代谢综合征与口服糖耐量试验1小时血糖的相关性研究

目的探讨口服糖耐量试验(OGTT)1 h血糖(1 h PG)同动脉硬化危险因素及代谢综合征(MS)的相关性。方法以参加2008年北京市顺义区南法信镇体检的年龄35岁以上的当地常住居民为研究对象,将空腹血糖(FPG)≥5.6 mmol/L且无糖尿病史者行OGTT,根据OGTT结果除外糖尿病患者,再根据OGTT 1 h PG水平,将剩余183人分为1 h PG<8.6 mmol/L组(64人)和1 h PG≥8.6 mmol/L组(119人)。比较两组的身高、体质量、腰围、臀围、血压及血脂等指标,并比较MS发生率。结果同1 h PG<8.6 mmol/L组比较,1 h PG≥8.6 mmol/L组受试者腰臀比(WHR)、收缩压、空腹血糖FPG、OGTT 2 h血糖水平显著升高,而高密度脂蛋白胆固醇(HDL-C)水平显著降低(P<0.05);1 h PG≥8.6 mmol/L组MS发生率较1 h PG<8.6 mmol/L组显著升高,差异有统计学意义(P<0.01)。Logistic回归分析显示,在调整了性别、年龄、腰围、WHR、体质指数、血压、血脂各项因素后,1 h PG仍与MS的发生显著相关[OR=1.404,95%CI(1.165,1.692),P<0.01]。用受试者工作特征(ROC)曲线分析1 h PG对MS的预测价值,发现ROC曲线下面积(AUC)为0.678[95%CI(0.600,0.756),P<0.01]。结论在非糖尿病人群中,1 h PG与动脉硬化危险因素(腹型肥胖、高血压、血脂异常等)及MS密切相关。对OGTT 1 h PG升高者应予足够的重视。

The Study of the Relationship between One-Hour Plasma Glucose in OGTT and Metabolic Syndrome

Objective To investigate the relationship between elevated 1 h PG of OGTT and risk factors of vascular atherosclerosis and metabolic syndrome(MS).Methods Local residents aged over 35 who participated in the medical examination in Nanfaxin Town,Shunyi District,Beijing were involved into the study.OGTT was given to the people who had FPG≥5.6 mmol/L and without diabetes history.Diabetes patients were excluded according to the results of OGTT.183 non-diabetes were divided into two groups according to the level of OGTT 1 h PG,namely the 1 h PG<8.6 mmol/L group with 64 subjects and 1 h PG≥8.6 mmol/L group with 119 subjects.Body height,weight,waist circumference,hip circumference,blood pressure and blood lipids were measured in the two groups.MS incidence was determined by the 2004 Chinese Diabetes Association criteria and compared between the two groups.Results Subjects with 1 h PG≥8.6 mmol/L had significantly higher waist to hip ratio(WHR),systolic pressure,fasting plasma glucose,2 hour plasma glucose and significantly lower HDL-C level compared with 1 h PG<8.6 mmol/L group(P<0.05).Subjects with 1 h PG≥8.6 mmol/L also had significantly higher prevalence of MS(P<0.01).Logistic regression analysis showed that 1 h PG levels significantly associated with MS after adjusting sex,age,waist circumference,WHR,BMI,blood pressure and blood lipids.ROC curve analysis showed the area under the curve(AUC) of 1 h PG in detecting MS was 0.678[95%CI(0.600,0.756),P<0.01].Conclusion This study confirms the elevated 1 h PG of OGTT is closely related to atherosclerosis risk factors(abdominal obesity,hypertension,dyslipidemia) and MS in non-diabetic subjects.Subjects with elevated 1 h PG should be paid more attention to.