江苏省不同血糖水平人群心血管病危险因素聚集分析

缪伟刚; 覃玉; 苏健; 崔岚; 罗鹏飞; 杜文聪; 周金意

doi:10.16462/j.cnki.zhjbkz.2019.04.014

江苏省不同血糖水平人群心血管病危险因素聚集分析

doi: 10.16462/j.cnki.zhjbkz.2019.04.014

210009 南京市, 江苏省疾病预防控制中心慢性非传染病防制所

基金项目: 中央财政转移支付地方卫生计生服务项目

详细信息

通讯作者:
覃玉, E-mail: qinyu@jscdc.cn

中图分类号: R54;R181
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出版历程
- 收稿日期: 2018-10-20
- 修回日期: 2019-01-15
- 刊出日期: 2019-04-10

Different level of fasting blood glucose and cardiovascular risk factors clustering among population of Jiangsu Province

Department of Chronic Non-communicable Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China

Funds: The Ministry of Finance of China and National Health and Family Planning Commission of China

More Information

Corresponding author: Qin Yu, E-mail: qinyu@jscdc.cn

摘要

摘要: 目的了解江苏省社区不同血糖水平人群主要心血管病危险因素的聚集状况。方法 2015-2017年在江苏省6个项目点开展以社区人群为基础的筛查项目，共有83 522名35~75岁常住居民纳入本次研究。计算我省中老年人群高血压、肥胖、血脂异常和吸烟4类心血管危险因素的流行率及聚集性，采用非条件Logistic回归分析不同血糖水平与心血管病危险因素聚集风险之间的关系。结果江苏省35~75岁居民糖尿病患病率18.9%，其中知晓患病的比例为41.4%。在未知患病人群中，空腹血糖受损和高血糖人群心血管病危险因素聚集的风险分别是正常人群的1.29倍（OR=1.29，95% CI：1.24~1.36，P < 0.001）和1.99倍（OR=1.99，95% CI：1.89~2.08，P < 0.001）。在已知患病人群中，血糖控制率为15.5%，血糖控制与心血管病危险因素聚集并无关联。结论高血糖和空腹血糖受损增加成人心血管病危险因素聚集风险，应及时对糖尿病高危人群采取综合干预措施控制血糖。
- 血糖水平 /
- 心血管病危险因素 /
- 聚集性
Abstract: Objective To analyze the clustering of major cardiovascular risk factors among population with different level of fasting blood glucose (FBG) in Jiangsu provincial communities. Methods A population-based screening project was conducted during 2015-2017, with 83 522 residents aged 35-75 years from 6 areas included in the study. Prevalence and the clustering of four cardiovascular risk factors (hypertension, obesity, dyslipidemia and smoking) were analyzed. Binary Logistic regression analysis was performed to explore the relationship between FBG and cardiovascular risk factor clustering. Results The prevalence of diabetes was 18.9% among adults aged 35-75 years in Jiangsu province, and 41.4% of them were aware of their disease. Among undiagnosed population, the odd ratios (OR) of cardiovascular risk factors clustering in impaired fasting glucose (IFG) and hyperglycemia group was 1.29 (OR=1.29, 95% CI: 1.24-1.36, P < 0.001) and 1.99 (OR=1.99, 95% CI: 1.89-2.08, P < 0.001), compared with normal FBG group. The control rate of FBG was 15.5% among diagnosed cases. There was no difference in the risk clustering between diabetes patient with and without control of FBG. Conclusions Hyperglycemia and IFG increase the risk of cardiovascular risk factor clustering. Comprehensive interventions should be served as an important role to keep blood glucose at a normal level in high-risk population.
- Fasting blood glucose /
- Cardiovascular risk factor /
- Clustering

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图 1 未知患病人群不同血糖水平心血管病危险因素聚集情况(%)

Figure 1. The clustering of major cardiovascular risk factors among undiagnosed population with different level of FBG

