军事飞行人员糖尿病前期影响因素的列线图分析  

Nomogram analysis of the influencing factors of prediabetes in military flying personnel

作　　者：朱迪 王凤琳 王良宸 陈莹 周露瑶 梁洁梅 杨彩哲 ZHU Di;WANG Fenglin;WANG Liangchen;CHEN Ying;ZHOU Luyao;LIANG Jiemei;YANG Caizhe(Department of Endocrinology,Air Force Medical Center,Beijing 100142,China)

机构地区：[1]空军特色医学中心内分泌科,北京100142

出　　处：《空军军医大学学报》2024年第10期1155-1160,共6页Journal of Air Force Medical University

基　　金：首都临床特色应用研究项目(Z181100001718025);全军后勤科研计划重点项目(BKJ16J009);空军军医大学人才工程雏鹰项目(KT2021DX005)。

摘　　要：目的分析我军飞行人员糖尿病前期的影响因素,为糖尿病前期及糖尿病的防控提供参考依据。方法纳入2018年4月至10月在我军某两所特勤疗养中心疗养的飞行人员为研究对象,收集临床资料、飞行资料、身体测量指标、化验指标,并检测服用75 g葡萄糖2 h的血糖水平。采用logistic回归及列线图模型分析影响糖尿病前期的因素。结果1092名飞行人员中糖尿病前期患者77例(7.05%),正常血糖者1007例(92.22%),糖尿病患者8例(0.73%)。糖尿病前期组年龄、飞行时间、饮酒史占比、高甘油三酯血症(HTG)病史比例、体质量指数、腰臀比(WHR)、甘油三酯、总胆固醇、肝功能异常比例及空腹血糖、糖负荷后2 h血糖显著高于正常血糖组(P<0.05);饮酒、肝功能异常、WHR、飞行时间超2000 h、HTG可能是糖尿病前期的独立影响因素。列线图模型分析显示,各因素评分的总分范围为90~166分,对应的预测概率范围为0.05~0.60,总分越高,糖尿病前期的患病风险越大。结论饮酒、肝功能异常、飞行时间超2000 h、HTG、WHR可能是军事飞行人员糖尿病前期的独立影响因素,纳入上述因素的列线图模型可更直观地评价飞行人员糖尿病前期的风险,为糖尿病前期和糖尿病的筛查及预防提供线索。Objective To analyze the influencing factors of prediabetes in Chinese military flying personnel,and to provide reference for prevention and control of prediabetes and diabetes.Methods Flying personnel recuperating in two healthcare centers for special services from April to October 2018 were included as research objects.Clinical data,flight data,body measurements,and laboratory indicators were collected,and blood glucose levels were detected after taking 75 g glucose for 2 h.Logistic regression analysis and nomogram model were used to analyze the factors affecting prediabetes.Results Among the 1092 flying personnel,77(7.05%)had prediabetes,1007(92.22%)had normal glucose,and 8(0.73%)had diabetes.Age,flight time,proportion of drinking history,proportion of hypertriglyceridemia(HTG)history,body mass index,waist-to-hip ratio(WHR),triglyceride,total cholesterol,proportion of liver dysfunction,fasting blood glucose,and 2-hour postprandial blood glucose in prediabetes group were significantly higher than those in normal blood glucose group(P<0.05).Alcohol consumption,liver dysfunction,WHR,flight time exceeding 2000 h,and HTG were independent influencing factors of prediabetes.Nomogram model analysis showed that the total score of each factor ranged from 90 to 166,and the corresponding prediction probability ranged from 0.05 to 0.60.The higher the total score,the greater the risk of prediabetes.Conclusion Alcohol consumption,liver dysfunction,flight time exceeding 2000 h,HTG,and WHR may be independent influencing factors of prediabetes in military flying personnel.The nomogram model including the above factors can more intuitively evaluate the risk of prediabetes in flying personnel and provide clues for the screening and prevention of prediabetes and diabetes.

关 键 词：军事飞行人员 糖尿病前期 列线图 

分 类 号：R856[医药卫生—航空、航天与航海医学]