摘要目的 探讨糖尿病前期与高血压的关联及其影响因素,为制定防控心血管疾病的策略提供参考.方法 2013年6月—2014年9月,采用多阶段随机抽样的方法选取北京市平谷地区部分社区居民,对其进行一般情况调查、体格检查及血脂、75 g葡萄糖耐量试验等实验室检查,分析糖尿病前期人群发生高血压的情况,采用Logistic回归建立模型分析糖尿病前期和高血压的关系及其影响因素.结果 最终4 002人完成调查,年龄(50.3±11.8)岁,其中男性1 962人(49.0%),女性2 039人(51.0%),1人性别资料缺失.其中糖代谢正常2 188人,糖尿病前期1 066人,糖尿病748人,糖代谢正常、空腹血糖受损、糖耐量减低、空腹血糖受损合并糖耐量减低和糖尿病人群高血压患病率分别为28.3%、46.5%、46.3%、62.0%和61.2%,不同糖代谢状况人群高血压患病率不同(χ2=306.672,P<0.001).糖尿病前期(pre‐DM)人群与糖代谢正常人群相比,随着糖代谢异常程度的加重,高血压患病率群增加,存在线性趋势(χ2=299.009,P<0.001).糖代谢异常者中,未患高血压者的年龄、胆固醇、三酰甘油、低密度胆固醇脂蛋白、体质指数、腰围低于合并高血压者,差异有统计学意义(P<0.05).与正常糖代谢人群相比,糖尿病前期人群的高血压患病风险增加了1.5倍(OR=2.510,95%CI:2.156～2.922,P<0.001).考虑性别时糖尿病前期与高血压的关联强度无差别,同时考虑年龄、体质指数、向心性肥胖、血脂异常使糖代谢异常与高血压关联强度略有下降.结论 糖尿病前期人群高血压患病率高,糖尿病前期与高血压存在关联,即使考虑年龄、血脂异常、体质指数、向心性肥胖等因素,这种关联依然存在,因此对糖尿病前期人群需加强血压的管理,加强血脂异常、体质指数、向心性肥胖等危险因素干预,减少高血压的发生.

abstractsObjective To explore the relationship and influencing factors between pre‐diabetes mellitus (pre‐DM) and hypertension, providing evidence for formulating strategies for cardiovascular disease prevention and control. Methods We conducted this study from June 2013 to September 2014. Using stratified multistage random sampling, participants were administered a questionnaire survey, their height, weight, waist circumference, hip circumference, other physical attributes, blood pressure and blood lipids were measured. They also underwent the 75‐g glucose tolerance test and other laboratory examinations. A logistic regression model was used to analyze the relationship between pre‐DM and hypertension and its influencing factors. Results A total of 4 002 participants completed the survey. Participants'mean age was 50.3 ± 11.8 years. Of the total participants, 1 962 (49.0%) were males, while 2 039 (51.0%) were females; 1 participant had missing gender data. Further, 2 188 participants had normal glucose metabolism, 1 066 had pre‐DM, and 748 had diabetes. The prevalence of hypertension in participants with normal glucose metabolism, impaired fasting glucose, impaired glucose tolerance, both impaired fasting glucose and impaired glucose tolerance, and DM was 28.3%, 46.5%, 46.3%, 62.0%, and 61.2%, respectively. The prevalence of hypertension varied among people with different glucose metabolism (χ2=306.672, P<0.001). The prevalence of hypertension in the pre‐DM population increased with the aggravation of abnormal glucose metabolism compared to the normal glucose metabolism population, with a linear trend (χ2=299.009, P<0.001). Among those with abnormal glucose metabolism, there were differences in age, cholesterol, triglycerides, low‐density lipoproteins, body mass index, and waist circumference compared to those without hypertension (P<0.05). The risk of hypertension in the pre‐diabetic population was 1.5 times higher than that in the normal glucose metabolism population (OR=2.510, 95% CI: 2.156-2.922, P<0.001). There was no difference in the correlation intensity between pre‐DM and hypertension when gender was taken into account. Age and lipid abnormalities slightly decreased the correlation intensity between abnormal glucose metabolism and hypertension. Considering body mass index and centripetal obesity, the correlation intensity between abnormal glucose metabolism and hypertension could be reduced by controlling these factors. Conclusion The prevalence of hypertension is high in people with pre‐DM. There is a correlation between pre‐DM and hypertension, even when considering factors such as age, dyslipidemia, body mass index, and centripetal obesity. Therefore, it is necessary to strengthen the management of blood pressure in the pre‐diabetic population; improve early intervention for risk factors such as dyslipidemia, body mass index, and centripetal obesity; and reduce the occurrence of hypertension.