Associations of blood glucose and prevalent diabetes with risk of cardiovascular disease in 500 000 adult Chinese: the China Kadoorie Biobank.
Associations of blood glucose and prevalent diabetes with risk of cardiovascular disease in 500 000 adult Chinese: the China Kadoorie Biobank.
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DOI：
10.1111/dme.12392
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发表时间：
2014-05
期刊：
影响因子：
--
通讯作者：
China Kadoorie Biobank Collaborative Group
中科院分区：
文献类型：
--
作者：
Bragg F;Li L;Smith M;Guo Y;Chen Y;Millwood I;Bian Z;Walters R;Chen J;Yang L;Collins R;Peto R;Lu Y;Yu B;Xie X;Lei Y;Luo G;Chen Z;China Kadoorie Biobank Collaborative Group
研究中国成年人自我报告的糖尿病和无已知糖尿病个体的随机血糖水平与心血管疾病患病率的关系。我们检查了中国嘉道理生物库2004-2008年期间从中国10个不同地区招募的50万名30-79岁人群的横断面数据。Logistic回归用于估计与自我报告的糖尿病相关的流行心血管疾病的比值比，并在无糖尿病史的参与者中测量随机血糖水平，同时调整年龄，性别，地区，教育，吸烟，酒精，血压和体力活动。总共有3.2%的参与者有自我报告的糖尿病（男性2.9%;女性3.3%），2.8%的参与者有筛查检测到的糖尿病（男性2.6%;女性2.8%），即他们没有自我报告的糖尿病史，但血糖水平提示糖尿病诊断。与无糖尿病史的个体相比，与自我报告的糖尿病相关的优势比分别为2.18（95% CI 2.06-2.30）和1.88（95% CI 1.75-2.01），流行性缺血性心脏病和卒中/短暂性脑缺血发作。在没有自我报告糖尿病的参与者中，随机血糖和缺血性心脏病与卒中/短暂性脑缺血发作患病率之间呈正相关（趋势P <0.0001）。低于糖尿病阈值（<11.1 mmol/l）时，每增加1 mmol/l随机血糖分别与4%（95% CI 2-5%）和5%（95% CI 3-7%）的普遍缺血性心脏病和卒中/短暂性脑缺血发作的几率增加相关。在这个中国成年人群中，自我报告的糖尿病与普遍心血管疾病的几率增加一倍有关。在糖尿病阈值以下，随机血糖与心血管疾病患病率之间仍存在适度的正相关。
To examine the relationship of self‐reported diabetes, and of random blood glucose levels among individuals without known diabetes, with the prevalence of cardiovascular disease in Chinese adults. We examined cross‐sectional data from the China Kadoorie Biobank of 0.5 million people aged 30–79 years recruited from 10 diverse regions of China in the period 2004–2008. Logistic regression was used to estimate the odds ratios of prevalent cardiovascular disease associated with self‐reported diabetes, and with measured random blood glucose levels among participants with no history of diabetes, adjusting simultaneously for age, sex, area, education, smoking, alcohol, blood pressure and physical activity. A total of 3.2% of participants had self‐reported diabetes (men 2.9%; women 3.3%) and 2.8% had screen‐detected diabetes (men 2.6%; women 2.8%), i.e. they had no self‐reported history of diabetes but a blood glucose level suggestive of a diagnosis of diabetes. Compared with individuals without a history of diabetes, the odds ratios associated with self‐reported diabetes were 2.18 (95% CI 2.06–2.30) and 1.88 (95% CI 1.75–2.01) for prevalent ischaemic heart disease and stroke/transient ischaemic attack, respectively. Among participants without self‐reported diabetes there was a positive association between random blood glucose and ischaemic heart disease and stroke/transient ischaemic attack prevalence (P for trend <0.0001). Below the diabetic threshold (<11.1 mmol/l) each additional 1 mmol/l of random blood glucose was associated with 4% (95% CI 2–5%) and 5% (95% CI 3–7%) higher odds of prevalent ischaemic heart disease and stroke/transient ischaemic attack, respectively. In this adult Chinese population, self‐reported diabetes was associated with a doubling of the odds of prevalent cardiovascular disease. Below the threshold for diabetes there was still a modest, positive association between random blood glucose and prevalent cardiovascular disease.
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