石家庄市中老年代谢综合征人群糖代谢状态及HbA1c水平分析  

Analysis of HbA1c Profile and Glucose Tolerance State in Middle-aged and Senior People with Metabolic Syndrome in Shijiazhuang City

作　　者：王伟超[1] 张洁[2] 刘素波 闫淑静[1] 梁屹[1] 任巧华[1] 吴韬[1] 

机构地区：[1]石家庄市第一医院内分泌科,河北石家庄050011 [2]石家庄市第三医院眼科,河北石家庄050000

出　　处：《现代预防医学》2014年第8期1494-1497,共4页Modern Preventive Medicine

基　　金：石家庄市科学技术研究与发展指导计划项目(121461173)

摘　　要：目的 了解石家庄市中老年代谢综合征（MS）人群糖化血红蛋白（HbA1c）水平及糖代谢特点，了解不同糖代谢及HbA1c水平下MS患病情况。方法 分层随机抽样选择石家庄市9个社区，居住5年以上，年龄≥45岁的社区居民，进行横断面流行病学问卷调查和体格检查，检测空腹血糖（FPG）、HbA1c、血脂及口服糖耐量试验。据1999年WHO糖尿病诊断标准和2005年IDF代谢综合征全球共识定义诊断。以HbA1c及糖代谢状态分成不同亚组，并进行统计学分析。结果 石家庄市中老年人群MS患病率为21.2%，女性为14.8%，男性为6.4%（P＜0.05）；65岁以上和65岁以下人群分别为24.8%和19.7%（P＜0.01）。HbA1c以6.5%为切点MS患病率分别为14.1%和59.7%（P＜0.01）。其中除HbA1c＜5.0%与HbA1c介于5.0%～6.0%时各组间MS患病率无差异外，HbA1c＜6.5%时各分层之间及其与HbA1c≥6.5%时各分层间MS患病率两两不同。NGT、DM之间及其与IFG、IGT、IFG＋IGT间，MS患病率两两不同。年龄、性别、糖尿病家族史、喜食甜食、BMI、WHR、TG、HDL-C、SBP、DBP、FPG、2h-PG、HbA1c为MS高发的主要危险因素。结论 石家庄市MS患病率较高，HbA1c水平监控、糖代谢状态筛查，有助于MS的诊断及防控。Objective This study was to investigate the HbAlc profile and glucose tolerance state in middle-aged and senior people with metabolic syndrome in Shijiazhuang City. Methods Stratified random sampling method was utilized to select residents above 45 years old from 9 communities in Shijiazhuang City for the cross-sectional epidemiological questionnaire survey and physical ex- amination. A total of 1447 subjects （509 males and 938 females） were selected. Fasting plasma glucose, HbAlc, serum lipid test, and oral glucose tolerance test were conducted to the subjects. Glucose tolerance state and metabolic syndrome （MS） diagnosed by the criteria of WHO （1999） and IDF （2005） were used to divide the subjects into subgroups for statistical analysis by ANOVA test and SNK-q test methods. The prevalence of MS and its attributing factors were analyzed by logistic regression model. Results The prevalence of metabolic syndrome was 21.2% in Shijiazhuang, with 6.4% in male and 14.8% in female （X2=4.075, P=-0.044）, 24.8% for people above 65 years and 19.7% under 65 years （x2=4.651, P=-0.031）. The prevalence of metabolic syndrome was different by HbA1C profile, with 59.7% for the group of HbA l c t〉 6.5% and 14.1% for HbAlc〈6.5% （X2=237.732, P〈0.01）. The prevalence of metabolic syndrome did not show statistically significant differences between IFG, IGT, and IFG＋IGT group, but has significant dif ference between NGT and DM group （P〈0.01）. The multivariable stepwise analysis showed that the major risk factors for metabolic syndrome include age, sex, family history of diabetes, confection-eating, body mass index, waist-to-hip ratio, plasma triglyceride, low-density lipoprotein cholesterol, systolic blood pressures, diastolic blood pressures, fasting plasma glucose, 2-h postprandial blood glucose and hemoglobin Ale. Conclusion The prevalence of metabolic syndrome was high in Shijiazhuang City. Monitoring the changes in HbAle profile and glucose tolerance state of the patients will be important

关 键 词：代谢综合征 糖化血红蛋白 中老年 患病率 糖代谢状态 糖尿病 

分 类 号：R181.38[医药卫生—流行病学]