糖耐量低减的特征及其与冠心病发生的关联

CHARACTERISTICS OF SUBJECTS WITH IGT AND ITS CORRELATION WITH CORONARY HEART DISEASE

对大庆市25岁以上28万人口中的108, 660人进行糖尿病调查,按WHO标准,诊断糖耐量低减(IGT)有596例,糖尿病630例,两者检出率分别为5.5‰与5.8‰。原已发现的糖尿病有190例。与年龄、性别相配比的糖耐量正常对照组521例比较,IGT者高血压、肥胖患病率高2倍(分别为35.3和61％);高脂蛋白血症较多;冠心病患病率(3.76％)高8.9倍,尿白蛋白排泄率高2倍。IGT者伴有高胰岛素血症,但口服葡萄糖耐量试验1小时胰岛素释放指数低于对照组,故胰岛素抵抗与胰岛分泌功能障碍同时存在。多因素分析,除外年龄、高脂蛋白血症、高血压、肥胖等因素的影响,IGT无症状轻度高血糖状态亦为冠心病的危险因素。

Among 280,000 population aged 25-74 years in Da Qing, 108, 600 persons were surveyed for diabetes in 1 986. According to WHO criteria (1980), 596 (5.5‰) persons with impaired glucose tolerance (IGT) and 630 (5.8‰) new diabetics were diagnosed in addition to 190(1.7‰) diabetics known. In comparison to age-sex-matched controls with normal oral glucose tolerance test, hypertension(35.3%), obesity (BM1≥25, 61%) and rate of microalbuminurea excretion were twice as common in IGT as in controls. The prevalence of hyperlipoproteinemia were higher in IGT than that in controls, IGT had a prevalence of coronary heart disease 8.9 times greater than did controls. Although IGT had hyperinsulinemia, one-hour IRI (insulin mU/L: blood glucose mmol/L) after 75g glucose load were lower in IGT than that in controls. Therefore IGT had both insulin resistance and impaired function of islet. Non-symptomatic slight hyperglycemic state itself in IGT was a risk factor for CHD, which was independent of age, hyperlipoproteinemia, hypertension and obesity.