脂质比值TC/HDL-C、TG/HDL-C和LDL-C/HDL-C与胰岛素抵抗、糖尿病及糖尿病前期的关联性  

Study on the association of three TC/HDL-C,TG/HDL-C and LDL-C/HDL-C lipid ratios with insulin resistance,diabetes and pre-diabetes

作　　者：辛鹏[1] 李静[1] 李昌昆 范莉莉 郑文龙[1] 王德征[1] XIN Peng;LI Jing;LI Chang-kun;FAN Li-li;ZHENG Wen-long;WANG De-zheng(Institute of Non-communicable Disease Control and Prevention,Tianjin Centers for Disease Control and Prevention,Tianjin 300011,China)

机构地区：[1]天津市疾病预防控制中心非传染病预防控制室,天津300011

出　　处：《中华疾病控制杂志》2022年第5期535-540,共6页Chinese Journal of Disease Control & Prevention

基　　金：天津市卫生高层次人才选拔培养项目(2018)。

摘　　要：目的研究天津市成人脂质比值TC/HDL-C、TG/HDL-C和LDL-C/HDL-C与胰岛素抵抗、糖尿病和糖尿病前期的关联性,以期探索、评估这三项脂质比值在糖尿病的公共卫生预防、临床诊断、病情预测等方面的价值。方法根据中国成人慢性病与营养监测方案,调查天津市河西区等7个区18岁及以上常住居民,收集其空腹静脉血,检测血脂四项、FPG和胰岛素水平。将TC/HDL-C、TG/HDL-C和LDL-C/HDL-C按照四分位数法进行分组,采用二分类Logistic回归分析模型分析其与胰岛素抵抗、糖尿病和糖尿病前期的OR值及其95%CI。结果天津市调查人群中糖尿病患病率合并糖尿病前期患病率为46.6%(2030/4356)。总人群中,TC/HDL-C和TG/HDL-C升高均能增加胰岛素抵抗风险,但是与LDL-C/HDL-C<1.78组相比,只有≥2.86组胰岛素抵抗患病风险增加(OR=1.78,95%CI:1.21~2.63);不论是男性还是女性,随着TC/HDL-C和TG/HDL-C的升高,糖尿病、糖尿病前期的患病风险增加,关联性较强,且与LDL-C/HDL-C的关联性低于TC/HDL-C和TG/HDL-C;与男性相比,女性TC/HDL-C、TG/HDL-C和LDL-C/HDL-C增加会导致糖尿病、糖尿病前期和糖尿病合并糖尿病前期患病风险的增加。结论TC/HDL-C和TG/HDL-C的升高,会增加胰岛素抵抗、糖尿病和糖尿病前期的患病风险;LDL-C/HDL-C与胰岛素抵抗、糖尿病和糖尿病前期的患病风险关联性较弱。Objective To study the association between the ratios of lipid TC/HDL-C,TG/HDL-C and LDL-C/HDL-C and insulin resistant diabetes and pre-diabetes in adults in Tianjin City,in order to explore the evaluation value of lipid ratios levels in public health prevention,clinical diagnosis and disease prediction of diabetes.Methods According to the Chinese adult chronic disease and nutrition surveillance program,inhabitants aged 18 years and above were investigated in 7 Districts including Hexi District in Tianjin City.And their fasting venous blood was collected to detect four blood lipids,fasting plasma glucose and insulin.TC/HDL-C,TG/HDL-C,LDL-C/HDL-C levels were Divided into four groups according to the quartile method,and the OR value,95%CI with insulin resistance,diabetes and pre-diabetes were analyzed use binary Logistic regression analysis model.Results The prevalence of diabetes combined with pre-diabetes in the investigated population in Tianjin was 46.6%(2030/4356).The elevation of TC/HDL-C and TG/HDL-C increased the risk of insulin resistance in the participants,but limited to the LDL-C/HDL-C≥2.86 group,the risk of insulin resistance increased by 1.78(95%CI:1.21-2.63)times when compared with the ratio<1.78 group.With the increase of TC/HDL-C and TG/HDL-C,the risk of diabetes and pre-diabetes increased in both men and women,and the correlation was strong,and the correlation with LDL-C/HDL-C was lower than that of TC/HDL-C and TG/HDL-C.In addition,it was found that the increase of TC/HDL-C,TG/HDL-C and LDL-C/HDL-C had a stronger effect on increasing the risk of diabetes and pre-diabetes in females compared to males.Conclusions The increase of TC/HDL-C and TG/HDL-C can increase the risk of insulin resistance,diabetes and pre-diabetes.LDL-C/HDL-C is weakly associated with the risk of insulin resistance,diabetes and pre-diabetes.

关 键 词：胰岛素抵抗 糖尿病 糖尿病前期 脂质比值 

分 类 号：R587.1[医药卫生—内分泌]