糖耐量变化与降糖药物对社区中老年人中长期非意向性体重减轻的影响：2年随访研究  

Glucose tolerance changes and hypoglycemic drugs have impact on middle or long-term unintentional weight loss of the community-dwelling middle-aged and elderly adults：2 years follow-up study

作　　者：吴跃跃[1] 刘军[1] 徐炯[1] 陈灶萍[1] 盛励[1] 黄新梅[1] 杨敏[1] 许群欢[2] 顾勇[3] 洪洋[3] 韩小洁[3] 

机构地区：[1]复旦大学附属上海市第五人民医院内分泌代谢科,上海200240 [2]复旦大学附属上海市第五人民医院检验科,上海200240 [3]复旦大学附属上海市第五人民医院慢性病平台,上海200240

出　　处：《临床内科杂志》2017年第2期101-103,共3页Journal of Clinical Internal Medicine

摘　　要：目的探索糖耐量变化及降糖药物对社区中老年人中长期非意向性体重减轻的影响。方法选取2008年在我院体检中心完成健康体检并于2010年完成随访的中老年人2861例，比较分析其基线及2年后的体重、糖代谢指标及一般资料，采用Logistic回归分析社区中老年人非意向性体重减轻的危险因素。结果2年后，21．7％中老年人体重减轻，17．3％体重增加，61．O％体重稳定。9．6％新出现糖尿病，22．4％新出现糖耐量减低（IGT），3．4％新出现空腹血糖调节受损（IFG）；2．5％IGT患者糖耐量恢复正常，2．0％IFG患者空腹血糖恢复正常，60．1％糖耐量维持不变者。2年内服用降糖药物史：双胍类（5．6％），磺脲类（12．7％），氨基酸衍生物（0．3％），阿卡波糖（4．8％），噻唑烷二酮类（TZDs）（1．1％），胰岛素（1．8％），中成药（2．6％）。Log／st／c回归分析结果显示，新发糖尿病（OR=1．45，95％C，1．07～1．97，P：0．018）、阿卡波糖服用史（OR=1．56，95％CI1．00—2．46，P=0．051）是社区中老年人非意向性体重减轻的危险因素。结论新发糖尿病及阿卡波糖服用史是社区中老年人中长期非意向性体重减轻的危险因素。Objective To investigate the impact of glucose tolerance changes and hypoglycemic drugs on the middle or long-term unintentional weight loss of the community-dwelling middle-aged and elderly people. Methods A total of 2 861 middle aged and elderly people who completed physical examination in 2008 and completed 2 years follow-up study in 2010 were enrolled. Collect weight data of baseline and 2 years later, biochemical indexes of glucose metabolic and general information and analyze the weight changes, glucose tolerance changes and the usage of hypoglycemic drugs within 2 years. The risk factors of unintentional weight loss were analyzed by Logistic regression analysis. Results Two years later,21.7% participants had lost weight,17.3% had gained weight and 61.0% were weight-stable. A total of 9.6% participants were diagnosed with new onset diabetes, 22.4% had new appearance of abnormal glucose tolerance（IGT） and 3.4% had new appearance of impaired fasting glucose （IFG）. Meanwhile, 2.5% participants with IGT and 2.0% with IFG in baseline were found recovering to normal glucose tolerance. Another 60.1% participants were still with stable glucose tolerance state. The following hypoglycemic drugs were used within 2 years ： biguanides （ 5.6% ）, sulfonylureas （ 12.7 % ）, glinides （0.3 % ）, acarbose （4.8%） ,thiazolidinediones （ 1.1% ） ,insulin（ 1.8% ） and traditional Chinese medicine（2.6% ）. Logistic regression analysis showed that the new onset diabetes （ OR = 1.45,95 % CI 1.07-1.97, P = 0.018 ） and acarbose taking history（ OR = 1.56,95% CI 1.00-2.46 ,P =0. 051 ） were the risk factors for unintentional weight loss of the community-dwelling middle-aged and elderly people. Conclusion The new onset diabetes and acarbose taking history are risk factors for middle or long-term unintentional weight loss of the community-dwelling middle-aged and elderly adults.

关 键 词：糖耐量 降糖药物 中老年 非意向性体重减轻 

分 类 号：R541.4[医药卫生—心血管疾病]