CAJ | 학술논문

目的分析大庆糖尿病预防研究中糖耐量受损(IGT)人群随访6年期间的糖耐量演变及其与血压变化的关联.方法大庆糖尿病预防研究中有334例IGT患者未曾服用任何降血压药物,其中264例基线血压≥130/80 mm Hg(1mm Hg=0.133kPa).随机分配在对照、饮食、运动及饮食加运动干预4个组.从1986年随访到1992年.根据研究结束时口服葡萄糖耐量试验(OGTY)2h血糖水平(2hPG)分为<7.8、7.8～8.8、8.9～9.9、10.0～11.0、11.1～13.8、13.9～16.6和≥16.7mmol/L7个亚组,探讨各组血压水平的变化及其与血糖变化的关联.结果经多因素分析调整了年龄、性别、基线体重指数及随访期体重变化等因素的影响后,1986至1992年间各组的收缩压改变分别为-2.4、0.6、7.7、4.3、1.7、-2.9、和-6.9 mm Hg,舒张压变化为-3.2、3.0、3.3、1.7、-0.7、-1.3和-3.7 mm Hg.收缩压和舒张压在演变为糖耐量正常或糖尿病者比那些仍然保持为IGT且2hPG在8.9～9.9mmol/L者显著下降(均P<0.05).264 例基线血压≥130/80 mm Hg者中血压变化更为显著.在上述各组,收缩压变化分别为-5.2、-2.6、5.2、2.3、-2.3、-4.2、-7.6 mm Hg,舒张压变化分别为-5.0、-3.7、1.5、-2.9、-4.3、-4.0和-6.0mm Hg.结论大庆6年研究中IGT人群中血糖水平仍保持为IGT者血压有所升高.相反,IGT转化为正常糖耐量或糖尿病组血压明显下降.
목적 분석대경당뇨병예방연구중당내량수손(IGT)인군수방6년기간적당내량연변급기여혈압변화적관련.방법 대경당뇨병예방연구중유334례IGT환자미증복용임하강혈압약물,기중264례기선혈압≥130/80 mm Hg(1mm Hg=0.133kPa).수궤분배재대조、음식、운동급음식가운동간예4개조.종1986년수방도1992년.근거연구결속시구복포도당내량시험(OGTY)2h혈당수평(2hPG)분위<7.8、7.8～8.8、8.9～9.9、10.0～11.0、11.1～13.8、13.9～16.6화≥16.7mmol/L7개아조,탐토각조혈압수평적변화급기여혈당변화적관련.결과 경다인소분석조정료년령、성별、기선체중지수급수방기체중변화등인소적영향후,1986지1992년간각조적수축압개변분별위-2.4、0.6、7.7、4.3、1.7、-2.9、화-6.9 mm Hg,서장압변화위-3.2、3.0、3.3、1.7、-0.7、-1.3화-3.7 mm Hg.수축압화서장압재연변위당내량정상혹당뇨병자비나사잉연보지위IGT차2hPG재8.9～9.9mmol/L자현저하강(균P<0.05).264 례기선혈압≥130/80 mm Hg자중혈압변화경위현저.재상술각조,수축압변화분별위-5.2、-2.6、5.2、2.3、-2.3、-4.2、-7.6 mm Hg,서장압변화분별위-5.0、-3.7、1.5、-2.9、-4.3、-4.0화-6.0mm Hg.결론 대경6년연구중IGT인군중혈당수평잉보지위IGT자혈압유소승고.상반,IGT전화위정상당내량혹당뇨병조혈압명현하강.
Objective To investigate the blood pressure change in relation to the evolution of impaired glucose tolerance (IGT). Methods From 1986 to 1992, 334 subjects with IGT were randomized to placebo, diet, exercise and diet plus exercise intervention groups. No anti-hypertension drug was given to these enrolled subjects. Blood pressure was measured at the beginning and the end of the six-year prospective study. In this analysis these subjects were stratified to seven subgroups based on 2 h plasma glucose (2hPG) level during OGTT at the end of the study: < 7.8,7.8~8.8,8.9~9.9,10.0~11.0,11.1~13.8,13.9~16.6 and≥16.7mmol/L. Blood pressure changes in relation to the evolution of glucose tolerance in these subgroups were compared by least square mean procedure. Results Changes of systolic blood pressure (SBP) in average in these seven groups were -2.4,0.6,7.7,4.3,1.7,-2.9and-6.9mm Hg (1mm Hg=0.133kPa), and changes of diastolic blood pressure (DBP) were-3.2,3.0,3.3,1.7,-0.7,-1.3 and-3.7mm Hg respectively after controlling for age, sex, BMI at baseline and Δ BMI during the follow-up period. In those subjects with IGT evolved into normal glucose tolerance (NGT) or diabetes, reductions in SBP and DBP were significantly greater than those who retained IGT with 2hPG between 8.9-9.9mmol/L (all P < 0.05 ). In 264 out of the 334 subjects with IGT and blood pressure≥130/80mm Hg at baseline, blood pressure changed more strikingly: changes of SBP in these groups were-5.2,-2.6,5.2,2.3,-2.3,-4.2,-7.6mm Hg, and DBP were -5.0, -3.7,1.5, -2.9, -4.3, - 4.0 and-6.0mm Hg respectively after the adjustment of age, sex, BMI, BMI variation. The reductions of SBP and DBP in subjects whose status of IGT was converted to NGT or diabetes were significantly greater than those with retained IGT and 2hPG between 8.9-9.9mmol/L. Conclusion Blood pressure is increased in the subjects with IGT who retained in the IGT group during the six-year follow-up period in Da-Qing Study. On the contrary, subjects with IGT evolved into NGT or diabetes demonstrate significant reduction of blood pressure.