代谢综合征组分对2型糖尿病影响及预测  

Influence and predictive value of metabolic syndrome components on incidence of type 2 diabetes mellitus

作　　者：向泽林[1] 赵景波[1] 许加亮[1] 王从菊[1] 梁长威[1] 李杰[1] 

机构地区：[1]哈尔滨医科大学公共卫生学院流行病学教研室,黑龙江哈尔滨150081

出　　处：《中国公共卫生》2009年第12期1435-1437,共3页Chinese Journal of Public Health

基　　金：黑龙江省自然科学基金(D200623)

摘　　要：目的探讨代谢综合征(MS)各组分与2型糖尿病(T2DM)发病的关系,比较MS与空腹血糖受损(IFG)在预测T2DM时的作用。方法采用队列研究方法,对黑龙江省电业局1 318人(≥30岁)按MS和非MS分组后进行5年随访,每年定期进行问卷调查和身体检查,获取血糖(GLU)、腰围(WC)、血压(BP)等数据,进行分析比较。结果随访5年后,MS组发病73人,非MS组发病25人,2组间差异有统计学意义;MS及其组分中GLU、WC、和BP都会增加T2DM的发病风险;MS(RR=7.83,P<0.01)和GLU(RR=7.72,P<0.01)较强,WC和BP相对弱一些,而高密度脂蛋白(HDL)、甘油三酯(TG)对T2MD的发病基本无影响;灵敏度等指标分析表明,MS与GLU的灵敏度、特异度均较好,阳性预测值、正确指数较高;ROC曲线分析表明,在预测T2DM时,ROC曲线下面积(Az)MS(Az1=0.786,P=0.000)高于IFG(Az2=0.729,P=0.000),差异有统计学意义(U=2.75,P<0.05),表明MS和IFG对T2DM都有较高的预测价值,但MS稍高于IFG。结论MS及其组分中的GLU、WC和BP都会增加T2DM的发病风险,特别是MS作为一个整体时预测价值较高,稍高于IFG。Objective To analyze the incidence risk of type 2 diabetes mellitus（T2DM） associated with metabolic syndrome（MS） components and compare the predictive values of MS and impaired fasting glycaemia（IFG） on T2DM.Methods A cohort study with five years follow-up was carried out among 1 318 persons elder than 30 years and working in Electric Power Administration of Heilongjiang,and divided into MS group and normal group.Data on glucose（GLU）,waist circumference（WC）,blood pressure（BP） was obtained through interview and physical check-ups.Results There were 73 and 25 T2DM cases in MS and the normal,respectively,at the end of the follow-up with significant difference between the two groups.MS and its components（GLU,WC,BP）increased incidence risk of T2DM.The strength of MS（RR=7.83,P〈0.01） and GLU（RR=7.72,P〈0.01） correlation with T2DM was stronger than WC and BP.However,there was no significant difference in the strength between HDL and TG.The analysis of sensitivity and specificity showed that MS and GLU were better than other components.The analysis of ROC curves showed that the area zone（Az） under ROC curves of MS（Az1=0.786,P=0.000） was higher than that of IFG（Az2=0.729,P=0.000）with a significant difference（U=2.75,P〈0.05）.There were strong predictive values of MS and IFG for T2DM.Conclusion MS and its components（GLU,WC,BP） could increase the incidence risk of T2DM.MS has a high predictive value on the incidence of T2DM.

关 键 词：代谢综合征 2型糖尿病 空腹血糖受损 

分 类 号：R587.1[医药卫生—内分泌] R589[医药卫生—内科学]