The Comparison Of Radial Augmentation Index In People With Different Glucose Tolerance Status And Analysis Of Its Influencing Factors

Background and Objective:The aortic stiffness is an independent risk of death of manifold cardiovascular diseases.The measurement of aortic stiffness is very important to prevent and reduce the deadly cardiovascular diseases.The augmentation index(AI) is an indicator of pulse wave reflections and aortic stiffness,and associated with the mortality of cardiovascular diseases independently,the radial AI(rAI) is a simple and easily-obtainable and useful index of aortic stiffness,but the study of rAI is lack in Chinese.The reference values of rAI of Chinese have been reported,but the influencing factors of rAI is not clear in Chinese.Abnormal glucose metabolism is significantly associated with the mortality of cardiovascular diseases,but there is controversy regarding the association between the AI or rAI and abnormal glucose metabolism.The present study is to investigate the main influencing factors of rAI in adults and people with different glucose tolerance status in Chinese and analyse the association between rAI and glucose metabolism.Material and Methods:All subjcets(4616 individuals) of this study were 18 to 92 years old,the average age was 50.52±14.94 years,28.7%(1328 individuals)≧60years.All subjects were residents in urban or the surrounding rural areas of Beijing.There were 2242 men and 2374 women.The basic information were collected by questionnaire,then the height,weight,waistline and blood pressure and biochemical indexes were measured.The rAI were measured using an automated tonometric method(HEM-9000AI).According to the result of OGTT and the diagnosis standards of diabetes mellitus,all subjects were divided into normal glucose(NG,3467 individuals),impaired fasting glucose(IFG,69 individuals),impaired glucose tolerance(IGT,600 individuals) and diabetes mellitus(DM,480 individuals) groups.Statistical analysis were performed using SPSS 13.0.Results:In a simple correlation analysis,rAI of all subjects showed a positive association with age,BMI,SBP,DBP,PP,MBP,total cholesterol, HDL-C,LDL-C,glucose(120min) and a negative association with height,weight and HR,women had significantly higher AI than men.Stepwise regression analysis revealed that sex(β=0.22,P＜0.01 ),age(β=0.27,P＜0.01 ),height(β=-0.22, P＜0.01 ),weight(β=-0.06,P＜0.01 ),HR(β=-0.41,P＜0.01 ) and MBP(β=0.19, P＜0.01 )were independent determinants of rAI.In a simple comparison,the rAI of IGT and DM were significantly higher than it of NG,the rAI of IFG had no significant difference with those of other three groups(P＞0.05),the rAI of IGT and DM had no significant difference each other(P＞0.05 ).After adjustment of age, the rAI of DM were significantly higher than it ofNG(P＜0.01),but rAI had no significant difference among other groups(/＞0.05),After adjustment of age,sex, MBP and HR,the rAI had no significant difference among four groups(/＞0.05). In a simple correlation analysis,rAI of NG showed a positive association with age, BMI,SBP,DBP,PP,MBP,total cholesterol,LDL-C and a negative association with height,weight and HR,rAI of IFG showed a positive association with total cholesterol,HDL-C,LDL-C,glucose(120min)and a negative association with height,weight and HR,rAI of IGT showed a positive association with age,waistline,SBP,PP,MBP,HDL-C and a negative association with height,weight,HR and fasting glucose,rAI of DM showed a positive association with age,SBP,PP,LDL-C and a negative association with height,weight,HR,fasting glucose and glucose(120min),rAI of DM with hypertension showed a positive association with age,PP and a negative association with height,weight,HR,DBP and fasting glucose.women had significantly higher AI than men in every groups.Stepwise regression analysis revealed that sex(β=0.24,P＜0.01 ),age (β=0.29,P＜0.01),height(β=-0.22,P＜0.01),weight(β=-0.09,P＜0.01),HR (β=-0.39,P＜0.01 ),MBP(β=0.19,P＜0.01 ),total cholesterol(β=0.03,P＜0.05 ) and HDL-C(β=-0.04,P＜0.01 ) were independent determinants of rAI of NG,height (β=-0.33,P＜0.01 ) and HR(β=-0.35,P＜0.01 ) were independent determinants of rAI of IFG,sex(β=0.27,P＜0.01),age(β=0.16,P＜0.01),height(β=-0.12, P＜0.05 ),HR(β=-0.47,P＜0.01 ) and MBP(β=0.19,P＜0.01 ) were independent determinants of rAI of IGT,sex(β=0.12,P＜0.05 ),age(β=0.09,P＜0.05 ),height (β=-0.25,P＜0.01),HR(β=-0.50,P＜0.01 ) and MBP(β=0.12,P＜0.01 ) were independent determinants of rAI of DM,age(β=0.16,P＜0.01 ),height(β=-0.27, P＜0.01 ) and HR(β=-0.55,P＜0.01 ) were independent determinants of rAI of DM with hypertension.Conclusions:Sex,age,height,weight,HR and MBP were independent determinants of rAI of Chinese adults.After adjustment of age,sex,MBP and HR,the rAI had no significant difference among different glucose tolerance groups. Sex,age,height,weight,HR,MBP,total cholesterol and HDL-C were independent determinants of rAI of NG,height and HR were independent determinants of rAI of IFG,sex,age,height,HR and MBP were independent determinants of rAI of IGT and DM,age,height and HR were independent determinants of rAI of DM with hypertension.