中老年人葡萄糖调节受损的临床特征及其与代谢综合征的关系

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目的 探讨中老年人葡萄糖调节受损 (IGR)临床特征及其与代谢综合征 (MS)的关系。方法 采用横断面调查的方法对重庆局部地区 4 0岁以上 2 810例自然人群的IGR进行调查 ,行 75g葡萄糖耐量试验后以WHO 1999年IGR诊断标准分组 :葡萄糖耐量正常 (NGT) ,IGR[包括空腹血糖受损 (IFG) ,糖耐量低减 (IGT) ,复合性糖耐量低减 (IFG +IGT) ]和糖尿病 (DM )。结果 IGR检出率18.11% ,其中IGT占IGR的 85 .2 6 % ,IFG占 6 .6 8% ,IFG +IGT占 8.0 6 %。与NGT组比较 ,IGR人群年龄、体重指数 (BMI)、血压、甘油三脂 (TG)、总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL c)、HOMA IR等显著增高 ,高密度脂蛋白胆固醇 (HDL c)、HOMA B明显较低。与糖尿病组比较 ,IGR组血压、TG、HOMA IR升高程度不如糖尿病组显著 ,HDL c、HOMA B降低程度较糖尿病轻。复合性糖耐量低减组和IFG组较IGT组BMI、HOMA IR明显较高 ,而HOMA B明显较低。IGR中高血压、脂代谢紊乱、肥胖或超重及微量白蛋白尿检出率均显著高于NGT组。复合性糖耐量低减组MS检出率高于IGT组。结论 重庆局部地区 4 0岁以上人群IGR发生率较高 ,IGR者伴代谢综合征的发生率高。IGR各亚组存在不同的代谢异常 ,复合性糖耐量低减组和IFG组较IGT组的BMI、高血压、微量蛋白尿、HOMA IR? Objective To investigate the clinical features of impaired glucose regulation (IGR) and its relationship with metabolic syndrome (MS) in the elderly. Methods A cross-sectional survey was conducted to investigate the IGR of 2 810 natural populations over 40 years of age in some areas of Chongqing. The 75-g glucose tolerance test was used to determine the IGR according to 1999 WHO diagnostic criteria: normal glucose tolerance (NGT), IGR Impaired fasting glucose (IFG), impaired glucose tolerance (IGT), combined impaired glucose tolerance (IFG + IGT), and diabetes mellitus (DM). Results The detection rate of IGR was 18.11%, of which IGT accounted for 85.26% of IGR, IFF accounted for 6.68% and IFG + IGT accounted for 8.06%. Compared with NGT group, the age, body mass index (BMI), blood pressure, triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDLc) and HOMA IR in IGR group were significantly increased, while high density lipoprotein Cholesterol (HDL c), HOMA B was significantly lower. Compared with diabetic group, the levels of blood pressure, TG and HOMA IR in IGR group were not as significant as those in diabetic group, and the levels of HDLc and HOMA B were lower than those in diabetic group. BMI and HOMA IR were significantly higher in IGT group and IFG group than those in IGT group, while HOMA B was significantly lower in IGT group. Hypertension, dyslipidemia, obesity or overweight and microalbuminuria in IGR were significantly higher than NGT group. MS detection rate of low glucose tolerance group was higher than IGT group. Conclusion The incidence of IGR in people over 40 years old in some areas of Chongqing is high, and the incidence of IGR with metabolic syndrome is high. There were different metabolic abnormalities in each subgroup of IGR. BMI, hypertension, microalbuminuria, HOMA IR in IGT group and IFG group were lower than those in IGT group
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