糖尿病临床流行病学

　　【摘要】 目的 探讨糖尿病人群不同类型高血压的发病率及影响因素。方法 选择基线血压正常的糖尿病患者2367例，观察平均25.6月后进展为不同类型高血压的发病率及影响因素。 结果 进展为单纯收缩期高血压(ISH)、单纯舒张期高血压(IDH)及收缩期-舒张期双期高血压(SDH)的标化发病率(/1000人年)分别为80.2、89.2、130.8，男性为81.7、97.9、145.6，女性为66.8、55.6、80.3。影响糖尿病人群进展为ISH的危险因素是年龄、SBP及BMI (RR分别为2.409、2.757、1.807，P<0.05);进展为IDH的危险因素是男性、DBP、BMI、SUA(RR分别为2.064、1.771、1.569、1.463，P<0.05);进展为IDH的保护因素是年龄、糖尿病病程5年以上(RR分别为0.809、0.552，P<0.05);进展为SDH的危险因素是男性、SBP、BMI、TG、LDL-C(RR分别为1.882、2.720、1.549、1.284、1.410，P<0.05)。 结论 糖尿病人群SDH的标化发病率最高，高血压各亚型发病影响因素不同，且有性别差异。

　　【关键词】糖尿病; 单纯收缩期高血压; 单纯舒张期高血压; 收缩期-舒张期双期高血压;发病率; 影响因素

　　【Abstract】 Objective To explore the incidence and influencing factors of hypertension subtypes in diabetes patients. Methods The data was derived from of 2367 diabetes patients with normal blood pressure , was collected, and the incidence of hypertension subtypes and the influencing factors were observed after mean 25.6 months later. Results The standardized incidences of Isolated Systolic Hypertension (ISH),Isolated Diastolic Hypertension (IDH),Systolic Diastolic Hypertension (SDH) were was 80.2,89.2,130.8(per 1000 persons-year),respectively. They were Which was 81.7,97.9,145.6 in male and 66.8,55.6,80.3 in female, respectively. Binary logistic regression showed that the risk factors of ISH were age,SBP, and BMI (respectively , RR 2.409,2.757,1.807，P<0.05). The risk factors of IDH were male, DBP,BMI,UA(respectively, RR 2.064,1.771,1.569,1.463,respectively P<0.05),and the protective protect factors of IDH were age and more than 5 years diabetes duration(respectively, RR 0.809,0.552, respectively, P<0.05). The risk factors of SDH weremale,SBP,BMI,TG,LDL-C)( respectively, RR 1.882,2.720,1.549,1.284,1.410, respectively P<0.05). Conclusion The standardized incidence of SDH was the highest of all diabetes hypertension subtypes. The influencing factors havehas gender and subtypes difference in diabetes hypertension subtypes.

　　【Key words】Diabetes mellitus; Isolated Systolic Hypertension ; Isolated Diastolic Hypertension; Systolic Diastolic Hypertension;Incidence; Influencing factors