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目的研究河北省任丘市老年居民腰围身高比值(WHt R)对新发血糖异常的影响,为该地区老年居民的慢性病防治提供依据。方法于2012年5-10月,采用整群随机抽样方法,在河北省任丘市抽取100个村和20个社区,选取体检时空腹血糖(FPG)水平<5.6 mmol/L且无糖尿病史,腰围、身高及FPG数据均完整的3 897名常住居民作为观察人群进行体格检查、实验室检测及面对面调查问卷,追踪随访至2014年,观察新发血糖异常情况。根据2012年健康体检时基线腰围身高比值(WHt R)四分位数进行分组:第1组WHt R<0.48、第2组0.48≤WHt R<0.51、第3组0.51≤WHt R<0.55和第4组WHt R≥0.55,比较4组间血糖异常的发生率。用SPSS 18.0软件进行χ~2检验、Kruskal-Wallis H检验,WHt R与新发血糖异常的关系采用logistic回归分析。结果随访至2014年,3 897名血糖正常者发生新发血糖异常560例(14.4%),其中新发糖尿病131例(3.4%),空腹血糖受损(IFG)429例(11.0%)。新发血糖异常组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、尿酸(UA)、WHt R、收缩压(SBP)和空腹胰岛素(FINS)水平,糖尿病家族史比例均高于无新发血糖异常组,高密度脂蛋白胆固醇(HDL-C)低于无新发血糖异常组,差异均有统计学意义(P<0.01,P<0.05)。多因素logistic回归模型结果显示,糖尿病家族史(OR=1.565,95%CI:1.165~2.103)、TG(OR=1.132,95%CI:1.031~1.243)、FPG(OR=8.231,95%CI:6.402~10.581)、WHt R(OR=12.493,95%CI:2.349~66.433)和SBP(OR=1.005,95%CI:1.001~1.009)是新发血糖异常的独立危险因素,HDL-C(OR=0.650,95%CI:0.469~0.902)是保护因素。根据2012年健康体检时WHt R进行分组,第1组新发血糖异常率为1.51%,第2组为1.87%,第3组为3.41%,第4组为7.57%。结论 WHt R是新发血糖异常的独立危险因素,有效监测WHt R并控制其比值在一定范围将有效减少糖尿病的发生发展。
Objective To study the effect of height to body mass ratio (WHtR) of elderly residents in Renqiu City, Hebei Province on the new abnormalities of blood glucose, and to provide basis for the prevention and treatment of chronic diseases in elderly residents in this area. Methods From May to October 2012, 100 villages and 20 communities in Renqiu City of Hebei Province were sampled by cluster random sampling method. The fasting blood glucose (FPG) level was less than 5.6 mmol / L during physical examination and no history of diabetes, Waist circumference, height and FPG data of 3,897 residents were observed as physical examination, laboratory testing and face-to-face questionnaire, follow-up to 2014, observe the new abnormal blood glucose. Grouping according to the WHt R quartiles at the 2012 physical examination: WHt R <0.48 for group 1, 0.48 ≦ WHR <0.51 for group 2, 0.51 ≦ WHR <0.55 for group 3, and WHt R≥0.55 in 4 groups, the incidence of abnormal blood glucose was compared between the 4 groups. SPSS 18.0 softwareχ ~ 2 test, Kruskal-Wallis H test, WHt R and the relationship between new blood glucose abnormalities using logistic regression analysis. Results Follow-up to 2014, 560 newborns (14.4%) with abnormal blood glucose were found in 3 897 patients with normal blood glucose, including 131 cases of new-onset diabetes (3.4%) and 429 cases of impaired fasting glucose (IFG) (11.0%). The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FPG), uric acid (UA), WHt R, SBP and fasting The levels of FINS, family history of diabetes were higher than those without new abnormal blood glucose, high density lipoprotein cholesterol (HDL-C) was lower than that without new abnormal blood glucose, the difference was statistically significant (P <0.01, P <0.05). Multivariate logistic regression model showed that family history of diabetes (OR = 1.565,95% CI: 1.165-2.103), TG (OR = 1.132,95% CI: 1.031-1.253), FPG (OR = 8.231,95% CI: 6.402 ~ 10.581), WHt R (OR = 12.493, 95% CI: 2.349 ~ 66.433) and SBP (OR = 1.005,95% CI: 1.001 ~ 1.009) were the independent risk factors of new blood glucose. HDL-C = 0.650, 95% CI: 0.469 ~ 0.902) is a protective factor. According to the WHt R grouping at the 2012 physical examination, the incidence of new abnormalities of blood glucose in group 1 was 1.51%, in group 2 was 1.87%, in group 3 was 3.41% and in group 4 7.57%. Conclusions WHt R is an independent risk factor for newly diagnosed abnormal blood glucose. Effective monitoring of WHt R and controlling its ratio within a certain range will effectively reduce the occurrence and development of diabetes.