上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2020, Vol. 40 ›› Issue (4): 494-.doi: 10.3969/j.issn.1674-8115.2020.04.013

• 论著·临床研究 • 上一篇    下一篇

基于倾向性评分匹配法探索血糖与动脉硬化的关系

董姣姣1，唐 兰2，孙艳丽2，姚晓倩1，王 婧1，王永红2，彭 斌1   

  1. 1. 重庆医科大学公共卫生与管理学院，医学与社会发展研究中心，健康领域社会风险预测治理协同创新中心，重庆 400016；2. 重庆医科大学附属第一医院体检中心，重庆 400042
  • 出版日期:2020-04-28 发布日期:2020-05-22
  • 通讯作者: 彭 斌，电子信箱：pengbin@cqmu.edu.cn。
  • 作者简介:董姣姣（1993—），女，硕士生；电子信箱：dongjiaoj@163.com。
  • 基金资助:
    重庆市卫生和计划生育委员会项目（20142016）。

Exploring the relationship between blood glucose and arteriosclerosis based on propensity score matching

DONG Jiao-jiao, TANG Lan, SUN Yan-li, YAO Xiao-qian, WANG Jing, WANG Yong-hong, PENG Bin   

  1. 1. School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China; 2. Physical Examination Center, The First Affiliated Hospital of Chongqing Medical University. Chongqing 400042, China
  • Online:2020-04-28 Published:2020-05-22
  • Supported by:
    Project of Chongqing Health and Family Planning Commission (20142016).

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摘要： 目的·以心踝血管指数（cardio-ankle vascular index, CAVI）为动脉硬化指示指标，探索血糖与动脉硬化的关系。方法·选取2016—2018年在重庆医科大学附属第一医院体检中心完成体检的8 547名成年人（年龄≥18岁），收集CAVI及相关生理生化指标。以空腹血糖、是否有糖尿病史为标准将研究对象分为血糖正常组与高血糖组，采用1:1倾向性评分匹配法匹配2组的性别、年龄、血压、血脂、体质量指数以均衡组间协变量。匹配后数据采用Logistic回归与限制性立方样条法（restricted cubic spline，RCS）分析空腹血糖与CAVI的关联及剂量-效应关系。结果·共1 463对完成倾向性评分匹配，匹配后2组间协变量达到基本平衡。Logistic回归分析结果显示，高血糖是CAVI的危险因素（OR1.63，95% CI 1.36～1.95）。空腹血糖与CAVI异常风险的RCS曲线整体呈现上升趋势，即随着空腹血糖水平的增高CAVI异常的风险也随之增大。结论·随着空腹血糖水平的升高，发生动脉硬化的危险性随之升高。

关键词: 心踝血管指数, 动脉硬化, 血糖, 倾向性评分匹配法

Abstract:

Objective · To explore the relationship between blood glucose and arteriosclerosis with cardio-ankle vascular index (CAVI) as the indicator of arteriosclerosis. Methods · 2016 to 2018, a total of 8 547 participants aged 18 years and above who completed physical examinations in the Physical Examination Center of the First Affiliated Hospital of Chongqing Medical University were selected to collect CAVI and other relevant biochemical indicators. Based on fast blood glucose (FBG) and history of diabetes, the subjects were divided into normal blood glucose group and hyperglycemia group. The 1:1 propensity score matching was used to match the gender, age, blood pressure, blood lipids, and body mass index to balance the covariates between the groups. The matched data were analyzedLogistic regression and restricted cubic spline (RCS) to explore the relationship and the dose-effect relationship between FBG and CAVI. Results · A total of 1 463 pairs completed propensity score matching, and the covariates between the two groups were balanced after matching. Logistic regression analysis showed that hyperglycemia was a risk factor of CAVI (OR1.63, 95% CI 1.36-1.95). The RCS curve of FBG and CAVI abnormal risk showed an upward trend, i.e., as FBG increased, the risk of CAVI abnormalities increased. Conclusion · As the fasting blood glucose increases, the risk of arteriosclerosis also increases.

Key words: cardio-ankle vascular index (CAVI), arteriosclerosis, blood glucose, propensity score matching (PSM)