空腹葡萄糖调节受损与10年动脉粥样硬化性心血管疾病风险的相关性研究

Association of impaired fasting glucose with 10-year atherosclerotic cardiovascular disease risk

摘要:

目的：基于10年动脉粥样硬化性心血管疾病（atherosclerotic cardiovascular disease，ASCVD）风险评估模型，探究空腹葡萄糖调节受损（impaired fasting glucose，IFG）及空腹血糖（fasting blood glucose，FBG）水平与心血管疾病风险的相关性。方法：收集2015年7月至2017年4月在遵义医科大学附属医院心内科门诊、病房就诊的患者及来院体检者中具有FBG测定结果的研究对象362名纳入本研究，其中87名处于IFG状态。IFG根据世界卫生组织1999年发布的糖尿病诊疗指南中的定义进行界定（6.1 mmol/L≤FBG<7.0 mmol/L）。估计的10年ASCVD风险评分使用美国心脏病协会（ACC/AHA）实践指南工作组给出的计算方程进行统计。结果：与糖代谢正常的人群相比，IFG人群具有更高的体质指数、收缩压、FBG、餐后2 h血糖水平及甘油三酯水平（P<0.05）。多元logistic回归分析表明，在校正潜在相关的混杂因素后，与糖代谢正常组人群相比，IFG组与10年ASCVD风险升高（≥7.5%）明显相关[OR：95%CI=4.41（1.78~10.93），P=0.001]。限制性样条曲线表明，FBG与10年ASCVD风险评分密切相关。随着FBG水平的升高，10年ASCVD风险逐渐升高，其中当空腹血糖大于5.7 mmol/L时，10年ASCVD风险明显升高（≥7.5%）。结论：基于最新发布的10年ASCVD风险评估方程，空腹葡萄糖调节受损与心血管疾病风险升高密切相关。

Abstract:

Objective：To investigate the association of impaired fasting glucose（IFG） and fasting blood glucose（FBG） levels with the risk of cardiovascular disease based on the latest 10-year atherosclerotic cardiovascular disease（ASCVD） risk assessment model. Methods：The study enrolled 362 subjects with FBG measurement results from those patients who visited our internal medicine outpa－tient and wards of our hospital，and those who came to our hospital for physical examination，between July 2015 and April 2017，a－mong which 87 subjects in IFG status. The IFG is defined according to the definition of diabetes reported by the World Health Or－ganization in 1999（6.1 mmol/L≤FBG<7.0 mmol/L）. The estimated 10-year ASCVD risk score was calculated through the computa－tional equations given by the American Heart Association（ACC/AHA） Practice Guidelines Working Group. Results：Compared with people with normal glucose metabolism，statistical analysis showed that IFG people had higher body mass index，systolic blood pres－sure，diastolic blood pressure，FBG，and triglyceride levels（P<0.05）. Multivariate logistic regression indicated that，the IFG people was significantly associated with an increased risk of at 10-year ASCVD（≥7.5%）[OR：95%CI=4.41（1.78-10.93），P=0.001] compared to people with normal fasting glucose. FBG level was closely related to 10-year ASCVD risk score. With the increase of FBG level，the 10-year ASCVD risk gradually increased，especially when the FBG was higher than 5.7 mmol/L，the 10-year ASCVD risk was signifi－cantly increased（≥7.5%）. Conclusion：Based on the latest published 10-year ASCVD risk assessment equation，the study has found that both IFG and FBG levels are significantly associated with an increased risk of cardiovascular disease.