广西29503人糖调节受损的临床特征及危险因素分析  

Clinical characteristics and risk factors analysis of impaired glucose regulation of 29503 citizens in Guangxi

作　　者：谢冬梅[1] 陈青云[1] 夏宁[1] 罗佐杰[1] 李春灵[1] 覃伟武[1] 彭育欢[2] 罗秋萍[2] 李必迅[3] 赵爱香[4] 王民登[5] 李舒敏[6] 韦宏[7] 谭菁[7] 韦志明[8] 陆凤机[8] 戴霞[1] 沈寒蕾[1] 张绍峰[1] 赖璐华[1] 杨艳[1] 韦华[1] 翟日洪[9] 雷新云[10] 陈民生[10] 韦业良[11] 

机构地区：[1]广西医科大学第一附属医院,南宁市530021 [2]贺州市人民医院 [3]广西壮族自治区江滨医院 [4]百色市人民医院 [5]右江民族医学院附属医院 [6]钦州市第二人民医院 [7]南丹县人民医院 [8]隆安县人民医院 [9]广西壮族自治区工人医院 [10]鹿寨县人民医院 [11]凤山县砦牙乡卫生院

出　　处：《广西医学》2007年第2期156-159,共4页Guangxi Medical Journal

基　　金：国家自然科学资金资助项目(30260042)

摘　　要：目的了解广西人群糖调节受损(IGR)的临床特征,探讨其主要危险因素,为制定预防和干预措施提供依据。方法选用广西2003-2005年糖尿病流行病学调查时行简易糖耐量试验(OGTT)的5岁以上29 503例居民资料,根据WHO1999年IGR诊断标准分为:糖耐量正常组(NGT),单纯空腹血糖受损组(I-IFG),单纯糖耐量减低组(I-IGT),I-IFG与I-IGT合并组(IFG/IGT)及糖尿病组(DM)。IGR则包含I-IFG、I-IGT及IFG/IGT。比较分析各组间临床特征,运用单因素和多因素非条件Logistic回归分析,探讨影响IGR发生的危险因素。结果IGR总的粗患病率为15.81%,用2000年广西人口普查数据进行标准化计算标化患病率为10.56%;IGR各亚组的粗患病率(标化率)分别为:I-IFG 2.53%(2.08%)、I-IGT11.08%(7.14%)及IFG/IGT2.20%(1.34%);IFG、IGT、IFG/IGT占IGR的比例分别为15.97%、70.09%及13.94%。与NGT组比较,IGR人群年龄、收缩压(SBP)、舒张压(DBP)、体重指数(BMI)、腰围(WC)、甘油三醋(TG)、总胆固醇(TC)、胰岛素抵抗指数(HOMA-IR)等显著增高,高密度脂蛋白(HDL)、B细胞功能(HOMA-B)明显较低。与DM组比较,I-IFG和I-IGT组SBP、DBP、BMI、WC、TG、TC、HOMA-IR升高程度不如DM组显著,HDL、HOMA-B降低程度较DM轻。IFG/IGT组的BMI、WC、血压、血脂与DM组比较差异无统计学意义。进入多因素非条件logistic回归模型的因素有年龄、SBP、WC、TG、血尿酸(UA)、胰岛素抵抗指数(HOMA-IR)、高血压病史、糖尿病家族史(P<0.01)。结论广西人群糖调节受损的主要类型为I-IGT。IGR各亚组存在不同的代谢异常,IFG/IGT组较I-IFG和I-IGT组的BMI、WC、血压、血脂、HOMA-IR增高的程度更高,接近DM组。高龄、高血压、WC、TG、UA、HOMA-IR、糖尿病家族史为IGR的主要危险因素。Objective To investigate the clinical characteristics of impaired glucose regulation （IGR）of citizens in Guangxi and to identify risk factors of IGR. Methods The investigation of IGR of 29,503 Guangxi citizens over 5 years old was done by OGTY in a cross-section study. Normal glucose tolerance （ NGT）, IGR and diabetes mellitus （ DM ） were grouped based on the 1999 diagnosis standard of WHO. IGR was composed of isolated impaired fasting glucose （ I-IFG ）, isolated impaired glucose tolerance （I-IGT） and both impaired fasting glucose and impaired glucose tolerance （IFG/IGT）. The clinical characteristics of IGR were analyzed. The relationships between risk factors and IGR were analyzed by unconditional univariate and multivariate logistic regression. Results The standardized rate of IGR was 10.56%. The standardized rates of I-IFG ,I-IGT and IFG/IGT were 2.08% ,7.14% and 1.34% respectively. The proportions of I-IFG,I-IGT and IFG/IGT to IGR were 15.97% ,70.09% and 13.94% respectively. Compared with the NGT group,the IGR group had higher age, blood pressure, body mass index （BMI） ,waist circumference （WC） ,triglyceride （TG） ,total cholesterol（ TC ）and HOMA-IR, lower high density lipoprotein cholesterol （HDL） and HOMA-B. The I-IFG and I-IGT groups had lower blood pressure, BMI ,WC ,TC ,TG and HOMA-IR,and higher HDL,HOMA-B than the DM group＇,while there were no differences between the IFG/IGT group and the DM group. Age,SBP,WC,TG, UA, HOMA-IR, history of Hypertension and family history of DM entered the logistic equation with statistic significance（ P 〈 0. 01 ）. Conclusion In Guangxi, I-IGT was the main type of IGR. There were various metabolic disorders in the subgroupsof IGR. The IFG/IGT group had higher blood pressure, BMI, WC, TC,TG and HOMA-IR than I-IFG and I-IGT groups, closed to the DM group. Age, SBP, WC, TG, UA, HOMA-IR, history of Hypertension and family history of DM were main risk factors of IGR.

关 键 词：糖尿病 糖调节受损 人群特征 危险因素 

分 类 号：R587.1[医药卫生—内分泌]