浦东新区某社区居民糖代谢状况及糖代谢正常人群空腹胰岛素水平与血糖、血压、血脂和肥胖的相关性  

Association of fasting plasma insulin with blood glucose, blood pressure, blood lipids and obesity in residents with different glucose metabolism of a community in Pudong new area

作　　者：芮欣忆[1] 阮晓楠[1] 周先锋[1] 于思雨[1] 邱桦[1] 周弋[1] 吴抗[1] 王小楠[1] 刘红 姚玉萍 RUI Xin-yi RUAN Xiao-nan ZHOU Xian-feng YU Si-yu QIU Hua ZHOU Yi WU Kang WANG Xiao-nan LIU Hong YAO Yu-ping(Chronic Non-communicable Disease Control and Prevention Section, Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai 200136, China)

机构地区：[1]上海市浦东新区疾病预防控制中心慢性病防治科,复旦大学浦东预防医学研究院,上海200136 [2]浦东新区高桥社区卫生服务中心预防保健科

出　　处：《中国慢性病预防与控制》2016年第10期741-745,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：上海市卫生局科研项目(20124379)

摘　　要：目的分析上海市浦东新区某社区居民糖代谢状况及糖代谢正常人群空腹胰岛素（FIns）水平与血糖、血压、血脂和肥胖的相关性,为2型糖尿病（T2DM）的防控提供依据。方法 2009年在浦东新区某社区高桥过多阶段随机抽样方法抽取1 317名居住满5年及以上的35-74岁社区居民进行横断面调查。上述调查对象于2012年进行复查,947名社区居民完成2次调查并资料完整,该研究对第2次调查结果进行了分析。调查对象均进行体格检测、血压、空腹血糖（FPG）、FIns及血脂等生化检测,并根据不同FIns水平将糖代谢正常人群分为高胰岛素血症组（NGT-HIns）和非高胰岛素血症组（NGT-NHIns）,分别为588和49例。采用SPSS 22.0软件进行t检验、方差分析和χ^2检验,采用logistic回归进行多因素分析。结果该社区居民T2DM患病率为18.16%,糖调节受损（IGR）患病率为14.57%。男性IGR和T2DM患病率高于女性,差异均有统计学意义（P〈0.05）。T2DM患病率在75-岁达到峰值（40.00%）,其次是65-74岁组（23.27%）;65-74岁组调查对象的IGR患病率最高（20.13%）,其次为35-44岁组（19.78%）。不同糖代谢人群的收缩压、舒张压、体质指数（BMI）、腰围、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、FPG和FIns水平差异均有统计学意义（P〈0.05）。NGT-HIns人群的收缩压、舒张压、BMI、腰围、TG、FPG、稳态模型胰岛素抵抗指数（HOMA-IR）、胰岛β细胞功能指数（HOMA-B）均高于NGT-NHIns人群,HDL-C和胰岛素作用指数均低于NGT-NHIns人群,差异均有统计学意义（P〈0.05）。多因素回归分析结果显示,收缩压上升（OR=1.023）、超重（OR=2.851）以及肥胖（OR=3.911）都是正常糖耐量人群中有高胰岛素血症的危险因素（P〈0.05）;年龄增长（OR=0.955）及HDL-C的升高（OR=0.056）能降低正常糖耐量人群中�Objective To aralyze the association of fasting plasma insulin（FIns）with blood glucose, blood pressure, blood lipids and obesity in residents with different glucose metabolism of a community in Pudong new area, and to provide the basis for preventing and treating T2DM. Methods The two-stage cluster randomized sampling method was used to select 1 317 community residents（35-74 years old）living in Gaoqiao Town for at least five years to conduct the cross-sectional study in 2009. In 2012, the secondround cross-sectional study was performed for 947 residents and the data was analyzed. A structured questionnaire was used for interview, the physical examination and biochemical test（FPG, FIns and blood lipid）were also conducted. According to FIns level, the subjects were divided into NGT-HIns group（588 cases）and NGT-NHIns group（49 cases）. The χ^2 test, t test, ANOVA and multinomial logistic regression were used to analyze the data with SPSS 22.0 software. Results The morbidity of T2DM among the residents was 18.16%, and the morbidity of impaired glucose regulation（IGR）was 14.57%. The morbidities of T2DM and IGR in males were significantly higher than those in females（P〈0.05）. The morbidity of T2DM in residents 〉75 years old was the highest（40.00%） and the morbidity of IGR in residents 65-74 years old was the highest（20.13%）. There were significant differences of systolic pressure, diastolic pressure, BMI, waistline, TC, TG, HDL-C, LDL-C, FPG and FIns between NGT-HIns group and NGT-NHIns group（P〈0.05）. The systolic pressure, diastolic pressure, BMI, waistline, TG, FPG, HOMA-IR and HOMA-B in NGT-HIns group were significantly higher than those in NGT-NHIns group; the HDL-C and Insulin action index in NGT-HIns group were significantly lower than those in NGT-NHIns group（P〈0.05）. The multinomial logistic regression analysis showed that increasing SBP level（OR =1.023）, overweight（OR =2.851） and obesity（OR =3.911） were the risk factors for hyperinsulinemia（HIns�

关 键 词：空腹胰岛素 血糖 血压 血脂 

分 类 号：R587.1[医药卫生—内分泌]