Age-specific difference in the association between prediabetes and subclinical atherosclerosis: an analysis of a chinese prospective cohort study.
Age-specific difference in the association between prediabetes and subclinical atherosclerosis: an analysis of a chinese prospective cohort study.
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DOI：
10.1186/s12933-022-01592-8
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发表时间：
2022-08-10
影响因子：
9.3
通讯作者：
Li, Mian
中科院分区：
文献类型：
--
作者：
Cao, Qiuyu;Xin, Zhuojun;He, Ruixin;Wang, Tiange;Xu, Min;Lu, Jieli;Dai, Meng;Zhang, Di;Chen, Yuhong;Zhao, Zhiyun;Wang, Shuangyuan;Lin, Hong;Wang, Weiqing;Ning, Guang;Bi, Yufang;Xu, Yu;Li, Mian
糖尿病前期是心血管疾病（CVD）的重要危险因素，与亚临床动脉粥样硬化相关。然而，糖尿病前期作为心血管危险因素的证据主要来自中年人。最近，多项研究支持老年人的前驱糖尿病不会导致CVD或死亡率的风险升高。我们的目的是在一项中国前瞻性队列研究中研究糖尿病前期和亚临床动脉粥样硬化之间的年龄特异性差异。我们纳入了4739名年龄≥ 40岁且无糖尿病或CVD病史的个体，并将其分为中年人（年龄< 60岁）和老年人（年龄≥ 60岁）。在基线时测量空腹血糖（FPG）、负荷后2小时血糖（2 h-PPG）和糖化血红蛋白（HbA 1c），以确定糖尿病前期状态。在随访时，通过肱踝脉搏波速度（baPWV）和颈动脉内膜中层厚度（CIMT）评估亚临床动脉粥样硬化状态。采用Logistic回归分析、限制性三次样条函数和交叉滞后路径分析进行统计学分析。60岁以上1634例，糖尿病前期占64.3%。3105名40-59岁的受试者中，49.3%患有前驱糖尿病。我们发现，糖尿病前期与中年人亚临床动脉粥样硬化风险增加有关，但这种关联在老年人中明显减弱。与正常葡萄糖耐量相比，糖耐量受损（IGT）仅在老年人中与baPWV增加风险降低39%相关。与此一致，在老年人中，2 h-PPG与baPWV升高风险之间的相关性为“U形”，而在中年人中，baPWV升高风险随2 h-PPG线性增加。在交叉滞后分析中，FPG和2 h-PPG的增加在老年人中并不先于baPWV的增加，但在中年人中似乎与baPWV同时增加。我们的研究结果表明，前驱糖尿病可能是较少相关的亚临床动脉粥样硬化在老年人比中年人，并建议年龄是重要的考虑在照顾成人前驱糖尿病。在线版本包含补充材料，可通过10.1186/s12933-022-01592-8获得。
Prediabetes is an important risk factor of cardiovascular disease (CVD) and is associated with subclinical atherosclerosis. However, the evidence of prediabetes as a cardiovascular risk factor is mainly derived from middle-aged adults. Recently, multiple studies supported that prediabetes in older adults would not lead to higher risk of CVD or mortality. We aimed to investigate the age-specific difference in the association between prediabetes and subclinical atherosclerosis in a Chinese prospective cohort study. We included 4739 individuals aged ≥ 40 years and without diagnosed diabetes or CVD history, and divided them into middle-aged adults (age < 60) and older adults (age ≥ 60). Fasting plasma glucose (FPG), 2-h post-load plasma glucose (2 h-PPG) and glycated hemoglobin (HbA1c) were measured at baseline to identify prediabetes status. At follow-up visits, subclinical atherosclerosis status was assessed by branchial-ankle pulse wave velocity (baPWV) and carotid intima-media thickness (CIMT). Logistic regression analysis, restricted cubic splines and cross-lagged path analysis were used in statistical analysis. 1634 participants aged over 60 years, and 64.3% of them had prediabetes. 3105 participants aged 40–59 years, and 49.3% of them had prediabetes. We found that prediabetes was associated with increased risk of subclinical atherosclerosis in middle-aged adults, but the association attenuated substantially in older adults. Impaired glucose tolerance (IGT), compared to normal glucose tolerance, was associated with 39% lower risk of increased baPWV only in older adults. In accordance, the association between 2 h-PPG and risk of increased baPWV was “U-shaped” in older adults, while risk of elevated baPWV increased linearly with 2 h-PPG in middle-aged adults. In the cross-lagged analysis, increase in FPG and 2 h-PPG tended not to precede increase in baPWV in older adults, but appeared to increase simultaneously with baPWV in middle-aged ones. Our results indicated that prediabetes might be less related to subclinical atherosclerosis in older adults than in middle-aged adults and suggested that age was important to consider in the care of adults with prediabetes. The online version contains supplementary material available at 10.1186/s12933-022-01592-8.
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DOI：
10.1136/bmj.i5953
发表时间：
2016-11-23
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Huang Y;Cai X;Mai W;Li M;Hu Y
通讯作者：
Hu Y
影响因子：
2
作者：
DURRLEMAN, S;SIMON, R
通讯作者：
SIMON, R
三种新型胰岛素抵抗相关血脂指数在中国农村空腹血糖正常人群中预测 2 型糖尿病的效用
影响因子：
4.5
作者：
Wang, Bingyuan;Zhang, Ming;Hu, Dongsheng
通讯作者：
Hu, Dongsheng
影响因子：
3.5
作者：
Deedwania, Prakash;Patel, Kanan;Ahmed, Ali
通讯作者：
Ahmed, Ali
影响因子：
16.2
作者：
Tang, Olive;Matsushita, Kunihiro;Selvin, Elizabeth
通讯作者：
Selvin, Elizabeth