上海市延吉社区中老年糖调节受损分布特征及危险因素分析

目的调查社区中老年居民糖调节受损（IGR）各类型的分布情况,探讨该人群IGR发生的危险因素。方法对上海市杨浦区延吉社区2228例45～74岁居民进行空腹血糖检测,采用葡萄糖氧化酶-计量安培法进行测定。对筛检出的IGR人群进行问卷调查、体格检查、空腹血糖、糖负荷后2h血糖测定和血脂检测。结果共筛检出IGR者393例,其中,糖耐量正常者（NGT）占39.19%、空腹血糖受损（IFG）占12.72%、糖耐量受损（IGT）占16.54%、空腹血糖受损合并糖耐量受损（IFG＋IGT）占16.03%、新发糖尿病（DM）占15.52%。不同年龄组,NGT、IFG、IGT、IFG＋IGT和DM的构成比不同（χ2=21.295,P=0.006）,IGT、IFG＋IGT和DM的比例有随年龄增长而增加的趋势。不同体质指数人群中,NGT、IFG、IGT、IFG＋IGT和DM的构成比不同（χ2=26.155,P=0.01）,随体质指数的增加,糖代谢异常的比例逐渐增加。Logistic回归分析显示,该社区IGR的主要危险因素是糖尿病家族史（OR=1.945）、高血压病史（OR=1.884）、高三酰甘油（OR=1.469）、年龄（OR=1.038）。结论延吉社区中老年IGR人群以IFG＋IGT、IGT为主,发生率随着年龄的增加而升高;IGR发生的危险因素为糖尿病家族史、高血压病史、高三酰甘油和年龄。

Investigation on Distribution of Population with Impaired Glucose Regulation and Analysis of Risk Factors in Yanji Community in Shanghai

Objective To study the constituent ratio and risk factors of impaired glucose regulation （IGR） in elderly subjects of Yanji community. Methods A group of 2 228 randomly selected adults, aged 45-74 years and living in the Yanji community in Shanghai, were measured by fasting plasma glucose （FPG） screening. All cases were taken questionnaire survey, physical examination, fasting plasma glucose （FPG） and 2-hour postprandial plasma glucose （2 h PG） testing, and serum lipid profiles measurements. Total 393 cases were screened out as the patients with IGR. Results In the population with data integrity, NGT accounted for 39.19%, impaired fasting glucose （IFG） accounted for 12.72%, impaired glucose tolerance （IGT） accounted for 16.54%, impaired fasting glucose combined with impaired glucose tolerance （IFG/IGT） accounted for 16.03% and DM accounted for 15.52%. The constituent ratio of NGT, IFG, IGT, IFG/IG and DM was distinct in different aged groups （χ2=21.295, P=0.006）. The proportion of IGT, IFG/IGT and DM increased with age while IFG didn’t. The constituent ratio of NGT, IFG, IGT, IFG/IGT and DM was distinct in different body mass index （BMI） groups （χ2=26.155, P=0.01）.The ratio of abnormal glucose metabolic rise with BMI. Logistic regression analysis revealed that the main risk factors of IGR were family history of DM（OR=1.945）, history of hypertension （OR=1.884）, high triglycerides （OR=1.469）, age （OR=1.038）. Conclusion IFG/IGT and IGT is the most common IGR subcategory in Yanji community. The frequencies of IFG/IGT and IGT increase with age. Family history of DM, history of hypertension, high triglyceride and age are main risk factors of IGR.