中老年人葡萄糖调节受损的临床特征及其与代谢综合征的关系

目的探讨中老年人葡萄糖调节受损(IGR)临床特征及其与代谢综合征(MS)的关系。方法采用横断面调查的方法对重庆局部地区40岁以上2810例自然人群的IGR进行调查,行75g葡萄糖耐量试验后以WHO 1999年IGR诊断标准分组：葡萄糖耐量正常（NGT),IGR包括空腹血糖受损(IFG),糖耐量低减(IGT),复合性糖耐量低减(IFG IGT)]和糖尿病(DM)。结果IGR检出率18．11％,其中IGT、占IGR的85．26％,IFG占6．68％,IFG IGT占8．06％,与NGT组比较,IGR人群年龄、体重指数(BMI)、血压、甘油三脂(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL—c)、HOMA—IR等显著增高,高密度脂蛋白胆固醇(HDL—c)、HOMA-B明显较低。与糖尿病组比较,IGR组血压、TG、HOMA—IR升高程度不如糖尿病组显著,HDL—c、HOMA-B降低程度较糖尿病轻。复合性糖耐量低减组和IFG组较IGT组BMI、HOMA—IR明显较高,而HOMA—B明显较低。IGR中高血压、脂代谢紊乱、肥胖或超重及微量白蛋白尿检出率均显著高于NGT组。复合性糖耐量低减组MS检出率高于IGT组。结论重庆局部地区40岁以上人群IGR发生率较高,IGR者伴代谢综合征的发生率高。IGR各亚组存在不同的代谢异常,复合性糖耐量低减组和IFG组较IGT组的BMI、高血压、微量蛋白尿、HOMA—IR增高的程度更高,HOMA—B明显较低。

The clinical characteristics and its relationship with metabolic syndrome in elderly subjects with impaired glucose regulation

Objective To study the clinical characteristics of impaired glucose regulation (IGR) in elderly subjects and its relationship with metabolic syndrome (MS). Methods The exploration of IGR in 2 810 Chongqing citizens over 40 years old was done by OGTT in a cross-section study. Normal glucose tolerance(NGT), IGR and diabetes(DM) were grouped based on the1999 diagnosis standard of WHO. IGR was composed of impaired fasting glucose(IFG), impaired glucose tolerance(IGT) and both of which. Results The prevalence of IGR was 18.11%, among which IGT(85.27%).Compared with the NGT group, the IGR group had higher age, body mass index(BMI), blood pressure, triglyceride(TG), total cholesterol(TC), low density lipoprotein cholesterol (LDL-c) and HOMA-IR, lower high density lipoprotein cholesterol (HDL-c) and HOMA-B. The IGR group had lower blood pressure, TG and HOMA-IR, and higher HOMA-B than the DM group.When each subgroup of IGR was compared with each other, both IFG plus IGT subgroup and IFG subgroup had higher BMI and HOMA-IR, and lower HOMA-B than IGT subgroup. The prevalences of hypertension, lipid disorder, obesity/overweight, and microalbuminuria in each subgroup of IGR were statistically higher than that of the NGT group. The prevalence of MS in the IFG plus IGT subgroup was higher than that of the IGT subgroup. Conclusions The incidence of IGR was high in elderly people over 40 years old in local district of Chongqing city. There were various metabolic disorders in the subgroups of IGR. The IFG plus IGT and IFG group had higher BMI, hypertension, microalbuminuria and HOMA-IR, but lower HOMA-B than the IGT group.