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目的肥胖与2型糖尿病的发生、发展密切相关,体质指数(body mass index,BMI)是世界公认的一种评定肥胖程度的分级方法,本文探讨BMI与高血糖的关系及其在2型糖尿病一级亲属中进行糖尿病筛查的预测价值。方法选取2003年1—6月期间住院以及门诊确诊的2型糖尿病患者的一级亲属296例为研究对象,所有受试者均测量身高、体重,计算BMI,并行75 g口服葡萄糖耐量试验(OGTT),采用葡萄糖氧化酶法测定空腹血糖、餐后30、60及120 min血糖。采用梯形规则计算血糖曲线下面积。用接收者工作特征曲线分析评价BMI水平在糖尿病筛查中的价值。结果 (1)2型糖尿病一级亲属糖调节异常及糖尿病患病率分别为30.07%和19.93%。从正常糖耐量经糖调节异常到糖尿病状态,BMI进行性增加(P<0.001)。(2)对糖耐量正常组分别以OGTT血糖下面积(area under the blood glucose curve,AUCg)为因变量,以年龄、BMI为自变量进行线性逐步回归分析显示,年龄、BMI是影响AUCg的独立因素(P=0.027、0.015)。(3)ROC分析提示,BMI≥24.95 kg/m~2出现糖调节异常的可能性大,灵敏度为67.3%,特异度为62.2%。结论 2型糖尿病具有明显家族聚集性,BMI为2型糖尿病一级亲属高血糖重要的预测因子,建议以BMI≥24.95 kg/m~2为切点对2型糖尿病一级亲属进行筛查。
Objective obesity is closely related to the occurrence and development of type 2 diabetes mellitus, body mass index (BMI) is a world-accepted classification of obesity. This article discusses the relationship between BMI and hyperglycemia and its role in type 2 diabetes mellitus Level relatives in the prediction of diabetes screening. Methods Totally 296 first-degree relatives of type 2 diabetic patients diagnosed in hospital and outpatient department from January to June in 2003 were selected as study subjects. All subjects were tested for height and weight, BMI was calculated, and 75 g oral glucose tolerance test (OGTT ), The fasting blood glucose was measured by glucose oxidase method, and the blood glucose was measured at 30, 60 and 120 min after meal. Use the trapezoidal rule to calculate the area under the blood glucose curve. The receiver operating characteristic curve was used to evaluate the value of BMI in diabetes screening. Results (1) The first-degree relatives of type 2 diabetes had abnormal glucose regulation and the prevalence of diabetes were 30.07% and 19.93%, respectively. BMI progressively increased (P <0.001) from normal glucose tolerance to impaired glucose regulation to diabetic status. (2) For the normal glucose tolerance group, the area under the blood glucose curve (AUCg) was taken as the dependent variable and the age and BMI as the independent variables respectively. The linear stepwise regression analysis showed that age and BMI were the independent factors influencing AUCg Factors (P = 0.027,0.015). (3) ROC analysis indicated that there was a high possibility of abnormal glucose regulation in BMI≥24.95 kg / m ~ 2 with a sensitivity of 67.3% and a specificity of 62.2%. Conclusion Type 2 diabetes has obvious familial aggregation. BMI is an important predictor of hyperglycemia in first-degree relatives of type 2 diabetes. It is recommended to screen the first-degree relatives of type 2 diabetes by using BMI≥24.95 kg / m ~ 2 as the cut-off point.