老年糖代谢异常人群冠心病患病率、发病率及其危险因素的分析

对老年人群冠心病（CHD）患病率和发病率及其相关危险因素进行分析研究。选择1996年5月－1997年6月在本院接受健康查体,年龄60岁以上的无CHD的老年人群作为基线人群,随访至2000年6月。糖尿病（DM）诊断分别按照1985年WHO和1997年美国糖尿病学会（ADA）标准确定。计算基线时CHD患病率,采用人年法计算其发病率,同时还采用Logistic回归分析对4年中新发的CHD危险因素进行分析。基线时按1985年WHO标准,糖耐量低减组（IGT）和DM组的CHD和心肌梗死（MI）患病率均明显高于糖耐量正常组（NGT）（P＜0．05,P＜0．01）。基线时无CHD人群875例,老年人群CHD的发病率为34．26／1000人年,其中IGT和DM组分别为50．42和57．08／1000人年,明显高于NGT组的27．55／1000人年（P＜0．05,P＜0．01）。Logistic逐步回归分析表明,DM、IGT、高血压（HT）、体重指数（BMI）和年龄与CHD发生明显相关;按ADA诊断标准分类,与CHD发生密切相关的危险因素为年龄、HT和DM,空腹血糖异常（IFG）与CHD的发生无明显关系（P＞0．05）。老年人群中按1985年WHO标准诊断的IGT和DM组的CHD患病率和发病率明显高于NGT组,糖代谢异常、高血压、肥胖和增龄与CHD发病密切相关。而按ADA诊断标准,只有糖尿病（DM）的CHD患病率和发病率明显高于NGT组,而与IFG无关。

ANALYSIS OF THE PREVALENCE AND INCIDENCE OF CORONARY HEART DISEASE AND ASSOCIATED RISK FAC-TORS IN THE ELDERLY WITH IMPAIRED GLUCOSE METABOLISM

To evaluate the prevalence and incidence of coronary heart disease (CHD) and associated risk factors with CHD in the elderly, a survey was conducted among old subjects aged 60 to 90 who had health examination in PLA General Hospital from 1996 to 1997. A cohort population without CHD had been followed up until 2000, and the incidence of CHD was calculated as the baseline. The incidence of CHD was calculated by person year method. The risk factors of incidence in CHD of different groups were analyzed with multiple logistic regression at the end of four observation years. The incidences of CHD and myocardial infarction (MI) of IGT and DM group were significantly higher than that of NGT group( P <0 05, P <0 01, respectively). There were 875 cases in the cohort population without CHD at baseline. The incidence of CHD was 34 26 per 1 000 observation person year in the elderly. The incidences of CHD in IGT and DM groups were 50 42 and 57 08 per 1 000 observation person year, respectively. Both were significantly higher than that of NGT group (27 5/ 1 000 person year)( P <0 05, P <0 01). Logistical regression analysis showed that DM, IGT, hypertension, BMI and age were risk factors related to incidence of CHD. According to ADA criteria, however, logistical regression analysis showed DM, hypertension and age were risk factors related to incidence of CHD . According to 1985 WHO criteria, the prevalence and incidence of CHD in IGT and DM groups were significantly higher than that of NGT group. The incidence of CHD was associated with risk factors including impaired glucose metabolism, hypertension, obesity and age. According to ADA criteria, the prevalence and incidence of CHD in DM group were significantly higher than that of NFG group, but IFG was not