| BackgroundDiabetes mellitus is a major worldwide public health problem.It's caused by a variety of risk factors and the pathogenesis of diabetes has not yet been fully clarified.Many studies have shown the relationship between cardiovascular risk factors and diabetes.However,there is no large-population prospective cohort study on the combined effects of heart rate(HR)and family history of hypertension with diabetes.Our research will explore this issue.PurposesTo explore the association of HR and family history of hypertension with diabetes in Mongolian population,in order to provide epidemiology evidence for assessment of diabetes risk factors.MethodsThe baseline investigation was conducted from 2002 to 2003 in 32 villages of two adjacent townships,Kezuohou banner(country)and Naiman banner,Inner Mongolia of China.2589 Mongolian people with ?20 years old were recruited and signed informed consent.They completed the standard questionnaire and blood samples collection.The follow-up investigation was conducted from 2013 to 2014 among subjects with normal blood glucose at baseline(fasting plasma glucose<6.1 mmol/L).The fasting plasma glucose and 2 hour post load glucose were measured by trained staffs.Epidata 3.1 software was used to establish a database,and all questionnaires were input after checking by two staffs.All p-values were based on two-side test and a significance level of 0.05.Statistical analysis used SAS 9.3.Results1.1468 subjects with normal plasma glucose were included in the data analysis after excluded the subjects with incomplete information.During the follow up,there were 154 cases of diabetes occurred,the cumulative incidence of diabetes was 10.5% and incidence density was 82.18/10000 person-years.2.67.2% of these have a high level of HR,which also have a high level of blood pressure,waist circumference,hip circumference,homeostasis model assessment-insulin resistance,body mass index and high proportion of women and smoking and a lower proportion of drinking.3.Compare with normal plasma glucose individuals,individuals with diabetes were more likely to have a family history of hypertension and higher levels of HR,diastolic blood pressure,waist circumference,hip circumference,homeostasis model assessment-insulin resistance,body mass index,total cholesterol,triglycerides and low density lipoprotein-cholesterol.4.Participants were stratified into two groups according to the level of HR.Compared to the subjects with low level of HR,subjects with high level of HR were associated with increased risk of diabetes.Odds ratios(OR)(95% confidence interval [CI])of high level of HR with diabetes was 1.65(1.17-2.34)before adjustment.Then,they were stratified into two groups according to family history of hypertension.Compared to the subjects without family history of hypertension,subjects with family history of hypertension were associated with increased risk of diabetes.The OR(95%CI)of subject with family history of hypertension was 1.82(1.11-2.93)before adjustment.After adjusting for other risk factors,the associations remained significant(P<0.05).5.Logistic regression analysis for risk of diabetes showed that unadjusted OR(95%CI)of diabetes in the subjects with family history of hypertension and HR<80bmp,subjects without family history of hypertension and HR?80bmp,subjects without family history of hypertension and HR ? 80 bmp were 1.11(0.57-2.14),1.25(0.87-1.81)and 3.42(1.84-6.37),after multiple adjustment,the OR(95%CI)were 0.94(0.47-1.90),1.02(0.99-1.04)and 3.44(1.80-6.56).The OR of subjects with family history of hypertension and HR?80bmp had statistical significance(P<0.05).6.Logistic regression analysis for the clustering of cardiovascular risk factors showed that unadjusted OR of diabetes in the participants with 1,2,?3 cardiovascular risk factors were 1.11(0.59-2.10)?2.28(1.23-4.17)?3.80(2.21-7.10),compared with those without cardiovascular risk factors.After multiple adjustments,the OR of diabetes in the participants with 1,2,? 3 cardiovascular risk factors were 1.13(0.59-2.12)?2.29(1.24-4.24)?3.88(2.05-7.37),which had statistical significance.Conclusions1.Mongolian population has low incidence of diabetes..2.Faster HR and family history of hypertension are important risk factors of diabetes.They have combined effects,Mongolians with both faster HR and family history of hypertension had higher risk of diabetes.3.The clustering of cardiovascular risk factors significantly increased the risk of diabetes. |
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