安徽省蚌埠地区22例糖调节受损者随访25年资料分析

目的对安徽省蚌埠地区1980年普查出的24例糖调节受损(IGT)人群进行干预,探讨IGT发生糖尿病(DM)的危险性及其影响因素。方法25年间,指导IGT者予生活方式及药物干预,对其转归及各项临床指标进行随访调查。结果①随访到的22人按1980年WHO的DM诊断标准统计:9例(40.9%)发展成DM,年转变率为1.6%;按1999年WHO的DM诊断标准再次统计:11例(50%)发展成DM,年转变率为2.0%。②DM转归组的其基线2 h静脉血糖(2hPG)均明显高于其他转归组(P<0.05),收缩压(SBP)、体质量指数(BMI)均明显高于糖耐量正常(NGT)转归组(P<0.05)。③25年后,HBP、低HDL-C血症患病率,DM转归组>IGT转归组>NGT转归组,差异有统计学意义(P<0.01)。高TG血症患病率在DM转归组、NGT转归组间差异有统计学意义(P<0.01)。DM转归组SBP、DBP、HOMA-IR均值均明显高于NGT转归组,HBCI均值明显低于NGT转归组;DM转归组、IGT转归组的BMI、TC、UAER均值明显高于NGT转归组。结论2hPG、UAER、SBP、BMI为IGT转变为DM的危险因素,尽早发现、综合干预不仅可逆转IGT、降低DM的发病率,亦可降低代谢综合征的发生率。

Data analysis of 22 subjects with IGT over 25 years follow-up in Bengbu region

Objective To explore the risk and influence factors of impaired glucose tolerance （IGT） converting to diabetes mellitus（DM） ,24 cases with IGT censused in 1980 were intervened. Methods 24 cases with IGT were guided with life style and drug intervention,and all kinds of clinical indices were surveyed in a cohort of 25 years follow-up. Resuits （1） There were 9 cases （40. 9% ） diagnosed as DM in 22 patients with IGT according to the standard of WHO in 1980,and annual turnover rate was 1.6%. In the diagnostic criteria of WHO in 1997,11 cases （50. 0%） progressed to DM,and annual turnover number was 2.0%. （2） The baseline of 2 hour postprandial blood sugar（2hPG） and urinary albumin excretion rate （UAER） of DM turnover group were significandy higher than those in other turnover groups （P 〈 0.05）. Systolic blood pressure （SBP） and body mass index （BMI） were remarkably higher than those in NGT group,respectively （P 〈0. 05）. （3） After 25 years,the prevalence of HBP and low high density lipoprotein-C of DM were markedly more than those in IGT turnover group,with which more than those in NGT turnover group （P 〈 0.01 ）. The hypertriglyceridemia of DM turnover group was significantly more prevalent than that in other turnover groups （P 〈0.01 ）. Means of SBP,DBP and HOMA-IR of DM turnover group were higher than those of NGT turnover group, except for lower HBCI. The average of BMI,TC and UAER in DM and IGT turnover groups were both higher than those in NGT turnover group. Conclusion The risk factors of IGT converting to DM were 2hPG, UAER. SBP and BMI. Comprehensive intervention could not only decrease morbility of DM,but also reduce incidence of metabolism syndrome.