青少年空腹血糖受损与体脂分布的关系

目的探讨青少年空腹血糖受损（IFG）与体脂分布的关系。方法通过分层整群随机抽样，测定3874例13～18岁青少年身高、体重、腰围、臀围和空腹血糖（FPG）水平，通过问卷调查了解其父母糖尿病患病情况。根据FPG水平，分为空腹血糖正常组（FPG〈5．6mmol／L，n=3738）和空腹血糖受损组（5．6mmol／L≤〈FPG〈7．0mmol／L，n=136）。结果两组间各体脂指标比较，应用协方差分析校正性别、年龄后，空腹血糖受损组体重指数、腰围、腰围／身高比和腰臀比均高于空腹血糖正常组，组间比较差异有统计学意义（P〈0．05）。应用偏相关分析校正年龄、性别后，BMI、腰围、腰臀比及腰围／身高比均与FPG呈正相关（P〈0．05），其中腰围／身高比的r’值最大（r’=0．0925）。对FPG的多元线性回归分析，最佳模型引入年龄（β=-0．102，P〈0．05）、糖尿病家族史（β=0．186，P〈0．05）和腰围／身高比（β=0．842，P〈0．05）。结论中心性肥胖与青少年空腹血糖受损关系密切，腰围／身高比是描述青少年中心性肥胖的有效指标，是青少年空腹血糖受损的独立危险因素。

Relationship between impaired fasting glucose and fat distribution in adolescents

Objective To investigate the relationship between impaired fasting glucose（IFG） and the distribution of body fat in adolescents. Methods Stratified cluster sampling was used to select 3874 adolescents aged 13-18 years for this cross-sectional study. Measurements included height, weight, waist circumference, hip circumference and fasting plasma glucose （FPG）. Family history of diabetes was determined by using a self-administered questionnaire. Participants were divided into normal fasting glucose group （ FPG 〈 5.6 mmol/L, n = 3738 ） and impaired fasting glucose group （ 5.6 mmol/L≤ FPG 〈 7.0 mmol/L,n = 136） according to their FPG levels. Results （ 1 ） After adjusting for age and sex using covariance analysis, the impaired fasting glucose group showed increased levels of body mass index, weight circumference, waist/hip ratio, waist/height ratio, as compared to the normal fasting glucose group （ P 〈 0. 05）. （2）After the age and gender were adjusted, body mass index, weight circumference, waist/hip ratio and waist/height ratio were positively correlated with FPG level （ P 〈 0.05 ）. Among the partial relation coefficients, that between waist/height ratio and FPG （r＇= 0. 0925 ） was the highest. （3） In multiple regression analyses, age （β = - 0.102, P 〈 0. 05 ）, family history of diabetes （β = 0. 186, P 〈 0. 05 ） and waist/height ratio （β = 0.842, P 〈 0.05 ） were consistently associated with FPG. Conclusion Central obesity was an important predictor of IFG in adolescents. Waist/height ratio may be an useful index of central obesity and an important predictor of IFG in adolescents.