不同空腹血糖受损下限切点对重庆地区人群代谢状态的影响

目的寻找预测2型糖尿病（T2DM）和糖耐量减低（IGT）发生的最佳空腹血糖受损（IFG）下限切点及其对代谢状态的影响。方法采用横断面调查的方法对重庆局部地区3189例既往无糖尿病史的自然人群的空腹血糖（FPG）进行ROC分析，绘制ROC曲线，并进行糖脂代谢调查和分析。结果预测T2DM和IGT发生的最佳IFG下限切点ROC曲线下面积分别为0．899和0．728。用FPG来预测T2DM和IGT，其灵敏度及特异度均较好的点分别为5．6mmol／L和5．2mmol／L。在负荷后2h血糖（2hPG）〈7．8mmol／L人群中，与FPG〈5．6mmol／L亚组比较，FPG5．6～6．1mmol／L亚组肥胖、高血压、代谢综合征和胰岛素抵抗的发生率分别增加了53％、54％、60％和126％。IFG下限切点下调前后，糖调节受损（IGR）各亚组组分的代谢特征不改变。结论将5．6mmol／L作为IFG的下限值适用于中国人群。

The best cut point of IFG and effects of its change on the statues of metabolism among Chongqing adults in China

Objective To find the best cut point of FPG to predict diabetes(DM) and impaired glucose tolerance(IGT) and to study its effects on the metabolism status.Methods The ROC analysis of FPG in 3189 citizens from some area of Chongqing without a previous history of diabetes was done by OGTT in a cross-section study.The metabolic features of impaired glucose regulation(IGR) and its subcategories were analyzed according to 5.6 mmol/L and 6.1 mmol/L as the FPG threshold for IFG.Results The areas under the ROC curve were 0.899 for diabetes and 0.728 for IGT.The cut point of FPG with the best equilibrium between sensitivity and specificity was 5.6 mmol/L for diabetes and 5.2 mmol/L for IGT.Among people whose 2 hPG<7.8 mmol/L,compared with the FPG<5.6 mmol/L subsection,the prevalences of obesity,hypertension,metabolic syndrome and insulin resistance were increased by 53%,54%,60% and 126%respectively in the FPG 5.6~6.0 mmol/L subsection.The metabolic features of IGR and its subcategories had not changed between these two kinds of FPG threshold.Conclusion It is suitable to use 5.6 mmol/L as the lower limit of IFG in Chinese people.