Prevalence And Influencing Factors Of Carotid Intima-media Thickening Under Different Glucose Metabolism Levels In Middle-aged And Elderly In Rural Tianjin

Objective:To explore the epidemiological status of carotid intima-media thickening in middle-aged and elderly people in rural areas of China.Moreover,this study aim to research the distribution of risk factors related to carotid intima-media thickening under different glucose metabolism,in order to prevent atherosclerosis in early in rural areas and reduce stroke burden among low-income population.Methods:The study was a cross-sectional study of carotid intima-media(CIMT)thickening in rural middle-aged and elderly residents in Yangjinzhuang Town,Jizhou District,Tianjin from April to May 2019.A total of 2975 residents aged over 50 were included in this study.In this study,the intima-media thickness of bilateral carotid arteries,plaques and stenosis in all subjects were measured by ultrasound.The demographic characteristics,physical examination data,previous medical history,and laboratory test indicators of the population were collected.In analysis model,we analyzed the risk factors of CIMT thickening and AS across demographic information,lifestyle,medical condition,physical examination and blood glucose and lipid levels.Stratified analysis by gender,age group,education level were conducted,in advance,to learn the distribution of risk factors of stenosis.Stratified analysis by gender,age group,education level were conducted,in advance,to explore the distribution of relative risk factors of CIMT thickening.After adjusting for multiple factors,it compares the changes in related risks in different populations of different genders and blood glucose metabolism.Results:In this study population,the mean CIMT was 0.72 ± 0.14 mm,and the mean CIMT in man was 0.73 mm,in women was 0.70mm(P <0.001).The prevalence of CIMT thickening in this population was 1.4%,with 2.1% for men and 1.0% for women.Among diabetic patients,the prevalence of CIMT thickening in men was 4.1%,while in female diabetic patients was 1.8%.Among pre-diabetic patients,the prevalence of CIMT thickening was 5.8% in men and 1.1% in women.Among people with normal blood glucose levels,the prevalence of CIMT thickening was 2.1% in men and 1.0% in women.CIMT thickening in men was more susceptible to blood glucose metabolism.For the general population,males,high LDL-C levels are risk factors for CIMT thickening.In addition,older age,smoking are independent risk factors for CIMT thickening in diabetic patients;men are independent risk factors for CIMT thickening in pre-diabetic patients;in the normal blood glucose population,only older age group are risk factors for CIMT thickening.Each increased of 1mm Hg SBP and 1 year age resulted in CIMT increases by 0.001 mm and 0.004 mm,respectively(all P<0.05).Conclusion:The mean CIMT among middle-aged and elderly people in rural areas in northern China was 0.72 mm,and the prevalence of CIMT thickening is 1.4%.With the weakening of blood glucose metabolism,the prevalence of CIMT thickening in men increased significantly.Older age,amd elevated LDL-C will increase the risk of CIMT thickening.However,the standardized treatment rate for hypertension and diabetes is extremely lower in the middle-aged and elderly in rural areas.Therefore,the prevention and treatment of atherosclerosis in rural areas needs to continue.