老年男性人群高血压合并糖耐量减低与全因死亡风险的相关性

Association between hypertension with impaired glucose tolerance and risk of all-cause mortality in elderly males

摘要:

目的 探讨高血压合并糖耐量减低(IGT)对老年男性人群全因死亡风险的影响。方法 纳入2005年5月至2007年5月在解放军总医院第二医学中心行口服葡萄糖耐量试验检出的老年男性IGT患者和正常糖耐量(NGT)人群,根据基线时是否存在高血压病史和IGT分为4组:非高血压(NH)+正常糖耐量(NGT)组、高血压(H)+NGT组、NH+IGT组、H+IGT组,每年至少随访1次。采用SPSS 13.0统计软件进行数据分析。采用Cox回归模型分析不同组别全因死亡风险的差异。结果 与NH+NGT组比较,H+IGT组(HR=2.55,95%CI 1.56-4.16; P<0.001)和NH+IGT组(HR=2.40,95%CI 1.35-4.25; P=0.003)2型糖尿病发病风险显著升高。单因素Cox比例风险回归分析提示,与NH+NGT组比较,H+IGT组(HR=2.59,95%CI 1.34-5.01; P=0.005)全因死亡风险明显升高,而H+NGT组和NH+IGT组无统计学差异(P>0.05)。在调整相关危险因素后多因素Cox比例风险回归分析显示,H+IGT组(HR=1.83,95%CI 0.90-3.70; P=0.095)全因死亡风险较NH+NGT组虽无统计学差异(P>0.05),但有升高的趋势。结论 老年男性人群高血压合并IGT与全因死亡风险密切相关,高血压与IGT并存可导致全因死亡风险增加。

Abstract:

Objective To investigate the influence of hypertension with impaired glucose tolerance (IGT) on the risk of all-cause mortality in the elderly males. Methods The study included the elderly males with IGT and normal glucose tolerance (NGT) detected by oral glucose tolerance test in the Chinese PLA General Hospital from May 2005 to May 2007. According to the baseline history, they were divided into four groups (NH+NGT, H+NGT, NH+IGT, and H+IGT) and followed up at least once a year. SPSS statistics 13.0 was used for data analysis and Cox regression model for the analysis of the differences in all-cause mortality risk between the four groups. Results Compared with the NH+NGT group, the risk of incidental type 2 diabetic mellitus in the H+IGT group (HR=2.55,95%CI 1.56-4.16; P<0.001) and the NH+IGT group (HR=2.40,95%CI 1.35-4.25; P=0.003) significantly increased. Univariate Cox proportional hazard regression indicated that the risk of all-cause mortality in the H+IGT group (HR=2.59,95%CI 1.34-5.01; P=0.005) was significantly higher than the NH+NGT group, while there was no significant difference in H+NGT group and NH+IGT group as compared with NH+NGT group (P>0.05). After adjustment of related risk factors at baseline, multivariate Cox proportional hazard regression showed that the trend of all-cause mortality risk in H+IGT group (HR=1.83,95%CI 0.90-3.70; P=0.095) still increased as compared with NH+NGT group (P>0.05). Conclusion Hypertension with impaired glucose tolerance is closely associated with the risk of all-cause mortality in the elderly males. The coexistence of hypertension and IGT can further increase the risk of all-cause mortality.