血浆致动脉硬化指数与中青年人群新发高血压发生风险的关系

The association between atherogenic index of plasma and the risk of new-onset hypertension in young and middle-aged individuals

    摘要
  • 摘要:
    目的 探讨血浆致动脉硬化指数（AIP）与中青年人群（年龄18～＜60岁）新发高血压的相关性。
    方法  利用开滦研究前瞻性队列数据库，选取2006年6月至2007年10月参加开滦集团职工健康查体的中青年人群作为研究对象，共纳入43 825例参与者进行回顾性队列研究。根据AIP的四分位数将参与者分为4组：第1四分位组（AIP＜−0.63）；第2四分位组（AIP −0.63～＜−0.24）；第3四分位组（AIP −0.24～＜0.23）；第4四分位组（AIP≥0.23）。用Kaplan-Meier法绘制累积发病率曲线，并采用log-rank检验比较组间差异；采用Cox比例风险回归模型探究AIP与新发高血压的相关性。
    结果  中位随访8.97年，共有新发高血压14 680例（33.50 %）。第1～4四分位组累积新发高血压发病率分别为34.53 %、38.79 %、43.26 %和51.07 %。在多因素Cox回归分析中，校正混杂因素后，结果显示：与第1四分位组相比，第2～4四分位组新发高血压的HR（95%CI）分别为1.06（1.01～1.12）、1.11（1.06～1.16）、1.23（1.17～1.29）。AIP每增加一个标准差（0.67），发生新发高血压的HR（95%CI）为1.08（1.05～1.10）。排除2年内新发高血压（n=1 887）以及服用降糖药及降脂药的研究对象（n=2 758）后分别进行敏感性分析，结果与主要分析结果相似。死亡竞争风险分析结果与主要分析结果相似。AIP分组与年龄、性别之间存在交互作用（P＜0.05）。
    结论  AIP是中青年人群新发高血压发病风险的独立危险因素。

     

    Abstract:
    Objective To investigate the correlation between atherogenic index of plasma (AIP) and new-onset hypertension in young and middle-aged population (age ＜ 60 years).
    Methods  A retrospective cohort study was conducted using the prospective cohort database (Kailuan Study), selecting middle-aged and young adults who participated in the Kailuan Group employee health examination from June 2006 to October 2007 as study subjects, with a total of 43 825 participants included. The participants were divided into four groups according to the quartile of AIP: group Q1 (AIP＜−0.63); group Q2 (AIP −0.63 to ＜−0.24); group Q3 (AIP −0.24 to ＜0.23); group Q4 (AIP≥0.23). The cumulative incidence curve was plotted using the Kaplan-Meier method, and the difference between groups was compared using the log-rank test. Cox proportional hazards regression model was used to investigate the association between AIP and incident hypertension.
    Results The median follow-up was 8.97 years. There were 14 680 (33.50 %) cases of new-onset hypertension. The cumulative incidence of new-onset hypertension in groups Q1 to Q4 was 34.53 %, 38.79 %, 43.26 % and 51.07%, respectively. In multivariate Cox regression analysis, the HR (95%CI) for new-onset hypertension in groups Q2 to Q4 was 1.06 (1.01–1.12), 1.11 (1.06–1.16) and 1.23 (1.17–1.29), respectively, compared with the AIP group Q1, after adjustment for confounders. For each one standard deviation (0.67) increase in mean AIP , the HR (95%CI) for new-onset hypertension was 1.08 (1.05–1.10). Sensitivity analyses were performed after excluding patients with new-onset hypertension within 2 years (n=1 887) and those taking hypoglycaemic and lipid-lowering medications (n=2 758), and the results were similar to those in the main analysis.The risk analysis for competing death was performed, and the result was similar to that of the main analysis. There was interaction between AIP group and age or gender (P＜0.05).
    Conclusion AIP is an independent risk factor for new-onset hypertension in young and middle-aged people.

     

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