Life-course blood pressure trajectories and incident diabetes: A longitudinal cohort in a Chinese population

Ying Liu; Xiaohong Chen; Chunxia Li; Bingbing Fan; Jiali Lv; Yanlin Qu; Yongjiang Cai; Tao Zhang

doi:10.3389/fendo.2022.1035890

Life-course blood pressure trajectories and incident diabetes: A longitudinal cohort in a Chinese population

Front Endocrinol (Lausanne). 2022 Nov 11:13:1035890. doi: 10.3389/fendo.2022.1035890. eCollection 2022.

Authors

Ying Liu^{1

2}, Xiaohong Chen³, Chunxia Li^{1

2}, Bingbing Fan^{1

2}, Jiali Lv^{1

2}, Yanlin Qu^{1

2}, Yongjiang Cai³, Tao Zhang^{1

2}

Affiliations

¹ Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
² Institute for Medical Dataology, Shandong University, Jinan, China.
³ Center of Health Management, Beijing University Shenzhen Hospital, Shenzhen, Guangdong, China.

Abstract

Background: Blood pressure levels are correlated with diabetes among middle-aged or older adults. However, longitudinal trajectories of blood pressure during young adulthood and their impact on diabetes have been insufficiently studied.

Methods: The longitudinal cohort consisted of 4,625 adults who had blood pressure and body mass index (BMI) repeatedly measured five to nine times during 18-60 years of age. Distinct systolic blood pressure (SBP) trajectories were identified by a group-based trajectory model. Logistic regression analyses were used to investigate the association between trajectory patterns or quartiles of area under the curve values of SBP trajectories and incident diabetes, respectively.

Results: Four distinct trajectory groups were identified for SBP: normotensive-stable (n = 761, 16.5%), prehypertension-stable (n = 2,381, 51.5%), stage I hypertension-increasing (n = 1,231, 26.6%), and stage II hypertension-increasing (n = 251, 5.4%). Compared with subjects who remained at SBP <120 mmHg in the normotensive-stable group, individuals in the prehypertension-stable trajectory exhibited a normal SBP range (<140 mmHg), and they still had a significantly higher risk of diabetes (adjusted OR = 1.82, p = 0.029). Individuals had a greater risk of diabetes in the stage I hypertension-increasing group (adjusted OR = 2.31, p = 0.006) and the highest risk in the stage II hypertension-increasing group (adjusted OR = 3.91, p < 0.001) relative to the normotensive-stable group. Furthermore, compared with the first quartile, adjusted ORs (95% CIs) of the fourth quartile of SBP incremental and total AUC were 2.50 (1.61-3.97) and 1.82 (1.15-2.94), respectively.

Conclusions: Long-term SBP trajectory is a significant predictor for incident diabetes, which is independent of baseline SBP and body weight, attaching importance to maintaining optimal blood pressure levels and controlling changing slopes of SBP for preventing diabetes.

Keywords: diabetes; longitudinal study; prediabetes; systolic blood pressure; trajectory.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Blood Pressure / physiology
China / epidemiology
Diabetes Mellitus* / epidemiology
Humans
Hypertension* / epidemiology
Middle Aged
Prehypertension* / epidemiology
Risk Factors
Young Adult