从心血管危险因素看空腹血糖受损切点下调  

The clinical significance of lowering the cut-point of impaired fasting glucose:in view of cardiovascular risk factors

作　　者：王瑶[1] 杨文英[1] 杨兆军[1] 李光伟[1] 

机构地区：[1]中日友好医院内分泌科,北京100029

出　　处：《中华内分泌代谢杂志》2004年第5期399-402,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：卫生部课题资助基金 (94 1 0 93)

摘　　要：目的　在不同空腹血糖水平下分析心血管危险因素的聚集情况 ,探讨我国成人空腹血糖受损 (IFG)切点下调的合理性。方法　对 1994年全国 2 5岁以上 2 2 .4万人群糖尿病普查中 15 5 64例经口服75克葡萄糖耐量试验检查的人群资料进行分析。结果　 (1)将人群按空腹血糖 (FPG) 0 .5 6mmol/L间隔分组 ,BMI≥ 2 5kg/m2 、高甘油三酯、高血压及代谢综合征的比率随FPG逐渐上升 ,FPG 5 .0～ 5 .6mmol/L组超重比率出现明显升高 (P =0 .0 0 1) ,FPG 5 .6～ 6.1mmol/L组其余各组分及代谢综合征比率均有明显升高 (P<0 .0 0 1)。 (2 )餐后 2h血糖 <7.8mmol/L时 ,FPG 5 .6～ 6.1mmol/L组与FPG <5 .6mmol/L组比较 ,BMI≥2 5kg/m2 、高血压、代谢综合征患病率分别升高 2 5 % ,15 % ,46% ;糖尿病家族史阳性率增高。 (3 )按照 1999年WHO诊断分型标准及 2 0 0 3年ADA专家委员会建议将非糖尿病人群分为正常糖耐量 (NGT) ,单纯IFG ,单纯糖耐量受损 (IGT)及IFG合并IGT(IFG +IGT)组。IFG诊断切点下调至 5 .6mmol/L后 ,糖调节受损各组仍具有FPG 6.1mmol/L为切点时临床特点。IFG +IGT组代谢异常较单纯IFG及单纯IGT为重。单纯IFG与单纯IGT组比较 :IFG组年轻、糖尿病家族史阳性多 ,相对肥胖 ,总代谢综合征比率高 ;IGT组收缩压、甘油三?Objective To evaluate the rationale of lowering the cutoff value of normal fasting plasma glucose (FPG) by studying the cardiovascular risk factors in subjects with different FPG levels and different glucose tolerance states. Methods A population-based survey of diabetes was undertaken in 1994, data from 15564 Chinese adults (age≥25) who adopted 75 g-oral glucose tolerance test were analyzed. Results (1) The frequencies of BMI≥25 kg/m 2 , hypertension, hypertriglyceridemia, metabolic syndrome were increasing with graded FPG levels at a 0.56 mmol/L interval. FPG at 5.0-5.6 mmol/L level overweight frequency elevated significantly (P=0.001), and FPG at 5.6-6.1 mmol/L level the metabolic syndrome and other components also elevated (P<0.001). (2) The group with the 2 h postprandial glucose level <7.8 mmol/L and FPG 5.6-6.1 mmol/L, there were increments of 25%, 15%, 46% in frequencies of BMI≥25kg/m 2 , hypertension, and metabolic syndrome compared with FPG<5.6 mmol/L group. And more had family history of diabetes. (3) Non-diabetic subjects were divided into normal glucose tolerance (NGT) group, isolated impaired fasting glucose(IFG),isolated impair glucose tolerance(IGT)and IFG combined IGT(IFG+IGT)groups according the WHO criteria(1999) and the ADA Expert Committee recommended criteria (2003). More metabolic abnormalities were found in IFG+IGT group than in IFG and IGT group. IFG subjects were younger, more had family history of diabetes, relatively obese, and the frequency of metabolic syndrome was higher;whereas the frequencies of systolic BP, plasma triglyceride, post-prandial insulin levels were higher in IGT group, and more female suffered IGT. Conclusion (1) The CVD risk increased with increasing FPG even in pre-diabetic period. The frequency of metabolic syndrome and the single components rise at FPG 5.6 mmol/L. (2) The IFG subjects with the lower cut-point of 5.6 mmol/L was younger, more had family history of diabetes, and the frequency of metabolic syndrome was higher than NGT and IGT subjec

关 键 词：代谢综合征 IGT 人群 心血管危险因素 升高 年轻 空腹血糖受损 间隔 聚集 代谢异常 

分 类 号：R587.1[医药卫生—内分泌]