1.Analysis of the relationship and influencing factors between pre?diabetes mellitus and hypertension
Lianying WANG ; Xiuying ZHANG ; Xiangshuang KONG ; Zuodi FU ; Cuiling ZHAO ; Lijuan WANG ; Yajing ZHANG ; Linong JI ; Yufeng LI
Chinese Journal of Health Management 2019;13(4):308-313
Objective To explore the relationship and influencing factors between pre‐diabetes mellitus (pre‐DM) and hypertension, providing evidence for formulating strategies for cardiovascular disease prevention and control. Methods We conducted this study from June 2013 to September 2014. Using stratified multistage random sampling, participants were administered a questionnaire survey, their height, weight, waist circumference, hip circumference, other physical attributes, blood pressure and blood lipids were measured. They also underwent the 75‐g glucose tolerance test and other laboratory examinations. A logistic regression model was used to analyze the relationship between pre‐DM and hypertension and its influencing factors. Results A total of 4 002 participants completed the survey. Participants'mean age was 50.3 ± 11.8 years. Of the total participants, 1 962 (49.0%) were males, while 2 039 (51.0%) were females; 1 participant had missing gender data. Further, 2 188 participants had normal glucose metabolism, 1 066 had pre‐DM, and 748 had diabetes. The prevalence of hypertension in participants with normal glucose metabolism, impaired fasting glucose, impaired glucose tolerance, both impaired fasting glucose and impaired glucose tolerance, and DM was 28.3%, 46.5%, 46.3%, 62.0%, and 61.2%, respectively. The prevalence of hypertension varied among people with different glucose metabolism (χ2=306.672, P<0.001). The prevalence of hypertension in the pre‐DM population increased with the aggravation of abnormal glucose metabolism compared to the normal glucose metabolism population, with a linear trend (χ2=299.009, P<0.001). Among those with abnormal glucose metabolism, there were differences in age, cholesterol, triglycerides, low‐density lipoproteins, body mass index, and waist circumference compared to those without hypertension (P<0.05). The risk of hypertension in the pre‐diabetic population was 1.5 times higher than that in the normal glucose metabolism population (OR=2.510, 95% CI: 2.156-2.922, P<0.001). There was no difference in the correlation intensity between pre‐DM and hypertension when gender was taken into account. Age and lipid abnormalities slightly decreased the correlation intensity between abnormal glucose metabolism and hypertension. Considering body mass index and centripetal obesity, the correlation intensity between abnormal glucose metabolism and hypertension could be reduced by controlling these factors. Conclusion The prevalence of hypertension is high in people with pre‐DM. There is a correlation between pre‐DM and hypertension, even when considering factors such as age, dyslipidemia, body mass index, and centripetal obesity. Therefore, it is necessary to strengthen the management of blood pressure in the pre‐diabetic population; improve early intervention for risk factors such as dyslipidemia, body mass index, and centripetal obesity; and reduce the occurrence of hypertension.
2.Study on the value of the Epworth sleepiness scale in assessing the severity of type 2 diabetes mellitus with obstructive sleep apnea hypopnea syndrome
Xiangshuang KONG ; Lianying WANG ; Jiahui YIN ; Xinhui YANG ; Cuiling ZHAO ; Yufeng LI
Chinese Journal of Diabetes 2024;32(7):510-514
Objective To evaluate the clinical screening value of the Epworth sleepiness scale(ESS)for patients with type 2 diabetes mellitus(T2DM)and obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 399 hospitalized T2DM patients were selected for portable monitoring(PM)and ESS assessment.Based on the presence or absence of OSAHS,the study was divided into a simple T2DM group(T2DM,n=143)and a group with comorbid OSAHS(OSAHS,n=256).According to the apnea-hypopnea index(AHI),the study participants were categorized into a normal group(AHI<5 times/h,n=143),a mild OSAHS group(AHI 5~15 times/h,n=147),a moderate OSAHS group(AHI>15~30 times/h,n=69),and a severe OSAHS group(AHI>30 times/h,n=40).Differences in ESS scores across various OSAHS severity groups were compared.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the screening value of ESS for OSAHS.Results Body mass index,proportion of obesity,proportion of central obesity,serum creatinine and fasting C-peptide were significantly higher the OSAHS group compared to the non-OSAHS group(P<0.05).Significant statistical differences in ESS scores were observed between the severe and mild OSAHS groups(P=0.006).When an ESS score of≥9 was used as the threshold for screening OSAHS,the concordance rate with PM diagnosis was 40.6%.ROC curve analysis revealed that the area under the curve(AUC)for ESS screening for OSAHS,moderate-to-severe OSAHS,and severe OSAHS,and their respective optimal thresholds(95%CI),were as follows 0.518(95%CI 0.459~0.577,P=0.545),0.571(95%CI 0.507~0.635,P=0.029)and 0.624(95%CI 0.531~0.718,P=0.010),with cutoffs of≥2 points,≥3 points,and≥4 points,respectively.Conclusions An increased ESS score in T2DM patients significantly indicates the likelihood of severe OSAHS.Using an ESS score of≥9 as a threshold to screen for OSAHS is ineffective,whereas an ESS score of≥3 for screening moderate-to-severe OSAHS and≥4 for severe OSAHS has some reference value.
3.Hemodynamic Analysis on Functional End-to-Side Anastomosis of Autogenous Arteriovenous Fistula
Hongyu YANG ; Yuwen LIU ; AMANGUL·HAYRAT ; Xiangshuang ZHAO ; MARHABA·DAMAOLA ; Zhuotao XIAO
Journal of Medical Biomechanics 2022;37(1):E118-E123
Objective To explore the hemodynamic characteristics in functional side-to-end (STE) anastomosis arteriovenous fistula (AVF) by computational fluid dynamics (CFD), so as to provide theoretical basis for clinical application of the AVF. Methods AVF models of functional STE anastomosis (STE group) and conventional STE anastomosis (cSTE group) were established. The hemodynamic parameters of models in two groups under retrograde and antegrade flow states were analyzed, including blood flow velocity, pressure drop, low wall shear stress area (LWSSA). Results Under retrograde flow, the total LWSSA in STE group was 5.70% lower than that in cSTE group, and the LWSSA on venous wall in STE group was 49.71% lower than that in cSTE group. Under antegrade flow, the total LWSSA in STE group was 6.97% greater than that in cSTE group, and the LWSSA on venous wall in STE group was 10.62% lower than that in cSTE group. Conclusions Under retrograde flow state, functional STE anastomosis can significantly decrease the LWSSA of AVF, while under antegrade flwo state, functional STE anastomosis has no significant impact on improving the LWSSA of AVF.