Relationship Of Serum Fasting Glucose With Arterial Stiffness And Peripheral Arterial Disease Among Hypertensive Population In Rural Areas Of Two Cities

Objective We aimed to assess the prevalence of arterial stiffness and peripheral arterial disease among hypertensive population in rural areas of Eastern China;investigate the relationship of the fasting blood glucose levels with arterial stiffness and peripheral arterial disease alleviating the future burden of arterial stiffness and its related diseases.Methods A cross-sectional study was conducted among hypertensive population in Lianyungang and Anqing City from July to September 2013.Multivariable logistic regression models and generalized linear regression models were used to examine the relationship of fasting blood glucose with arterial stiffness [brachial-ankle pulse wave velocity(baPWV)≥18 m/s] and peripheral arterial disease [ankle brachial index(ABI)<0.9],and baPWV levels,respectively.Results A total of 3 894 participants were included in analysis of relation of fasting blood glucose with baPWV levels and arterial stiffness.The prevalence of participants with normal fasting glucose(defined as fasting blood glucose <5.6 mmol/L),impaired fasting glucose(IFG,5.6-<7.0 mmol/L)and new-diagnosed diabetes(≥7.0 mmol/L)were 44.5%,43.0%,and 12.5%,respectively.The prevalence of arterial stiffness was 46.7%.Each 1-mmol/L increase of fasting blood glucose levels was significantly associated with a 0.26 m/s increase in baPWV levels(95%CI: 0.20,0.33;P<0.001),and 16% increase of arterial stiffness prevalence(OR=1.16;95%CI: 1.10,1.23;P<0.001).Consistently,the significantly higher baPWV levels were observed in participants with IFG(β=0.50 m/s;95%CI: 0.28,0.72;P<0.001)and new-diagnosed diabetes(β=1.13 m/s;95%CI: 0.80,1.47;P<0.001)when compared with those with normal fasting glucose.Accordingly,the higher risk of arterial stiffness was also found in participants with IFG(OR=1.48;95%CI: 1.25,1.75;P<0.001)and new-diagnosed diabetes(OR=1.90;95%CI: 1.48,2.45;P<0.001)when compared with those with normal fasting glucose.Furthermore,a stronger positive association between fasting blood glucose and baPWV was observed in participants with higher systolic blood pressure levels(≥140 mm Hg;β=0.34 m/s;95%CI: 0.24,0.44;P<0.001;vs.<140 mm Hg;β=0.18 m/s;95%CI: 0.09,0.27;P<0.001;P for interaction=0.027).A total of 4 009 participants were included in the analysis for association between fasting blood glucose and peripheral arterial disease.The prevalence of peripheral arterial disease was 2.9%.However,we have not found a significant association between fasting blood glucose and peripheral arterial disease.Conclusion There was a positive relationship of fasting blood glucose with baPWV levels and the prevalence of arterial stiffness among hypertensive population in rural areas of Eastern China,especially in those with SBP ≥140 mm Hg.However,fasting blood glucose was not associated with peripheral arterial disease.