摘要
目的了解糖尿病前期人群的血脂特点,并探讨血脂对糖尿病前期人群血糖转归的影响。方法采用整群随机抽样法,选取2011年4—11月泸州市区内茜草、大山坪、龙马潭3个社区居民4 000名,从中筛选出糖尿病前期人群1 090名,根据不同血糖状态分为单纯空腹血糖受损（IFG）（n=79）、单纯糖耐量异常（IGT）（n=856）和空腹血糖受损＋糖耐量异常（IFG＋IGT）（n=155）3组。对糖尿病前期人群进行基线调查和为期3年的随访,比较3组基线血脂水平及血脂异常患病率、随访3年后的血糖转归情况、不同转归患者的基线资料,并分析血脂对糖尿病前期血糖转归的影响。结果 IFG＋IGT组总胆固醇（TC）水平高于IGT组,三酰甘油（TG）水平高于IFG、IGT组,高密度脂蛋白胆固醇（HDL-C）水平低于IFG组,差异均有统计学意义（P〈0.05）;而且IFG＋IGT组高TG血症患病率高于IFG、IGT组,差异亦有统计学意义（P〈0.016 7）。随访3年后,1 090名糖尿病前期人群转归为正常糖耐量395人、IFG 32人、IGT 419人、IFG＋IGT 56人、糖尿病188人,3组血糖转归分布间差异有统计学意义（χ2=41.579,P〈0.001）;其中IFG、IGT、IFG＋IGT转变为糖尿病的年转变率分别为4.2%、5.0%、10.5%。转归为糖尿病的患者基线年龄、BMI、腰围、臀围、收缩压、糖化血红蛋白、空腹血糖、口服葡萄糖耐量试验（OGTT）2 h血糖、TG水平及糖尿病家族史、饮酒史比例均高于转归为正常糖耐量的患者,差异有统计学意义（P〈0.05）。TG为糖尿病前期转归为糖尿病的危险因素,在调整性别、年龄、BMI、腰围、臀围、糖尿病家族史、吸烟史、饮酒史、收缩压、糖化血红蛋白、空腹血糖、OGTT2 h血糖后,与TG1水平（0.35~0.98 mmol/L）相比,TG4水平（2.08~11.70 mmol/L）的OR（95%CI）为1.285（1.067,2.151）,P=0.045。结论糖尿病前期人群合并有不同程度的脂代谢异常,其中以高TG血症为主;IFG＋IGT人群糖尿病的转变率最高;TG对糖尿病前期人群的转归有影响,或可成为糖尿病前期人群糖尿病转归的预测指标。
Objective To investigate the characteristics of blood lipid level of patients with prediabetes and explore the influence of blood lipid level on patients＇ outcome. Methods Using cluster random sampling method,we enrolled 4 000 residents in Qiancao,Dashanping and Longmatan communities from April to November in 2011. A total of 1 090 residents were detected with prediabetes,and these patients were divided into three groups： pure impaired fasting glucose（ IFG） group（ n = 79）,pure impaired glucose tolerance（ IGT） group（ n = 856） and IFG ＋ IGT group（ n = 155）. Baseline data and three- year follow- up were conducted on patients with prediabetes,and comparison was made among the three groups in blood lipid level,prevalence of dyslipidemia,outcome after three- year follow- up and baseline data of patients with different outcomes. The influence of blood lipid on the outcome of patients with prediabetes was also analyzed. Results IFG ＋ IGT group was higher than IGT group in TC level,and was higher than IFG group and IGT group in TG level and lower in HDL-C level than IFG group（ P〈0. 05）; IFG＋ IGT group was higher in the prevalence of high TG level than IFG group and IGT group（ P〈0. 016 7）. After three- year follow- up,the numbers of patients who had an outcome of normal sugar tolerance,IFG,IGT,IFG ＋ IGT and diabetes were395,32,419,56 and 188. The three groups were significantly different in outcome（ χ2= 41. 579,P〈0. 001）,the yearly conservation rates to diabetes from IFG,IGT and IFG ＋ IGT were 4. 2%,5. 0% and 10. 5% respectively. The patients with an outcome of diabetes were higher than the patients with an outcome of normal glucose tolerance in baseline age,BMI,waistline,hipline,systolic pressure,glycosylated hemoglobin,fasting blood glucose,OGTT 2 h blood glucose,TG level and family history of diabetes proportin,history of alcoholic consumption proportion（ P〈0. 05）. TG level was a risk factor for diabetes outcome from prediabetes. After the adjustment of gender,age,BMI,waistline,hipline,the family history of diabetes,the history of smoking,the history of alcoholic consumption,systolic pressure,glycosylated hemoglobin,fasting blood glucose and OGTT 2 h blood glucose and compared with the minimum interquartile range（ TG1 0. 35 ~ 0. 98 mmol / L）,the OR（ 95% CI） of the maximum interquartile range（ TG4 2. 08 ~ 11. 70 mmol / L） was 1. 285（ 1. 067,2. 151）,P = 0. 045. Conclusion Patients with prediabetes have different degrees of dyslipidemia,mainly in the form of high TG level. Patients with IFG ＋ IGT have high conversation rate to diabetes; TG has influence on the outcome of patients with prediabetes and may be a potential predictor for the diabetes outcome of prediabetes patients.
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第1期54-58,共5页
Chinese General Practice
基金
国家代谢性疾病临床医学研究中心资助项目(2013BAI09B13)
关键词
糖尿病前期
血脂
糖尿病
转归
Prediabetic state
Blood lipids
Diabetes mellitus
Outcome