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表 1 研究对象一般特征[n(%)]^a

Table 1. Basic characteristics of subjects [n(%)]^a

特征	未患病人群	高血糖人群	已知患病人群	合计	χ²值	P值
性别					67.721	＜0.001
男	24 957(36.8)	3 784(41.0)	2 546(39.1)	31 287(37.5)
女	42 816(63.2)	5 451(59.0)	3 968(60.9)	52 235(62.5)
年龄(岁)					1 587.960^b	＜0.001
35~	18 461(27.2)	1 493(16.2)	605(9.3)	20 559(24.6)
50~	21 074(31.1)	3 041(32.9)	1 932(29.7)	26 047(31.2)
60~75	28 238(41.7)	4 701(50.9)	3 977(61.1)	36 916(44.2)
学历					305.961^b	＜0.001
大专及以上	3 909(5.8)	341(3.7)	234(3.6)	4 484(5.4)
高中/中专	8 047(12.0)	942(10.3)	735(11.3)	9 724(11.7)
初中	22 644(33.7)	2 758(30.1)	1 847(28.5)	27 249(32.9)
小学及以下	32 659(48.6)	5 132(55.9)	3 663(56.5)	41 454(50.0)
家庭年收入(万)					11.11^b	0.004
高收入(≥5)	20 512(30.3)	2 699(29.2)	1 862(28.6)	25 073(30.0)
低收入(＜5)	47 261(69.7)	6 536(70.8)	4 652(71.4)	58 449(70.0)
饮酒					100.38	＜0.001
是	17 059(25.3)	2 764(30.0)	1 600(24.7)	21 423(25.7)
否	50 455(74.7)	6 439(70.0)	4 881(75.3)	61 775(74.3)
合计	67 773(81.1)	9 235(11.1)	6 514(7.8)	83 522(100.0)
注：^a未患病人群包括血糖正常和空腹血糖异常人群，高血糖人群即患病未知人群；学历、饮酒分别缺失611和324人。^b采用Kruskal-Wallis H检验。

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表 2 心血管病危险因素分布情况[n(%)]^a

Table 2. Distribution of cardiovascular risk factors [n(%)]^a

影响因素	未患病人群	高血糖人群	已知患病人群	合计	χ²值	P值
高血压					1 816.439	＜0.001
是	35 841(52.9)	6 446(69.8)	4 807(73.8)	47 094(56.4)
否	31 932(47.1)	2 789(30.2)	1 707(26.2)	36 428(43.6)
血脂异常					1 167.471	＜0.001
是	16 589(24.5)	3 402(36.8)	2 556(39.2)	22 547(27.0)
否	51 184(75.5)	5 833(63.2)	3 958(60.8)	60 975(73.0)
BMI分组					900.435^b	＜0.001
低体重	760(1.1)	57(0.6)	49(0.8)	866(1.0)
正常	25 467(37.6)	2 513(27.2)	1 697(26.1)	29 677(35.6)
超重	28 931(42.8)	4 193(45.5)	3 030(46.6)	36 154(43.4)
肥胖	12 502(18.5)	2 460(26.7)	1 727(26.6)	16 689(20.0)
吸烟					20.453	＜0.001
是	12 907(19.0)	1 939(21.0)	1 229(18.9)	16 075(19.3)
否	54 848(81.0)	7 296(79.0)	5 282(81.1)	67 426(80.7)
注：^aBMI缺失136人，吸烟缺失21人。^bKruskal-Wallis H检验。

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表 3 不同血糖水平与心血管病危险因素聚集的多因素Logistic回归分析

Table 3. Multivariate Logistic regression analysis of different level of fasting blood glucose and the clustering of major cardiovascular risk factors

组别	偏回归系数	Wald值	OR(95% CI)值	P值
未知患病人群
正常血糖			1.00
空腹血糖受损	0.253	189.470	1.29(1.24~1.36)	< 0.001
高血糖	0.685	819.627	1.99(1.89~2.08)	< 0.001
已知患病人群
血糖控制			1.00
血糖未控制	0.117	0.721	1.12(0.86~1.47)	0.396
注：调整性别、年龄、饮酒、家庭年收入和学历。

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