综合干预对老年人糖代谢异常进程的影响

目的分析在综合干预状态下,老年糖耐量正常者(NGT)进展为糖调节异常者(IGR),以及IGR进展为糖尿病(DM)的情况。方法于2002年对军队老年离退休干部心血管疾病危险因素进行了4年综合干预,对其中549例NGT、110例IGR定期随访4年。结果综合干预结束时,研究人群的血压、血脂、体质量指数(BMI)均有显著性下降(P<0.01)。NGT进展为IGR的比率为30.97%,其中6.74%进展为空腹血糖受损(IFG),16.39%进展为糖耐量异常(IGT),7.83%进展为空腹血糖受损合并糖耐量异常(IFG/IGT),由NGT进展为IGT的比率明显高于IFG(P<0.01);IFG检出率增加了1.11倍,进展为IFG1的比率(4.55%)明显高于IFG2(2.19%)(P<0.05)。110例IGR人群中,19.61%的IGT进展为DM,16.28%的IFG进展为DM,IGT与IFG进展为糖尿病的比例差异无统计学意义(P>0.05)。8.70%的IFG1进展为DM,25.00%的IFG2进展为DM(P>0.05);43.75%的IFG/IGT进展为DM,进展率明显高于IFG、IGT(P<0.05)。基线时IGR累计进展为DM的比率是21.82%。结论老年人进展为IGT的比率明显高于IFG,IFG/IGT进展为DM的比率明显高于单独的IFG或IGT。

The effect of comprehensive intervention on abnormal glucose metabolism process in the elderly

Objective To analyze the effect of comprehensive intervention on abnormal glucose metabolism progression in the elderly. Methods Comprehensive intervention in the retired elderly cadres with the cardiovascular disease risk factors were conducted from the year of 2002 to 2006,549 elderly cadres with normal glucose tolerance （NGT） and 110 ones with impaired glucose regulation （IGR） were follow-up for four years. Results The average levels of blood pressure,TC, LDL-C ,TG and BMI were reduced significantly（P 〈 0. 01 ） at the end of comprehensive intervention. Among the 549 subjects with NGT,30.97% had progressed to IGR. Among the subjects developed to IGR, the progression rates of IFG, IGT, and combined IFG and IGT （IFG/IGT） were 6.74% , 16.39%, and 7.83%, respectively. The progression rates of IGT was significantly higher than that of IFG and IFG/IGT （ P 〈 0. 01 ）. The prevalence rate of IFG according to the new IFG criteria was 1.1 times the rate of the old IFG criteria, the progression rate of IFG1 with 4.55% was significantly higher than that of IFG2 with 2.19% （ P 〈 O. 05 ）. At baseline, 110 subjects had IGR. At the end of follow-up,16.28% had progressed to diabetes from IFG,whereas 19.61% to diabetes from IGT, and there was no statistically significant difference （ P 〉 0. 05 ）. 8.70% had progressed to diabetes from IFGl,while 25.00% to diabetes by IFG2 （P 〉0. 05）. 43.75% had progressed to diabetes by IFG-IGT, and the progression rate from IFG-IGT to diabetes was significantly higher than that of IFG or IGT （P 〈 0. 05 ）. The cumulative incident of diabetes from IGR at baseline was more than that of the newly acquired IGR from NGT （ 21.82 vs. 3.28%, P 〈0. 01 ）. Conclusion The progression rate of IGT from NGT is significantly higher than that from IFG in elderly, and the progression rate from IFG-IGT to diabetes is significantly higher than isolated IFG or IGT, the cumulative incident of diabetes of IGR at baseline is significantly more than that of the newly acquired IGR from NGT.