不同空腹血糖切点与肥胖人群7年后代谢异常状况的相关性研究

【目的】探讨不同空腹血糖（FPG）切点对肥胖人群7年后代谢异常状况的影响。[方法]2000年筛查出的583例单纯肥胖者[体重指数（BMI）≥25kg／m^2]，分为FPG〈5．6mmol／L组264例和FPG5。6～6．1mmol／L组319例，测定BMI、腰围（WC）、腰臀比（WHR）、收缩压（SBP）、舒张压（DBP）、总胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、FPG、2h血糖（2hPG）、空腹胰岛素（Fins）、及胰岛素抵抗指数（HOMA—IR）。7年后对上述人群进行随访。【结果】共随访到524例，随访率为89．9％。FPG5．6～6．1mmol／L组血脂异常、高血糖以及同时合并高血压、血脂异常和高血糖的累积发生率均显著高于FPG〈5．6mmol／L组（分别为51．0％、46．3％、38．2VS41．2％、36．0％、28．1％，均P〈0．05）。随访资料比较，FPG5．6～6．1mmol／L组wHR、SBP、DBP、TC、TG、HDL-C、LDL-C、FPG、2hPG、Fins、HOMA-IR与本组基线时比较及与FPG〈5．6mmol／L组比较均有统计学意义（P〈0．05或P〈0．01）。单因素分析显示FPG与wC、wHR、SBP、DBP、TC、TG、HDL-C、LDL-C、2hPG、Fins及HOMA-IR呈显著相关（P〈0．05或P〈0．01）。[结论]FPG5．6～6．1mmol／L组患者已存在与代谢综合征有关的代谢组分异常，IFG下限切点下调至5．6mmol／L更有利于提高对中国人糖尿病和心血管疾病的早期预测和早期防治。

Study on the Relationship Between Different Cut-off Points of Fasting Plasma Glucose and Abnormal Metabolic Parameters in Obese Subjects after 7 Years

[Objective]To investigate the effect of different cut-off points of fasting plasma glucose （FPG） on abnormal metabolic parameters in 7-year follow-up obese subjects. [Methods]A 7-year follow-up study was conducted in 583 simple obese subjects who were chosen in 2000. The subjects were divided into FPGGS. 6 mmol/L group and FPG5.6～6. lmmol/L group according to their FPG levels. Before and after follow up, body mass index （BMI）, waist circumference （WC）, waist-hip ratio （WHR）, systolic pressure （SBP）, diastolic pressure （DBP）,total cholesterin （TC）, triglyceride （TG）, HDL-C, LDL-C, FPG, OOTT 2h plasma glucose （2hPG）, fasting insulin （Fins） and insulin resistance index （HOMA-IR） were measured. [Results]About 524 of 583 subjects were followed up in 2007. The rate of followed up was 89.9%. The 7-year cumulative incidence of dyslipidemia, hyperglycemia and together with hypertension, dyslipidemia and hyperglycemia was higher in FPG5.6～6. lmmol/L group than that in FPGG5.6mmol/L group （51.0%, 46.3%, 38.2 vs 41.2%, 36.0%, 28.1% ,respectively, all P G0.05）. Comparison of the follow up data showed that WHR, SBP, DBP, TC, TG, HDL-C, LDL-C, FPG, 2hPG, Fins and HOMA-IR were higher and HDL C was lower in FPGS. 6～6. lmmol/L group than the basal levels of itself and FPGG5.6mmol/L group （ P 〈0.05 or P 〈0. 01）. The correlation analysis indicated that FPG was closely associated with WC, WHR, SBP, DBP, TC, TG, HDL C, LDL-C, 2hPG, Fins and HOMA-IR （ P 〈0.05 or P 〈0.01）. [Conclusion]The some subjects with FPG5.6～6. lmmol/L have occurred the abnormal metabolic composition which is correlated with metabolic syndrome and it is advantageous to forecast and prevent early diabetes and cardiovascular disease in Chinese to decrease FPG cut-point to 5.6mmol/L for IFG.