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首页> 外文期刊>JEMDSA: Journal of Endocrinology, Metabolism and Diabetes of South Africa (JEMSDA) : The Official Journal of the Society of Endocrinology, Metabolism, and Diabetes of South Africa >Lack of association of glycated haemoglobin with blood pressure and subclinical atherosclerosis in black South Africans: a five-year prospective study
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Lack of association of glycated haemoglobin with blood pressure and subclinical atherosclerosis in black South Africans: a five-year prospective study

机译：南非黑人缺乏糖化血红蛋白与血压和亚临床动脉粥样硬化的关联：一项为期五年的前瞻性研究

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Objectives: Hypertension and diabetes are common in rapidly urbanising sub-Saharan African communities. However, lack of longitudinal data in these regions prevents adequate analysis of the link between measures of glycaemia and cardiovascular disease. Therefore, we examined the relationships of fasting glucose and glycated haemoglobin (HbA1c) with brachial and central blood pressure (BP), and measures of vascular structure and function after five years in black South Africans.Setting and subjects: Nine hundred and twenty-eight participants were included as part of the Prospective Urban Rural Epidemiological (PURE) study in the North West Province.Outcome measures: Fasting glucose, HbA1c and brachial BP at two time points were determined. Central BP, augmentation index (AI) and carotid intima-media thickness (CIMT) were taken at follow-up.Results: Fasting glucose [4.78 (3.50, 6.30) vs. 5 mmol/l (3.96, 6.42)]; HbA1c [5.6 (4.9, 6.3) vs. 5.9% (5.2, 6.9) and (37 vs. 41 mmol/mol)]; and BP (134/88.1 vs. 138/89.5 mmHg) increased significantly over five years (p-value 1c. Multivariate analyses confirmed that neither glucose or HbA1c predicted changes in BP, CIMT or AI, but factors that did associate significantly were age, male gender, rural location, abdominal obesity, alcohol intake, total cholesterol to high-density lipoprotein ratio, C-reactive protein and antihypertensive medication (R2, ranging from 0.24-0.36).Conclusion: Although both BP and measures of glycaemia increased significantly over five years in black South Africans, glucose was not independently associated with BP or measures of large artery structure or function. We suggest that fasting glucose and HbA1c below the threshold of diagnosing diabetes should not be used in isolation to predict cardiovascular risk in African individuals.
机译：目标：高血压和糖尿病在撒哈拉以南非洲迅速城市化地区很普遍。但是，这些地区缺乏纵向数据，无法对血糖测量与心血管疾病之间的联系进行充分的分析。因此，我们研究了南非黑人中禁食葡萄糖和糖化血红蛋白（HbA 1c ）与肱和中央血压（BP）的关系，以及五年后血管结构和功能的测量指标。受试者：西北省城市农村流行病学（PURE）研究中有982名参与者。结果测量：两次空腹血糖，HbA 1c 和臂丛性BP确定点。结果：空腹血糖[4.78（3.50，6.30）vs. 5 mmol / l（3.96，6.42）];空腹血糖[4.78（3.50，6.30）vs. 5 mmol / l（3.96，6.42）]。 HbA 1c [5.6（4.9，6.3）比5.9％（5.2，6.9）和（37 vs. 41 mmol / mol）];和BP（134 / 88.1 vs. 138 / 89.5 mmHg）在五年内显着增加（p值为1c 。多变量分析证实，葡萄糖或HbA 1c 均未预测BP，CIMT的变化或AI，但与年龄，男性，农村地区，腹部肥胖，饮酒，总胆固醇与高密度脂蛋白比，C反应蛋白和降压药物相关的因素密切相关（R 2 结论：尽管南非黑人在五年中血压和血糖测量指标均显着增加，但血糖与血压或大动脉结构或功能的测量指标无关，我们建议禁食血糖和HbA不能单独使用低于诊断糖尿病阈值的 1c 来预测非洲个体的心血管风险。

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