS)及服糖后2小时胰岛素(Insulin 2 hours after oral glucose tolerance test,INS-2H)与高血压发病的风险。方法 本研究采用全人群多阶段整群随机抽样方法,抽取了贵州省12个区(县)的48个乡镇共9 280人进行调查,排除基线HbA1c、INS及INS-2H缺失及有高血压病史者,最终纳入1 684例进入分析。中位随访6.23年。采用Cox生存回归分析HbA1c、INS及INS-2H与高血压发病的相关性。PAF及Survival计算人群归因危险百分比。结果 HbA1c和INS-2H每升高一个单位,高血压发病风险分别增加31.5%和1.1%。HbA1c高水平组发病风险是低水平组的2.87倍。相比第一分位组,INS-2H第四分位组发病风险增加73.6%。HbA1c水平控制在6.3 mmol/L及以下可降低人群8.6%的发病。INS-2H水平分别控制在8.81 mIU/L、15.60 mIU/L、24.30 mIU/L以下,可降低人群22.6%、11.9%和6.8%的发病。年龄>42岁组的人群中,HbA1c高水平组发病风险是低水平组的2.84倍; INS-2H第二、三、四分位组发病风险分别是第一分位组的2.001倍、2.145倍和2.145倍。男性人群中,HbA1c高水平组发病风险是低水平组的2.760倍; INS-2H第三、四分位组发病风险是第一分位组的1.828倍和2.116倍。结论 HbA1c及INS-2H是高血压发病的危险因素,在年龄>42岁和男性人群更为敏感。控制HbA1c及INS-2H能有效降低人群高血压发病。
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| 关 键 词： | 高血压 糖化血红蛋白 空腹胰岛素水平 服糖后2小时胰岛素水平 发病风险 |
Associations between glycated hemoglobin,fasting insulin,insulin 2 hours after oral glucose tolerance test and incident hypertension in a prospective cohort study |
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| WANG Yi-ying,YU Yang-wen,WU Yan-li,SU Xu,ZHOU Jie,ZHAO Fou-xi,LI Xue-jiao,LIU Tao.Associations between glycated hemoglobin,fasting insulin,insulin 2 hours after oral glucose tolerance test and incident hypertension in a prospective cohort study[J].Modern Preventive Medicine,2022,0(9):1547-1553. |
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| Authors: | WANG Yi-ying YU Yang-wen WU Yan-li SU Xu ZHOU Jie ZHAO Fou-xi LI Xue-jiao LIU Tao |
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| Affiliation: | *Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou 550004, China |
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| Abstract: | Objective To investigate the relationship between glycosylated hemoglobin(HbA1c), fasting insulin(INS), and insulin 2 hours after oral glucose tolerance test administration(INS-2H)and the risk of hypertension. Methods In this study, a total of 9 280 people were selected from 48 towns in 12 districts(counties)of Guizhou Province using a population-wide multi-stage cluster random sampling method. Excluded the deficiency of HbA1c, INS, and INS-2H at baseline, finally included 1 684 cases into the analysis, with a median follow-up of 6.23 years. The correlation of HbA1c, INS, and INS-2H with hypertension was analyzed by Cox survival regression. PAF and Survival were used to calculate the percentage of population attributable risk. Results For each unit increase of HbA1c and INS-2H, the risk of hypertension increased by 31.5% and 1.1%, respectively. The risk of hypertension in the high level group was 2.87 times higher than that of low levels group. The risk of hypertension in the fourth quartile of INS-2H increased by 73.6% compared with the first quartile. Control HbA1c level at 6.3mmol/L or below can reduce the morbidity of the population by 8.6%. INS-2H levels below 8.81 mIU/L, 15.60 mIU/L, and 24.30 mIU/L can reduce the morbidity of 22.6%, 11.9%, and 6.8% of the population, respectively. In patients aged >42 years, The risk of hypertension in the high-level group was 2.84 times higher than that of low levels group. The risk of hypertension in the second, third, and quartile groups of INS-2H were 2.001, 2.145, and 2.145 times higher than that in the first quartile group, respectively. In men, the risk of hypertension in high-level group was 2.76 times higher than that of low levels group. The risk of hypertension in the third and quartile groups of INS-2H was 1.828 and 2.116 times higher than in the first quartile group. Conclusion HbA1c and INS-2H are independent risk factors for hypertension, and the age > 42 years and male are more sensitive. Controlling HbA1c and INS-2H can effectively reduce the incidence of hypertension in the population. |
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| Keywords: | Hypertension Glycosylated hemoglobin Fasting insulin Insulin 2 hours after oral glucose tolerance test Relative risk |
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