Association of home and office systolic and diastolic hypertension with glucose metabolism in a general population: the Ohasama study
Association of home and office systolic and diastolic hypertension with glucose metabolism in a general population: the Ohasama study
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DOI：
10.1097/hjh.0000000000003145
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发表时间：
2022-07-01
影响因子：
4.9
通讯作者：
Ohkubo, Takayoshi
中科院分区：
文献类型：
--
作者：
Tatsumi, Yukako;Satoh, Michihiro;Ohkubo, Takayoshi
目的：本研究旨在调查日本普通人群中高血压亚型与葡萄糖代谢的相关性。研究方法：这项研究涉及646名来自Ohasama（日本农村社区）的居民（平均年龄：62.4岁），他们没有接受高血压治疗或糖尿病史，接受了口服葡萄糖耐量试验。根据家庭和办公室SBP和DBP（分别为HBP和OBP）定义高血压亚型[血压正常、单纯收缩期高血压（ISH）、单纯舒张期高血压（IDH）和收缩期和舒张期高血压（SDH）]。通过调整可能的混杂因素的协方差分析比较各组间血糖相关指标的估计均值。结果：不同血压亚型间血糖相关指标无显著性差异。夜间高血压定义的ISH患者120分钟时的平均血糖估计值、胰岛素抵抗稳态模型评估值（HOMA-IR）和Matsuda-DeFronzo指数均显著高于NT患者（P均< 0.021）。OBP定义的SDH参与者的平均空腹血糖、30、60和120 min血糖、HOMA-IR和Matsuda-DeFronzo指数均显著高于NT参与者（均P < 0.0025）。结论：高血压各亚型间血糖相关指标存在差异。夜间HBP定义的ISH和OBP定义的SDH的参与者比相应定义的正常血压的参与者有更高的血糖水平和胰岛素抵抗，而早晨HBP的参与者则没有。这些发现表明测量夜间HBP和办公室血压对于早期发现并存的高血压和糖尿病的重要性。
Objective: This study was performed to investigate the association of hypertension subtypes with glucose metabolism among the Japanese general population. Methods: The study involved 646 residents (mean age: 62.4 years) without treatment for hypertension or a history of diabetes from Ohasama, a rural Japanese community, who underwent an oral glucose tolerance test. Hypertension subtypes [normotension, isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic and diastolic hypertension (SDH)] were defined on the basis of home and office SBP and DBP (HBP and OBP, respectively). The estimated means of blood glucose related indices among the groups were compared by analysis of covariance adjusted for possible confounding factors. Results: Blood glucose related indices were not different among the morning HBP-defined hypertension subtypes. Participants with evening HBP-defined ISH had a significantly higher estimated mean BG at 120 min, higher homeostasis model assessment-insulin resistance (HOMA-IR) and lower Matsuda-DeFronzo index than participants with NT (all P < 0.021). Participants with OBP-defined SDH had a significantly higher estimated mean fasting blood glucose; blood glucose at 30, 60 and 120 min; and HOMA-IR and a lower Matsuda-DeFronzo index than participants with NT (all P < 0.0025). Conclusion: The blood glucose related indices were different among hypertension subtypes. Participants with evening HBP-defined ISH and OBP-defined SDH had higher blood glucose levels and insulin resistance than participants with correspondingly defined normotension, while those with morning HBP did not. These findings suggest the importance of measuring evening HBP and office blood pressure for early detection of coexisting hypertension and diabetes.