高三酰甘油腰围表型与糖尿病前期及2型糖尿病发病风险的关系

摘要：目的探讨高三酰甘油（TG）腰围表型与糖尿病前期及2型糖尿病（T2DM）发病风险的关系。方法从参与2011年4—11月四川省泸州地区2型糖尿病患者肿瘤发生风险流行病学调查研究的基线调查者中筛选出1 722例糖耐量正常者，以血TG≥1.7 mmol/L、男性腰围≥90 cm或女性腰围≥80 cm为切点，分为TG和腰围正常组（856例）、单纯高三酰甘油血症组（133例）、单纯腹型肥胖组（518例）、高三酰甘油血症-腰围表型（HTWC）组（215例），行5年随访观察，比较各组间糖尿病前期及T2DM发病情况。结果随访5年后，1 722例糖耐量正常者中共445例发展为糖尿病前期，67例发展为T2DM。TG和腰围正常组、单纯高三酰甘油血症组、单纯腹型肥胖组、HTWC组糖尿病前期发病率分别为20.7%（177/856）、21.1%（28/133）、30.5%（158/518）、38.1%（82/215），T2DM发病率分别为2.9%（25/856）、3.8%（5/133）、4.4%（23/518）、6.5%（14/215）。在调整了年龄、性别、空腹血糖、餐后2 h血糖、收缩压、糖化血红蛋白后，多分类无序Logistic回归分析结果显示，HTGW表型人群的糖尿病前期及T2DM发病风险较正常组升高，其OR（95%CI）分别为1.961（1.387～2.773）与2.638（1.279～5.441）。结论HTWC表型是糖尿病前期及T2DM患病的危险因素，可作为筛选两者高风险人群的简便指标。

The relationship between the waist circumference phenotype of hypertriglyceridemic and the risk of prediabetes and type 2 diabetes mellitus

Abstract: Objective To study the relationship between the waist circumference phenotype of hypertriglyceridemic(TG) and the risk of prediabetes and type 2 diabetes mellitus (T2DM). Methods A total of 1 722 subjects with normal glucose tolerance were recruited from the epidemiological study of cancer risk of T2DM in Luzhou area in 2011. Based on the cut-point of triglyceride (TG) level≥1.7 mmol/L and waist circumference (WC) ≥ 90 cm for men and 80 cm for women, the subjects were divided into four groups: normal WC and normal TG level group (n=856), simple high TG level group (n=133),simple abdominal obesity group (n=518), and enlarged WC and high TG level (HTWC) group (n=215). The subjects were followed up for five years, and the incidence rates of prediabetes and T2DM were compared between four groups. Results After five-year follow up, in the 1 722 subjects with normal glucose tolerance, 445 developed prediabetes and 67 developed T2DM. The incidence rates of prediabetes were 20.7 (177/856), 21.1% (28/133), 30.5% (158/518) and 38.1% (82/215), and the incidence rates of T2DM were 2.9% (25/856), 3.8% (5/133), 4.4% (23/518) and 6.5% (14/215) for normal WC and normal TG level group, simple high TG level group, simple abdominal obesity group and HTWC group. After adjusting age, gender, fasting glucose, 2 h postprandial blood glucose, systolic pressure and glycated hemoglobin, subjects with the hypertriglyceridemic waist (HTGW) phenotype showed higher odds of prediabetes (OR=1.961, 95%CI: 1.387-2.773) and T2DM (OR=2.638, 95%CI: 1.279-5.441) compared to normal group. Conclusion HTGW phenotype is the risk factor of prediabetes and T2DM. It can serve as a simple tool to identify individuals at high risk of prediabetes and T2DM.