title: Analysis of the Synergistic Effects of Fasting Plasma Glucose and Hypertension on Cardiovascular Autonomic Neuropathy.
abstract: BACKGROUND
  The purpose of this study was to evaluate the associations of fasting plasma glucose (FPG) and hypertension (HTN) with cardiovascular autonomic neuropathy (CAN) and to estimate the extent to which the synergistic effects of FPG and HTN affect outcomes in a Chinese population.
  
  
  METHODS
  We conducted a large-scale, population-based study to analyze the association and interaction of the two factors with CAN in a sample of 2,092 Chinese people. Univariate and multiple linear regression (MLR) analyses were employed to detect these relationships. Interaction on an additive scale can be calculated by using the relative excess risk due to interaction, the proportion attributable to interaction (AP), and the synergy index (S).
  
  
  RESULTS
  After adjusting for confounding factors, MLR showed that FPG and HTN were independently associated with CAN (p < 0.001 for both). A significant synergistic effect of FPG and HTN on CAN was detected (p = 0.046, RETI = 0.733, 95% CI 0.059-1.450; AP = 0.167, 95% CI -0.033 to 0.367; S = 1.275, 95% CI 0.140-2.410).
  
  
  CONCLUSIONS
  Our findings suggest that FPG and HTN are independently associated with CAN, and they offer evidence to support the hypothesis that FPG and HTN have synergistic effects that influence the progression of CAN.
authors.affiliation: Department of Cardiothoracic Surgery, Xin Hua Hospital Affiated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Junwen
authors.initials: J
authors.lastname: Zhang
authors.forename: Jiaquan
authors.initials: J
authors.lastname: Zhu
authors.forename: Shiao
authors.initials: S
authors.lastname: Ding
authors.forename: Chunrong
authors.initials: C
authors.lastname: Bao
authors.forename: Zhaolei
authors.initials: Z
authors.lastname: Jiang
authors.forename: Zi-Hui
authors.initials: ZH
authors.lastname: Tang
authors.forename: Ju
authors.initials: J
authors.lastname: Mei
mesh_terms: D000368:Aged; D044466:Asian People; D001342:Autonomic Nervous System Diseases / Q000453:epidemiology*; D001786:Blood Glucose / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood*; D002681:China / Q000453:epidemiology; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D001786:Blood Glucose