老年糖耐量受损人群合并代谢异常及其转归分析

目的分析老年糖耐量受损(IGT)人群合并代谢异常的情况及其转归。方法对象为1996年至2002年间健康体检诊断IGT的老年人群。方法:行75 g口服葡萄糖耐量试验(OGTT)、血脂、血尿酸、尿白蛋白排泄率等指标的测定,每二年随访一次。结果对1 059例IGT患者8年的随访中,222例转变为糖尿病(DM,21.0%),47例转变为糖耐量正常(NGT,4.4%),790例仍为IGT(74.6%)。NGT组、IGT组和DM组在基线状态下的体重指数(BMI)、收缩压、负荷后血糖(餐后2h血糖、OGTT1 h和2 h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血糖对IGT的转归具有独立影响。结论负荷后血糖指标是决定老年IGT人群转归的独立危险因素,合并多项代谢异常也是增加老年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 geriatric patients

Objective To analyze the combination of impaired glucose tolerance (IGT) and metabolic abnormalities and its outcome in geriatric population. Methods 75goral glucose tolerance test (OGTT), blood lipid profile, blood uric acid and urinary albumin excretion rate were determined in 1059 geriatric cases with IGT and followed up every 2 years. Results Among 1059 cases with IGT followed up for 8 years, 222 cases deterioratedintodiabetesmellitus(DM)(21.0%),47casesreversedto normal glucose tolerance (NGT, 4.4%),and 790 cases remained IGT (74.6%). From NGT to IGT to DM,body mass index, systolic blood pressure, plasma glucose after loading (including postprandial 2 h glucose, 1 h and 2 h plasma glucose of OGTT) 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 geriatric population.