吉林省延边地区朝鲜族和汉族人群胰岛素抵抗对不同代谢危险因素及其聚集性的影响  

Influence of insulin resistance in different metabolic risk factors and their clusters among Yanbian Korean-Chinese and Han nationality people

作　　者：崔兰[1] 熊英环[2] 金乃星[3] 方今女[2] 

机构地区：[1]延边大学附属医院心内科,吉林延吉133000 [2]延边大学医学院预防医学教研部,吉林延吉133002 [3]延边大学护理学院预防医学教研部,吉林延吉133002

出　　处：《吉林大学学报（医学版）》2014年第2期422-427,共6页Journal of Jilin University：Medicine Edition

基　　金：国家自然科学基金资助课题(30860244);吉林省教育厅科研基金资助课题[2008(2)]

摘　　要：目的:调查吉林省延边朝鲜族自治州朝鲜族和汉族人群胰岛素抵抗(IR)及其相关代谢危险因素,分析IR对不同代谢危险因素及其聚集强度的影响。方法:在吉林省延边朝鲜族自治州安图县随机选择6个自然村,采用整群抽样的方法,抽取7 856名(朝鲜族4 052名和汉族3 804名)作为研究对象,通过问卷调查和体格检查的方式调查研究对象的一般情况,测定体质量指数(BMI)、腰围(WC)、血压(BP)和空腹血糖(FBG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)及胰岛素水平等指标。采用稳态模式评估法(HOMA)估测人体IR(HOMA-IR),根据《中国成人血脂异常防治指南》建议的标准诊断代谢综合征(MS)。结果:吉林省延边地区朝鲜族和汉族人群IR发生率分别为27.6%和22.3%,MS患病率分别为28.2%和18.9%,不同民族IR发生率比较差异有统计学意义(P<0.001);不同民族人群代谢危险因素检出率及MS患病率均随HOMA-IR水平升高而升高(P<0.001);朝鲜族人群代谢危险因素1种、2种、3种和4种以上异常者IR检出率分别为17.1%、25.2%、38.7%和68.8%,汉族人群上述指标分别为15.2%、25.2%、39.2%和60.4%,朝鲜族和汉族人群比较差异有统计学意义(P<0.001);多因素Logistic回归分析,IR对高血糖、腹型肥胖、低HDL-C、高TG和高血压患者患病危险的影响程度有所不同,其优势比(OR)和95%可信区间(CI)分别为26.383(18.654,37.314)、2.042(1.647,2.532)、1.994(1.736,2.291)、1.455(1.246,1.699)及1.188(1.031,1.368),且存在民族差异。IR对朝鲜族和汉族人群MS患病危险的影响程度不同,其OR和95%CI分别为4.649(3.685,5.865)和3.750(2.849,4.936)。结论:不同代谢危险因素检出率及MS的患病危险均随着IR程度的增加而升高;IR对不同代谢危险因素及MS患病危险的影响程度有所不同,且存在民族差异。Objective To investigate the insulin resistance （IR） and its related metabolic risk factors and to analyze the influence of IR in the different metabolic risk factors and their clusters among the Korean-Chinese and Han nationality people in Yanbian Korean Autonomous Prefecture area. Methods Six natural villages in Antu County of Yanbian Korean Autonomous Prefecture area were selected. Using epidemiological investigation methods combined with laboratory measurement, the body mess index （BMI）, waist circumference （WC）, blood pressure （BP）, fasting blood glucose （FBG）, triglycerides （TG）, high density lipoprotein-cholesterol （HDL-C）, and insulin levels in 7 856 persons （4 052 Korean-Chinese, 3 804 Han nationality） were measured. The homeostasis model assessment （HOMA） method was used to estimate the human IR （HOMA-IR）, and metabolic syndrome （MS） was detected according to the Guidelines on ＂Prevention and Treatment of Blood Lipid Abnormality in Chinese Adult＂. Results The prevalence rate of IR was 27.6% in Korean-Chinese and that was 22.3% in Han nationality, and the prevalence rates of MS were 28.2% and 18.9%, respectively. The detection rate of IR in Korean-Chinese was increased than that in Han nationality （P〈0. 001）. The prevalence rates of metabolic risk factors and MS were progressively increased with the increasing of the HOMA-IR levels （P〈0. 001）. The detection rates of IR in the Korean-Chinese people with one kind of metabolic risk factor were 17.1%, 25.2% in two kinds of metabolic risk factors, 38.7% in three kinds of metabolic risk factors, and 68.8% in more than four kinds of metabolic risk factors; they were 15.2%, 25.2%, 39.2%, and 60.4% in Han nationality（P〈0. 001）. The Logistic regression analysis results showed that the relative risks （95% CI of hyperglycemia, central obesity, low HDL-C, high TG and high BP for IR were 26.383 （18.654, 37.314）, 2.042 （1.647, 2.532）, 1.994 （1.736, 2.291）, 1.455 （1. 246, 1. 699）, and 1.

关 键 词：胰岛素抵抗 代谢危险因素 代谢综合征 朝鲜族 

分 类 号：R587.1[医药卫生—内分泌]