中老年IGT患者13年的转归及其影响因素

目的分析中老年IGT患者的转归及其影响因素。方法对1996年在我院行健康查体确诊的248例IGT患者进行为期13年的观察。每2年随访1次,进行75gOGTT,同时测定身高、体重、血压、血脂谱等指标。至2009年共有97例患者完成随访。结果97例IGT患者13年间共有72例（74.2%）转变为DM,9例（9.3%）转变为NGT,16例（16.5%）维持IGT,DM年转化率为5.7%。Logistic回归分析显示仅OGTT 2h血糖与糖尿病的发生呈显著正相关。当OGTT 2h血糖〉9.4mmol/L时,发生糖尿病的风险更高。转为糖尿病的风险稳定IGT组〉不稳定IGT组〉NGT组。结论本组IGT患者DM年转化率为5.7%,13年间74.2%转变为DM。OGTT 2h血糖是预测糖尿病的独立危险因素。

Outcome of impaired glucose tolerance in senile patients observed during a 13-year follow-up period and its influencing factors

Objective To analyze the conversion rate of impaired glucose tolerance （IGT） in senile patients and its influencing factors. Methods Levels of OGTT （75g）, height, weight, blood pressure, blood glucose, blood lipid, etc, in 248 IGT patients diagnosed in 1996 were measured every two years. Ninety-seven patients completed the 13- year follow-up till 2009. Results Of the 97 patients who were followed up, 72（74.2%） and 9（9.3%） had their IGT converted to diabetes mellitus and NGT, respectively, and 16（16.5%） had their IGT unchanged. The annual conversion rate of IGT to diabetes mellitus was 5.7%. Logistic multi-regression analysis showed that only 2h plasma glucose of OGTT had an independent effect on the conversion of IGT. It was more likely for IGT to convert to diabetes mellitus when the 2h plasma glucose of OGTT was higher than 9.4mmol/L. The risk of IGT conversion to diabetes mellitus was stable IGT〉 unstable IGT〉NGT. Conclusion The annual conversion rate of IGT to diabetes mellitus is 5.7% and IGT can convert to diabetes mellitus in 74.2% patients. Two- hour plasma glucose of OGTF is the key factor for the conversion of IGT to diabetes mellitus in senile patients.