空腹血糖受损、糖耐量受损人群2年自然转归及其影响因素的研究  

Natural outcome of impaired fasting glucose and impaired glucose tolerance——A survey of two-year follow-up and the related risk factor analysis

作　　者：杜群[1] 石福彦[1] 丁奇龙[1] 李子玲[1] 宋颖[1] 贾凤英[1] 

机构地区：[1]内蒙古医学院第三附属医院内分泌科,包头014010

出　　处：《中华内分泌代谢杂志》2004年第3期223-226,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的　探讨空腹血糖受损 (IFG)、糖耐量受损 (IGT)人群发生糖尿病的危险性及其影响因素。方法　对 1999年 7月～ 12月包钢集团公司 2万余人糖尿病普查中IFG、IGT患者 73 0人于 2 0 0 1年 9～ 11月进行随访调查。测量身高、体重、腰围、血压 ,作过夜空腹 75 g葡萄糖耐量试验 ,同时测定空腹胰岛素 (FINS)及服糖后 2h胰岛素 (PINS) ,血总胆固醇 (TC) ,甘油三酯 (TG) ,高密度脂蛋白胆固醇 (HDL C)。结果　随访的 65 6人中 13 8人发生糖尿病。其中孤立性IFG (I IFG)糖尿病年转变率为 5 .1% ,孤立性 (I IGT)为 11.5 % ,IGT为 14 .0 % ,IFG/IGT为 2 0 .2 %。I IGT、IGT及IFG/IGT糖尿病年转变率明显高于I IFG(均P <0 .0 0 1)。与I IFG比较 ,I IGT发生糖尿病的危险比为 2 .65 ,IFG/IGT为 5 .96。I IFG转归为糖尿病的危险因素主要是年龄 (OR 1.0 5 )和BMI(OR 1.0 3 )。I IGT是 2h血糖 (OR 2 .0 2 )、家族史 (OR2 .19)及腰围 (OR 1.0 8)。各项临床指标 2年的变化结果 :转归为I IFG、I IGT者 2年前后的年龄、体重、腰围、BMI、血压、TC均值及其肥胖、腹型肥胖、血脂代谢紊乱、高血压的患病率均比NGT转归组高 ;I IFG与I IGT比较差异无显著性。结论　I IGT发生糖尿病的危险性明显高于I IFG ,主要危险因素为腰围、餐后?Objective To investigate the natural outcome and related risk factors in subjects with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Methods Seven hundred and thirty subjects were divided into isolated IFG (I-IFG), isolated IGT (I-IGT) and combined IFG/IGT groups. They were followed up for 2 years after they had been diagnosed as abnormal glucose metabolism based on a population of over 20000 workers in Baotou Iron and Steel Group. The body height, weight, waist circumference and blood pressure were examined in these subjects. Meanwhile, oral 75 g glucose tolerance test (OGTT), fasting insulin (FINS), 2 hour insulin after glucose intake (PINS), serum total cholesterol (TC), triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) were also tested. Results Of the 656 subjects 138 cases were found to become diabetes during the 2 years. Among them the annual conversion rates to diabetic were 5.1%, 11.5%, 14.0% and 20.2% for the subjects with I-IFG, I-IGT, IGT and IFG/IGT respectively. The conversion rate was significantly higher in I-IGT, IGT and IFG/IGT groups than that of I-IFG (all P<0.001). Compared with I-IFG, the relative risk of I-IGT and IFG/IGT was 2.65 and 5.96 respectively. The risk factors in subjects with I-IFG were age (OR 1.05) and BMI (OR 1.03), and the risk factors in individuals with I-IGT were 2 h plasma glucose (OR 2.02), diabetes family history (OR 2.19) and waist circumference (OR 1.08). The clinical items at the end of 2 years including age, weight, waist circumference, body mass index (BMI), blood pressure, TG, TC, obesity and central obesity, disturbances of lipid metabolism as well as hypertension were significantly higher in those who remained with I-IFG or I-IGT than those who became NGT, and no significant differences were found between groups with I-IFG and I-IGT. Conclusion The rate of progressing to diabetes was obviously higher in subjects with I-IGT than that of I-IFG. The main risk factors of conversion to diabetes in I-IGT were waist circumfere

关 键 词：空腹血糖受损 糖耐量受损 自然转归 影响因素 糖尿病 发病率 

分 类 号：R587[医药卫生—内分泌]