甘油三酯水平与糖尿病发病危险的队列研究  

The association between the changes in triglyceride levels and the risk of incident type 2 diabetes mellitus： a 15 years followed-up results from the Chinese Multi-provincial Cohort Study

作　　者：王薇[1] 刘静[1] 孙佳艺[1] 王淼[1] 刘军[1] 齐玥[1] 赵冬[1] 

机构地区：[1]首都医科大学附属北京安贞医院北京市心肺血管疾病研究所流行病研究室,100029

出　　处：《中华内科杂志》2012年第7期516-519,共4页Chinese Journal of Internal Medicine

基　　金：“十一五”国家科技支撑计划（2006BA101A01）;国家自然科学基金（81170266、81070226、81000109）

摘　　要：目的分析多省市人群1992--2007年空腹TG水平变化与累积糖尿病发病风险的关系。方法以1992年6省市35～64岁参加了心血管病危险因素调查者为基线数据，2007年进行了危险因素再调查；去除1992年已有糖尿病和2次调查资料不完整者，用于本研究共5408例。根据TG水平分为3组：1组TG〈1．70mmol／L，2组TG1．70—2．25mmol／L，3组TG≥2．26mmol／L。结果与1992年相比，2007年该人群TC,水平增加了0．40mmol／L；高TG血症患病率从23．4％上升至39．0％。队列人群15年糖尿病累积发病率12．8％；按基线TG水平分3组，15年累积糖尿病发病率分别为10．5％、16．2％和26．6％。以基线TG1组为对照，在调整了多个危险因素后，2组和3组糖尿病发病风险RR分别为1．44（95％CI1．12—1．83）和2．40（95％CI1．90—3．03）。两时点（1992年和2007年）检测TG均以1组为对照，多因素分析显示，2次检测TG3组累计糖尿病发病风险均增加了2．39倍（RR3．39，95％C12．49—4．61）。结论多省市队列人群基线高TG水平是糖尿病发病风险独立影响因素；两时点TG的变化对糖尿病发病风险预测能提供更多的信息。Objective To explore the 15-years change in fasting TG level and the accumulative incidence of type 2 diabetes mellitus （T2DM） from 1992 to 2007, and to assess the association between the change in TG level and the accumulative onset risk of T2DM. Methods A total of 11 387 subjects aged 35- 64 years were recruited from 6 provinces in China in the baseline survey in 1992, and were followed-up for cardiovascular disease till 2007. In 2007, 9184 subjects were successfully followed-up and 5966 subjects entered into the second examination. Totally 5408 participants, who were free of diabetes at baseline and had complete information for both check ups, were included in this analysis. Fasting TG levels were categorized into three groups： 〈 1.70 mmol/L, 1.70-2. 25 mmol/L and ≥2. 26 mmol/L. The association between 15- years change in TG level and the accumulative onset risk of T2DM was assessed by logistic regression analysis. Results In 1992, the mean level of TG was 1.49 mmol/L in male and 1.26 mmol/L in female. During the 15 years, TG levels increased by 0.25 mmol/L and 0.53 mmol/L in male and female, respectively. The prevalence of elevated TG （ 〈 1.70 mmol/L） increased from 23.4% in 1992 to 39.0% in 2007. The 15-year accumulative incidence of diabetes was 13.9% in male and 11.8% in female. The incidence rates were 10. 5% , 16. 2% and 26. 6% for TG levels of 〈 1.70 mmol/L, 1.70-2. 25 mmol/L and ≥ 2. 26 mmot/L, respectively. Multivariate logistic regression analysis showed that the baseline TG level was significantly associated with the onset risk of diabetes after adjustment for other cardiovascular risk factors. At any given baseline TG level, the onset risk of diabetes increased with the TG levels in the second examination in 2007. After adjusting other risk factors, participants with the highest categories of both baseline and follow-up TG levels had 2. I folds higher accumulative onset risk of diabetes （RR = 3.39, 95% CI 2. 49-4. 61 ） than those with the lowest categories of both baseline a

关 键 词：甘油三酯类 糖尿病 2型 随访研究 流行病学 

分 类 号：R587.1[医药卫生—内分泌]