摘要
目的分析空腹血糖受损(IFG)的空腹血糖(FPG)诊断标准下调对糖调节受损(IGR)人群检出率的影响,并探讨区分糖调节正常与受损的FPG理想截定点。方法对2882例无2型糖尿病(T2DM)史的受试者进行口服葡萄糖耐量试验。采用1997年和2003年美国糖尿病学会分类诊断标准进行比较。结果(1)IFG诊断标准下调后,单纯IFG者增加367例,IFG者由424例增加到1032例,其中包含的糖耐量受损(IGT)者由243例增加到484例;709例IGT者,包括在IFG者中的比例由34%上升到68%。(2)与糖耐量正常(NGT)人群相比,新增单纯IFG人群体质指数、FPG、2hPG、糖化血红蛋白、甘油三酯、胆固醇均升高(均P<0.01),超重(52.6vs39.7%,χ2=6.79,P<0.01)和高甘油三酯血症发生率(32.2%vs24.9%,χ2=3.98,P<0.05)明显增高。(3)非T2DM人群中诊断IGR(7.8≤2hPG<11.1mmol/L)的FPG理想截定点为5.6mmol/L。结论IFG诊断标准下调后,IFG、IFG+IGT检出率明显增加;新增单纯IFG人群已经出现糖、脂代谢异常;非T2DM人群中诊断IGR的FPG理想截定点为5.6mmol/L。
To analyse the effect of the down regulation of diagnostic criteria of impaired fasting glucose on the detection rate of impaired gluose regulation subjects, and to investigate the optimal FPG cut-point for normal and abnormal glucose metabolism. Methods A total of 2882 subjects without history of type 2 diabetes mellitus （T2DM） received oral glucose tolerance test （OGTT）. The 1997 and 2003 ADA diabetes diagnostic criteria were used for analysis. Results （1） After the low limit for IFG was decreased from 6.1 to 5.6 mmol/L, the isolated IFG（I-IFG） subjects increased by 367 cases. Meanwhile the IFG subjects increased from 424 to 1032 cases, and the IGT subjects combining IFG increased from 243 to 484 cases. In all IGT subjects, the IGT subjects combining IFG increased from 34% to 68%. （2） The newly increased I-IFG population had higher levels of BMI, FPG, HbA1c, TG and TC （all P＜0. 01） and a higher prevalence of overweight （P＜0.01） as compared with those in NGT. （3） The optimal FPG cut-point relative to impaired glucose tolerance （IGT）（7.8≤2 hPG＜11. 1 mmol/L） was 5.6 mmol/L in non-DM subjects. Conclusions After the low limit for IFG is decreased, the IFG and IFG plus IGT subjects increase significantly. In newly increased I-IFG subjects, the metabolic abnormalities of glucose and lipid occur. In non-DM subjects the optimal FPG cut-point for IGR is 5.6 mmol/L.
基金
军队十五重点课题(01Z033)
关键词
空腹血糖受损
诊断标准
糖调节受损
脂代谢
糖尿病
Impaired fasting glucose
Impaired glucose tolerance
Diabetes
Diagnostic criteria
