摘要
目的探讨中心性肥胖与糖代谢异常的关系。方法采用前瞻性研究方法于2000年选择321例体质指数(BMI)<25kg/m2的健康体检者,测定BMI、腰围、血压、血脂、空腹血糖、餐后2h血糖、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)等,按腰围分为中心性肥胖组125例和对照组196例,7a后进行随访。结果中心性肥胖组随访到120例,男72例,女48例。对照组随访到172例,男101例,女71例。中心性肥胖组男性糖耐量受损和2型糖尿病的发生率高于对照组(P<0.05)。总的糖代谢异常发生率无论男女性,均为中心性肥胖组高于对照组(P<0.01)。中心性肥胖组基线时血压、血脂、血糖和HOMA-IR均高于对照组(P<0.05)。7年后随访时上述指标与基线水平比较,中心性肥胖组升高(P<0.05),对照组未见差异。Logistic回归分析显示,男性腰围(OR=2.53,P<0.01)、HOMA-IR(OR=3.12,P<0.05)和女性年龄(OR=2.79,P<0.05)、BM(IOR=1.58,P<0.01)、腰围(OR=1.47,P<0.05)、HOMA-IR(OR=2.79,P<0.05)是与糖代谢异常相关的危险因素。结论中心性肥胖和胰岛素抵抗是发生糖代谢异常的重要危险因素,与男性关系更密切。
Objective To longitudinally study the relationship between central obesity and glucose metabolic disorders. Methods A seven-year follow-up study was conducted in 321 subjects （body mass index 〈 25 kg/m2） included 125 central obese subjects and 196 normal control subjects who were chosen in 2000. Before and after follow-up, body mass index, waist circumference, blood pressure, lipid profile, fasting blood glucose and 2 hour blood glucose after glucose loading, fasting insulin and insulin resistance index （HOMA-IR） were measured. Results 120 subjects （72 men and 48 women） in central obesity group and 172 subjects （101 men and 71 women） in normal control group were followed up in 2007. The followed up rate of central obese subjects were higher than that of normal control subjects （96.0% vs 87.8%, X2=4.516,P〈0.05 ）. Seven-year cumulative incidence of impairment glucose tolerance and type 2 diabetes mellitus in male central obese subjects were significantly increased than in male control subjects（both P〈0.05 ）. The total cumulative incidence of glucose metabolic disorders, whether male or female, in central obesity group was higher than that in normal control group （all P〈0.05）. The basal levels of blood pressure, lipid profile, blood glucose and HOMA-IR were significantly increased in the former than in the latter （P〈0.05-0.01）. Compared with the basal levels, the above parameter in central obesity group after seven years follow-up were significantly increased （P〈0.05-0.01） and no change were found in normal control group. Logistic analysis showed waist circumference（OR=2.53, P〈0.01） and HOMA-IR（ OR=3.12, P〈0.05 ）in male and age（OR=2.79, P〈0.05）, body mass index （OR=1.58, P〈0.01）, waist circumferenee（OR=1.47, P〈0.05） and HOMA-IR （OR =2.79, P〈0.05） were major risk factors correlating with glucose metabolic disorders. Conclusion Central obesity and insulin resistance play very important roles in occurrence of glucose metabolic disorders
出处
《中国慢性病预防与控制》
CAS
北大核心
2009年第5期457-458,463,共3页
Chinese Journal of Prevention and Control of Chronic Diseases
