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肱踝脉搏波速度与非糖尿病及新诊断糖尿病中国人群心血管危险因素:广州生物库队列研究-心血管疾病。

Brachial-ankle pulse wave velocity and cardiovascular risk factors in the non-diabetic and newly diagnosed diabetic Chinese: Guangzhou Biobank Cohort Study-CVD.

机构信息

Department of Community Medicine, School of Public Health, The University of Hong Kong, Hong Kong.

出版信息

Diabetes Metab Res Rev. 2010 Feb;26(2):133-9. doi: 10.1002/dmrr.1059.

Abstract

BACKGROUND

Increased arterial stiffness is an important cause of cardiovascular disease (CVD). We examined determinants of arterial stiffness in subjects across strata of glycaemic status.

METHODS

A total of 1249 subjects from a sub-study of the Guangzhou Biobank Cohort Study (GBCS-CVD) had brachial-ankle pulse wave velocity (baPWV) measured by automatic oscillometric method. Major cardiovascular risk factors including glycosylated haemoglobin A1c (HbA(1c)), high sensitivity C-reactive protein (hsCRP), fasting triglyceride, low- and high-density lipoprotein cholesterol and both fasting and post 2-h oral glucose-load glucose, systolic and diastolic blood pressure were assessed.

RESULTS

In all, 649, 479 and 121 subjects were classified into normoglycaemia, impaired glucose metabolism (IGM) and newly diagnosed diabetes groups, respectively. Both age and systolic blood pressure were significantly associated with increased baPWV in all three groups (all p < 0.001). In both normoglycaemic and IGM groups, hsCRP and HbA(1c) were positively associated with baPWV (p from 0.04 to < 0.001), whereas current smoking and triglyceride were associated with baPWV in the normoglycaemic and IGM group, respectively (p = 0.04 and 0.001). No gender difference in baPWV was observed in the normoglycaemic or IGM groups. However, in the newly diagnosed diabetes group, men had higher baPWV than women (p = 0.01).

CONCLUSIONS

In the normoglycaemic and IGM subjects, after adjusting for age, blood pressure and other confounders, increasing HbA(1c) was associated with increased baPWV, suggesting a pathophysiological role of chronic glycaemia that can contribute to vascular disease risk in persons without diabetes.

摘要

背景

动脉僵硬度增加是心血管疾病(CVD)的一个重要原因。我们研究了各血糖状态人群中动脉僵硬度的决定因素。

方法

来自广州生物库队列研究(GBCS-CVD)子研究的 1249 名受试者使用自动振荡法测量了肱踝脉搏波速度(baPWV)。评估了主要心血管危险因素,包括糖化血红蛋白 A1c(HbA1c)、高敏 C 反应蛋白(hsCRP)、空腹甘油三酯、低和高密度脂蛋白胆固醇以及空腹和口服葡萄糖负荷后 2 小时血糖、收缩压和舒张压。

结果

共 649、479 和 121 名受试者分别归入正常血糖、糖代谢受损(IGM)和新诊断糖尿病组。在所有三组中,年龄和收缩压均与 baPWV 的增加显著相关(均 P<0.001)。在正常血糖和 IGM 组中,hsCRP 和 HbA1c 与 baPWV 呈正相关(P 值从 0.04 到<0.001),而在正常血糖和 IGM 组中,当前吸烟和甘油三酯与 baPWV 相关(P=0.04 和 0.001)。在正常血糖或 IGM 组中,baPWV 无性别差异。然而,在新诊断的糖尿病组中,男性的 baPWV 高于女性(P=0.01)。

结论

在正常血糖和 IGM 受试者中,在校正年龄、血压和其他混杂因素后,HbA1c 的增加与 baPWV 的增加相关,这表明慢性血糖对无糖尿病者的血管疾病风险有病理生理学作用。

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