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老年女性体质指数变化与高糖血症关系的五年随访研究
引用本文:刘秀,张爱军,科宇. 老年女性体质指数变化与高糖血症关系的五年随访研究[J]. 中国全科医学, 2020, 23(30): 3781-3784. DOI: 10.12114/j.issn.1007-9572.2020.00.395
作者姓名:刘秀  张爱军  科宇
作者单位:430061湖北省武汉市武昌医院
*通信作者:张爱军,主任医师;E-mail:yxt_lgd@163.com
摘    要:背景 糖尿病是临床常见病之一,相关研究发现高体质量人群常存在空腹血糖升高,但高体质量是否与高糖血症存在关系鲜有研究。目的 探讨老年女性体质指数(BMI)变化与高糖血症的关系。方法 选取2012年1-12月于武汉市武昌医院老年病科就诊的符合研究标准的65~76岁绝经女性300例。依据入组时空腹血糖将受试者分为血糖正常组(空腹血糖≤5.0 mmol/L,n=200)和预期血糖增高组(空腹血糖>5.0~<5.6 mmol/L,n=100),随访5年(截至2018年1月)。随访终点事件为高糖血症。本研究高糖血症定义为空腹血糖≥5.6 mmol/L(≥100 mg/L)或前驱糖尿病糖化血红蛋白(HbA1c)≥6.0%。比较两组基线和随访截止时一般资料、实验室检查指标。探究老年女性发生高糖血症的影响因素。结果 两组年龄、糖尿病家族史、基线吸烟率、基线饮酒率、基线舒张压、基线低密度脂蛋白、基线高密度脂蛋白比较,差异无统计学意义(P>0.05);预期血糖增高组基线BMI、基线收缩压、基线空腹血糖、基线三酰甘油高于血糖正常组(P<0.05)。两组随访截止时吸烟率、饮酒率、低密度脂蛋白、高密度脂蛋白、三酰甘油比较,差异无统计学意义(P>0.05);预期血糖增高组随访截止时BMI、收缩压、舒张压、空腹血糖高于血糖正常组(P<0.05)。随访截止时,共32例受试者发生高糖血症。最大似然估计结果显示,BMI变化、收缩压、舒张压、空腹血糖、三酰甘油是老年女性发生高糖血症的独立影响因素(P<0.05)。结论 老年女性BMI变化是其发生高糖血症的独立影响因素,超重和肥胖的老年女性降低体质量能有效降低其高糖血症的发生风险。

关 键 词:   高血糖症;人体质量指数;老年人;女性;影响因素分析  

Relationship between BMI Changes and Hyperglycemia in Elderly Women
LIU Xiu,ZHANG Aijun,KE Yu. Relationship between BMI Changes and Hyperglycemia in Elderly Women[J]. Chinese General Practice, 2020, 23(30): 3781-3784. DOI: 10.12114/j.issn.1007-9572.2020.00.395
Authors:LIU Xiu  ZHANG Aijun  KE Yu
Affiliation:Wuhan Wuchang Hospital,Wuhan 430061,China
*Corresponding author:ZHANG Aijun,Chief physician;E-mail:yxt_lgd@163.com
Abstract:Background Diabetes mellitus is a common clinical disease.Related studies have found that high body mass people often have elevated fasting blood glucose,but few studies have found that high body mass is related to hyperglycemia.Objective To explore the relationship between BMI changes and hyperglycemia in elderly women.Methods From January to December 2012,300 menopausal women aged 65-76 were selected from Department of Geriatrics,Wuhan Wuchang Hospital,and were divided into normal FBG group (FBG≤5.0 mmol/L,n=200) and predicted elevated FBG group (FBG > 5.0~<5.6 mmol/L,n=100) by FBG,receiving a 5-year follow-up (till January 2018) with an endpoint of hyperglycemia 〔hyperglycemia was defined as FBG ≥5.6 mmol/L or prediabetic glycated hemoglobin (HbA1c)≥6.0% in this study〕.Baseline and follow-up general data and laboratory test indicators were compared between the two groups.The influencing factors of hyperglycemia were explored in elderly women.Results There were no significant differences in average age,family history of diabetes,baseline smoking rate,drinking rate,diastolic blood pressure,low-density lipoprotein,and high-density lipoprotein between the two groups (P>0.05).Baseline average BMI,systolic blood pressure,FBG,and triacylglycerol were higher in predicted elevated FBG group than those in normal FBG group (P<0.05).There were no significant differences between the two groups in terms of follow-up smoking rate and drinking rate,average follow-up low-density lipoprotein,high-density lipoprotein,and triacylglycerol (P>0.05).The average follow-up BMI,systolic blood pressure,diastolic blood pressure,and FBG were higher in predicted elevated FBG group than those in normal FBG group (P<0.05).At the end of follow-up,32 subjects had hyperglycemia.Maximum likelihood estimation showed that changed BMI,systolic blood pressure,diastolic blood pressure,FBG,and triacylglycerol were independent influencing factors of hyperglycemia in elderly women.Conclusion Changed BMI is independently associated with lower risk of hyperglycemia in elderly women,and the risk may be reduced more significantly in those who are overweight or obese.
Keywords:Hyperglycemia  Body mass index  Aged  Femininity  Root cause analysis  
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