上海市社区中老年人代谢综合征与糖尿病发病风险相关性的研究  

Correlation of metabolic syndrome with incident diabetes

作　　者：施琰 高金丽 黄小琳[3] 彭魁[3] 徐敏[3] 毕宇芳[3] 倪衡如 

机构地区：[1]上海市宝山区大场镇第三社区卫生服务中心,上海200436 [2]上海市宝山区淞南镇社区卫生服务中心,上海200441 [3]上海市内分泌代谢病临床医学中心上海市内分泌代谢病研究所上海交通大学医学院附属瑞金医院内分泌代谢科,上海200025

出　　处：《诊断学理论与实践》2016年第4期354-359,共6页Journal of Diagnostics Concepts & Practice

基　　金：上海卫生系统重要疾病联合攻关项目(2013ZYJB1002);上海市宝山区科学技术委员会科研项目(13-E-44)

摘　　要：目的：探讨基线代谢综合征及其各组分与糖尿病发病风险间的相关性。方法：对上海市宝山区淞南社区5734名40岁及以上的非糖尿病常住居民进行问卷调查、体格检查、75g口服葡萄糖耐量试验及血糖、血脂等生化检测。按照亚洲人特点改良的美国国家胆固醇教育计划成人治疗组第三次报告 （the third report of the National Cholesterol Education Program Adult Treatment Panel Ⅲ, NCEP-ATP Ⅲ ）诊断标准，在排除高血糖后，符合2项及以上者定义为代谢综合征．而空腹血糖大于7．0mmol／L或正在服用降糖药者则定义为糖尿病。结果：4年随访期间，5734名上海市宝山区淞南社区40岁及以上的非糖尿病常住居民中有532名新发糖尿病，累积发病率为9．3％。基线代谢综合征患者的糖尿病发病风险较非代谢综合征者增加1．49倍（OR=2．49．95％CI为1．99．3．10）。代谢综合征组分个数与糖尿病发病风险增加呈显著正相关：而代谢综合征各组分中，高血压对新发糖尿病的影响最显著（OR=2．03，95％CI为1．64．2．51），其次为中心性肥胖、高三酰甘油。结论：上海市宝山区淞南社区40岁及以上的非糖尿病常住居民中，代谢综合征对新发糖尿病具有独立预测作用。组分个数越多，糖尿病发病风险越高，且各组分中，高血压对新发糖尿病的预测作用最显著。Objective： To investigate the effect of metabolic syndrome and its components on incident diabetes. Methods： Non-diabetes participants were recruited from a community-based cohort including 5 734 individuals aged 40 years or older. Questionaires, physical examination and blood biochemical examination were performed and the participants were followed for 4 years. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel Ill （NCEP-ATP m） criteria. Fasting plasma glucose ≥7.0 mmol/L or use of antidiabetie drugs was defined as incident diabetes. Results： During the 4 years of follow-up, 532 participants developed diabetes, with a cumulative incidence of 9.3%. Compared with participants without metabolic syndrome, people with metabolic syndrome had a 149% increased risk of incident diabetes （OR： 2.49, 95%CI： 1.99-3.10）. Number of metabolic syndrome components presented was positively correlated with the increased risk of incident diabetes. Moreover, among all the components, hypertension had a major contribution to the development of diabetes （OR： 2.03, 95% CI： 1.64-2.51）. Conclusions： Metabolic syndrome predicts the occurrence of diabetes in middle-aged and elderly Chinese people, and hypertension is the main attributor. Number of metabolic syndrome components presented is positively correlated with the increased risk of incident diabetes.

关 键 词：代谢综合征 糖尿病 相关性 

分 类 号：R587.1[医药卫生—内分泌]