甘油三酯、高密度脂蛋白变化与空腹血糖变化的5年随访研究  

Five-year follow-up study of the association between changes in triglycerides, high density lipoprotein cholesterol and the change in fasting blood-glucose

作　　者：郝志华[1] 吕超[1] 李岩[1] 陈春彦[1] 王亚珍[1] 刘玉静[1] 齐春萍[1] 宋光耀[1] 

机构地区：[1]河北省人民医院,河北石家庄050051

出　　处：《现代预防医学》2015年第14期2582-2586,共5页Modern Preventive Medicine

基　　金：河北省卫生厅2012年医学科学研究重点课题

摘　　要：目的 探讨甘油三酯（TG）、高密度脂蛋白（HDL）、甘油三酯/高密度脂蛋白（TG/HDL）变化对2型糖尿病发病的影响。方法 基线人群为石家庄市6个企事业单位职工,排除标准为糖尿病、冠心病、恶性肿瘤、肾衰及空腹血糖（FPG）≥5.6 mmol/L,进行连续5年随访,比较TG、HDL、TG/HDL不同变化下FPG变化率,运用Logistic回归模型分析研究三者变化与FPG变化的关系。结果 在随访过程中TG、HDL、TG/HDL未控制组FPG变化高于三者保持正常或控制组,差异有统计学意义（P〈0.05）。Logistic回归分析与各组在基线正常随访过程中仍保持正常相比,FPG变化TG组边缘升高转为TG升高RR值2.642（95%CI 1.572-4.379）、保持TG升高组RR值2.136（95%CI1.455-3.135）、TG正常转为TG升高RR值1.969（95%CI 1.572-4.379）、TG升高转为TG边缘升高RR值1.954（95%CI 1.084-3.522）、保持TG边缘升高RR值1.717（95%CI 1.110-2.654）、TG正常转为TG边缘升高RR值1.64（95%CI 1.183-2.273）、TG边缘升高转为TG正常RR值1.495（95%CI 1.032-2.167）;HDL组RR值最高为HDL正常转为HDL减低1.857（95%CI 1.620-2.129）;TG/HDL组RR值由高至低为比值仍保持升高组（RR值7.506,95%CI 1.431-4.388）、比值正常转为升高组（RR值2.453,95%CI 1.365-4.408）。结论 TG、HDL及TG/HDL比值长期的变化与空腹血糖水平明显相关,血脂代谢异常在2型糖尿病的发生发展中可能扮演着重要角色。Objective This study was to explore effects of triglycerides （TG）, high density lipoprotein cholesterol （HDL）, and ratio of TG and HDL （TG/HDL） on development of type 2 diabetes mellitus. Methods 2260 staff from enterprises and public institutions were followed up for 5 years. People who have suffered from diabetes mellitus, coronary disease, malignancy, renal failure, and those whose fasting blood-glucose （FPG） level was higher than 5.6 mmol/L were excluded. Logistic regression analysis was performed to examine the association between the change in FPG level and the changes in the level of TG, HDL and the ratio of TG/ HDL. Results Compared to TG normal group, the change in FPG level was significantly higher in the group with abnormal level of TG, HDL and TG/HDL ratio （P〈0.05） during the follow-up. The FPG change was significantly associated with the change of TG, HDL and TG/HDL ratio. With regard to TG, the adjusted RR was 2.642 （95% CI 1.572-4.379） for margin to high group, 2.136 （95% CI 1.455-3.135） for continuous high group, 1.969 （95% CI 1.572-4.379） for normal to high group, 1.954 （95% CI 1.084-3.522） for high to margin group, 1.717 （95% CI 1.110-2.654） for continuous margin group, 1.640 （95% CI 1.183-2.273） for normal to margin group, 1.495 （95% CI 1.032-2.167） for margin to high group. As for HDL, normal to low group had highest RR value （adjusted RR, 1.857; 95% CI 1.620-2.129）. As for TG/I-IDL, continuous high group （adjusted RR, 7.506; 95% CI 1.431-4.388, normal to high group （adjusted RR, 2.453; 95% CI 1.365-4.408） were independently associated with FPG changes. Conclusion The levels of TG, HDL and TG/HDL ratio in a long term follow-up were significantly associated with FPG levels. Impaired lipid metabolism can play an important role in development of type 2 diabetes mellitus.

关 键 词：甘油三酯 高密度脂蛋白 空腹血糖 变化 随访 

分 类 号：R319[医药卫生—基础医学] R446