肥胖糖耐量受损人群合并代谢异常及其转归分析

目的分析肥胖糖耐量受损人群合并代谢异常及其转归。方法2001—2006年健康体检诊断IGT的肥胖人群行75g口服葡萄糖耐量试验、血脂、血尿酸等指标的测定，每年随访一次。结果对256例IGT患者5年的随访中，54例转变为糖尿病（占21．0％），13例转变为糖耐量正常（占5．0％），189例仍为IGT（占73．8％）。NGT组、IGT组和DM组在基线状态下的体重指数、收缩压、负荷后血糖（餐后2h血糖、OGTT1h和2h血糖）均逐组增高（P〈0．05或P〈0．01）。基线状态时代谢异常项目越多者转变为DM的比率越高。Logistic多元回归分析显示仅负荷后糖对IGT的转归具有独立影响。结论负荷后血糖指标是决定肥胖IGT人群转归的独立危险因素，合并多项代谢异常也是增加肥胖IGT患者向DM转化的重要因素。

Analysis of the Combination of Impaired Glucose Tolerance and Metabolic Abnormalities and Its Outcome in Obesity Patients

Objective To analyze the combination of inpaired glucose tolerance（IGT） and metabolic abnormalities and its outcome in obesity patients. Methods 75g oral glucose tolerance test （OGTF）,blood lipid profile and blood uric acid were determined in 256 obesity cases with IGT and followed up every year. Results Among 256 cases with IGT followed up for 5 years, 54 cases deteriorated into diabetes mellitus （21.0%）,13 cases were normal glucose tolerance（5.0%）,and 189 cases remained IGT（73.8%）. From NGT to IGT to DM,body mass index,systolic blood pressure,plasma glucose after loading （including postprandial 2h glucose, lh and 2h plasma glucose of OGTr） were gradually increased in baseline（P〈 0.05 or P〈 0.01 ）. The more metabolic abnormalities combined in baseline, the higher conversion rate of DM （P 〈 0.01 ）. Logistic multi-regression analysis showed that only plasma glucose after loading had an independent effect on outcome of IGT. Conclusion Plasma glucose level after loading and its combined metabolic abnormalities are key factors affecting the outcome of IGT in the obesity population.