Joint Effect of Central Obesity and Family History on Hypertension in Type 2 Diabetes: A Cross-Sectional Study in China.

IF 2.8 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pub Date : 2025-07-17 eCollection Date: 2025-01-01 DOI:10.2147/DMSO.S536865

Xiangyu Chen, Lijin Chen, Ruying Hu, Weiyuan Yao, Zhimin Ma, Jieming Zhong

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Abstract

Purpose: This study aimed to examine the joint effect of central obesity (CO) and family history of hypertension (FHH) on hypertension in Chinese patients with type 2 diabetes mellitus (T2DM).

Methods: A total of 1756 T2DM patients were enrolled from a cross-sectional study conducted in Zhejiang Province, China (March - November 2018). Multivariate logistic regression models were used to analyze factors associated with hypertension and to assess CO-FHH interactions on both additive and multiplicative scales. Associations between waist circumference (WC) and systolic/diastolic blood pressure (SBP/DBP) were evaluated using generalized additive models (GAM) and Spearman correlation. The relationship between WC and hypertension was further explored using restricted cubic splines (RCS).

Results: The prevalence of hypertension was 64.52%. WC was positively correlated with SBP (r = 0.25, P<0.001) and DBP (r=0.27, P<0.001), and showed a linear association with hypertension in both sexes (P for non-linearity>0.05). After adjusting for potential covariates, T2DM patients with both CO and FHH had a 4.64-fold higher risk of hypertension (95% CI: 3.22-6.67) compared to the reference group. A statistically significant additive interaction between CO and FHH was observed, with a relative excess risk due to interaction (RERI) of 1.59 (95% CI: 0.39-3.19), an attributable proportion (AP) of 0.34 (95% CI: 0.08-0.51), and a synergy index (SI) of 1.78 (95% CI: 1.13-2.79). No statistically significant multiplicative interaction was found.

Conclusion: CO and FHH may jointly contribute to hypertension in Chinese T2DM patients through an additive effect beyond their individual associations. Maintaining a healthy WC is especially important for T2DM patients with a family history of hypertension.

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中心性肥胖和家族史对2型糖尿病高血压的共同影响：中国的一项横断面研究

目的：本研究旨在探讨中心性肥胖（CO）和高血压家族史（FHH）对中国2型糖尿病（T2DM）患者高血压的共同影响。方法：在中国浙江省（2018年3月至11月）进行的一项横断面研究中，共有1756名T2DM患者入组。采用多变量logistic回归模型分析与高血压相关的因素，并在加性和乘性尺度上评估CO-FHH的相互作用。腰围（WC）与收缩压/舒张压（SBP/DBP）之间的关系采用广义加性模型（GAM）和Spearman相关性进行评估。使用受限三次样条（RCS）进一步探讨WC与高血压的关系。结果：高血压患病率为64.52%。WC与收缩压呈正相关（r = 0.25, P0.05）。在调整潜在协变量后，T2DM合并CO和FHH的患者发生高血压的风险比对照组高4.64倍（95% CI: 3.22-6.67）。观察到CO和FHH之间具有统计学意义的加性相互作用，相互作用的相对超额风险（rei）为1.59 (95% CI: 0.39-3.19)，可归因比例（AP）为0.34 (95% CI: 0.08-0.51)，协同指数（SI）为1.78 （95% CI: 1.13-2.79）。没有发现统计学上显著的乘法相互作用。结论：CO和FHH可能通过一种累加效应共同促进中国2型糖尿病患者的高血压。对于有高血压家族史的2型糖尿病患者来说，保持健康的WC尤为重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pharmacology, Toxicology and Pharmaceutics-Pharmacology

CiteScore

5.90

自引率

6.10%

发文量

431

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed, open access, online journal. The journal is committed to the rapid publication of the latest laboratory and clinical findings in the fields of diabetes, metabolic syndrome and obesity research. Original research, review, case reports, hypothesis formation, expert opinion and commentaries are all considered for publication.