摘要
目的探讨社区非糖尿病人群随访4年糖代谢转归情况及其影响因素。方法选取2004年石景山社区的中老年人群1060例作为流行病学调查研究对象,将研究对象分为两组:正常糖耐量(NGT)组和糖调节受损(IGR)组。IGR组再分为3个亚组:空腹血糖受损(IFG)组、糖耐量异常(IGT)组和IFG+IGT组,其中IFG组又分为IFG1组(FBG5.6～6.0mmol/L)、IFG2组(FBG6.1～6.9mmol/L)。调查研究对象4年后糖代谢指标转归情况,比较组间临床特征、合并其他疾病情况,分析NGT、IGR人群转归的影响因素。结果随访4年该非糖尿病人群T2DM累积发病率8%,其中NGT组、IFG1组、IFG2组、IGT组、IFG+IGT组4年T2DM累积发病率分别为4.7%、10.8%、20.0%、11.5%、20.9%。IFG2及IFG+IGT组的T2DM累积发病率均明显高于IFG1或IGT组(P<0.01)。IGR组合并高血压、血脂紊乱、微量白蛋白尿、心肌梗死的比例均高于NGT组(P<0.05);其中,IFG+IGT组合并肥胖、脑卒中、周围血管病的比例明显高于IFG、IGT组(P<0.05)。多因素分析显示NGT转归为IGR或T2DM的危险因素主要是FBG(OR=3.96,95%CI1.97～7.96,P=0.001)和餐后2h血糖(2hBG,OR=1.37,95%CI1.13～1.66,P=0.002)。IGR转归为T2DM的危险因素是FBG(OR=4.09,95%CI2.32～7.20,P=0.000)、2hBG(OR=1.42,95%CI1.21～1.68,P=0.000)、BMI(OR=1.16,95%CI1.08～1.34,P<0.05)。结论FBG的升高对非糖尿病人群的转归有重要意义;FBG下调至5.6mmol/L提高了对糖尿病的预测价值。
Objective To investigate the influential factors related to the outcome of carbohydrate metabolism in subjects without diabetes mellitus in a community of Beijing.Methods A four-year follow-up study,conducted in a group of 1 060 subjects without diabetes mellitus,was carried out in Shijingshan District,Beijing in 2004.The subjects were divided into normal glucose tolerance group（NGT）and impaired glucose regulation group（IGR）.IGR subjects were further divided into impaired fast glucose subgroup（IFG）,impaired glucose tolerance subgroup（IGT）and IFG combined with IGT subgroup（IFG/IGT）.IFG subjects included IFG1 subjects [fasting blood sugar（FBG）5.6-6.0mmol/L] and IFG2 subjects（FBG 6.1-6.9mmol/L）.Comparisons were done 4 years later on natural progression,general clinical features and metabolism index,the incidence of combined diseases in the subjects,and influential factors of the turnover of NGT and IGR in the population.Results Cumulative incidence of diabetes in all subjects studied was 8%,and in groups NGT,IFG1,IFG2,IGT and IFG/IGT,it was 4.7%,10.8%,20.0%,11.5% and 20.9%,respectively.Cumulative incidence of diabetes was higher in groups IFG2 and IFG/IGT than in groups IFG1 and IGT（P〈0.001）.The incidence of combination with hypertension,dyslipidemia,microalbuminuria or myocardial infarction was significantly higher in IGR group than in NGT group（P〈0.05）,and the incidence of combination with obesity,stroke or peripheral angiopathy was higher in IFG/IGT group than in IFG and IGT groups（P〈0.05）.Multivariate analysis showed that the risk factors for NGT to IGR or diabetes were FBG（OR=3.96,95%CI 1.97-7.96,P=0.001）and 2hBG（OR=1.37,95%CI 1.13-1.66,P=0.002）.The risk factors for IGR to diabetes were FBG（OR=4.09,95%CI 2.32-7.20,P=0.000）,2hBG（OR=1.42,95%CI 1.21-1.68,P=0.000）and body mass index（OR=1.16,95%CI 1.08-1.34,P〈0.05）.Conclusions An eleration of FBG is of great significance in predicting the outcome of non-diabetic population,and reduction of FBG cut-off point to 5.6mmol/L has an important predictive value for diabetes.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2010年第1期74-78,共5页
Medical Journal of Chinese People's Liberation Army
基金
首都医学发展科研基金北京医学卫生科技联合攻关项目(2002-1009)
关键词
糖尿病
糖调节受损
随访研究
diabetes mellitus
impaired glucose regulation
follow-up studies
