摘要
目的探讨贵阳城区40岁以上中老年人群不同糖代谢状态与10年心血管疾病风险的相关关系。方法从2011年5月至2011年8月在贵阳市云岩区整群抽样40～78岁常驻居民10 140人，最终纳入9 228人，详细填写流行病学调查问卷，测量身高、体重、腰围及血压，采集血样测定肌酐、空腹血浆血糖（FPG）、餐后2 h血浆血糖（PPG）、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和空腹胰岛素（FINS）。本研究采用1999年世界卫生组织（WHO）糖尿病诊断标准以及糖代谢状态分类标准，心血管风险评估采用Framingham 10年冠心病风险评分作为评估方法，将男性和女性按照不同糖代谢状态分组后与心血管疾病相关因素以及心血管疾病风险预测进行比较分析。结果糖代谢异常组年龄、体重指数、血压、HbA1C、HOMA-IR、总胆固醇、三酰甘油、腰围、腰臀比、肌酐及Framingham 10年冠心病患病风险超过10%均显著高于正常糖调节（NGR）组，差异有统计学意义（均P〈0.05），高密度脂蛋白反之（P〈0.05）；男性患心血管风险明显高于女性，女性59岁以后患病风险开始增高（均P〈0.05）；校正各影响因素后，与NGR组相比，空腹血糖受损（IFG）组、糖耐量受损（IGT）组、糖尿病（DM）组Framingham 10年冠心病风险评估超过10%的风险分别增加1.13倍（OR＝1.13，95%CI 0.81～1.58，P〉0.05），1.18倍（OR＝1.18，95%CI 0.95～1.45，P〉0.05），1.44倍（OR＝1.44，95%CI 1.10～1.88，P〈0.05）。结论糖尿病及糖尿病前期人群的10年心血管疾病风险均呈显著上升。
ObjectiveTo investigate the association between blood glucose level and cardiovascular disease（CVD） risk in elderly people aged 40 and older in Guiyang City.MethodsPopulation-based cross-sectional studies on diabetes were performed in 10 140 adults, aged 40-78 years, living in the Yunyan Community in Guiyang City, during May, 2011 to August, 2011. The fasting venous blood samples were drawn for the measurements of serum creatinine（Cr）, fasting plasma glucose（FPG）, OGTT 2hPG, fasting triglyceride（TG）, total cholesterol（TC）, high-density lipoprotein-cholesterol（HDL-C）, low-density lipoprotein-cholesterol（LDL-C）, and fasting plasma insulin. The diabetes status and the classification system for diabetes in our study were categorized according to the Diabetes Diagnostic Standard which was issued by WHO in 1999. An estimated 10-year Framingham risk for coronary heart disease was calculated.ResultsCompared with those in normal glucose regulation（NGR） group, the subjects in abnormal glucose metabolism were associated with higher prevalence of various cardiovascular risk factors, including age, body mass index, blood pressure, HbA1C, HOMA-IR, total cholesterol, triglycerides, waist circumference, waist-hip ratio, and creatinine, as well as 10-year Framingham risks for coronary heart disease. The difference was statistically significant（all P〈0.05）. Men were more likely to have cardiovascular risk than women. Women developing the disease only begins to increase after the age of 59. The difference was statistically significant（P〈0.05）. Compared with the subjects in NGR group, the 10-year Framingham risk for coronary heart disease in impaired fasting glucose（IFG）, impaired glucose tolerance（IGT）, and diabetes mellitus（DM） groups shown 10% of increase were 1.13（OR=1.13, 95%CI 0.81-1.58, P〉0.05）, 1.18（OR=1.18, 95%CI 0.95-1.45, P〉0.05）, and 1.44（OR=1.44, 95%CI 1.10-1.88, P〈0.05）, respectively, after adjusting for various influencing factors.ConclusionDiab
作者
赵莼
张巧
徐淑静
张淼
彭年春
胡颖
时立新
Zhao Chun;Zhang Qiao;Xu Shujin;Zhang Miao;Peng Nianchun;Hu Ying;Shi Lixin(Department of Endocrinology and Metabolism,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China)
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2018年第8期643-648,共6页
Chinese Journal of Endocrinology and Metabolism
基金
贵州省省长资金临床应用课题专项研究[黔省专合字（2012）100号]
贵州省临床重点专科培育项目
