老年人不同空腹血糖水平与心血管危险因素关系的临床分析

Clinical analysis for relationship between fasting blood glucose level and cardiovascular risk factors in the elderly

目的 探讨老年人不同空腹血糖水平与心血管危险因素的关系。方法 选择积水潭医院 6 0岁以上的职工 378例 ,检测体重指数、血压、空腹血糖、血脂、血尿酸及纤维蛋白原 ,依据美国糖尿病学会空腹血糖诊断标准分为 3组 :糖尿病组、空腹血糖异常组和正常空腹血糖组 ,对 3组人群进行对比分析。结果 糖尿病组 4 0例 ,空腹血糖异常组 5 4例 ,空腹血糖正常组 2 84例。糖尿病组体重指数、舒张压、总胆固醇、甘油三酯、纤维蛋白原明显高于空腹血糖正常组 (P <0 0 5 ) ,高密度脂蛋白胆固醇显著低于空腹血糖正常组 (P <0 0 5 ) ;空腹血糖异常组体重指数明显高于空腹血糖正常组(P <0 0 5 ) ;糖尿病组舒张压、总胆固醇、甘油三酯、纤维蛋白原明显高于空腹血糖异常组 (P <0 0 5 ) ,高密度脂蛋白胆固醇明显低于空腹血糖异常组 (P <0 0 5 )。结论 依据美国糖尿病学会标准诊断的老年糖尿病病前状态 (空腹血糖异常阶段 )有低估心血管危险因素的倾向 ,需要寻找一种既经济又有效的筛查方法确定糖尿病病前状态 ,发现并控制心血管危险因素 ,降低心血管疾病的患病率。

Objective To explore the relationship between fasting blood glucose level and ardiovascular risk factors in elderly people. Methods Totally,378 healthy elderly people aged over 60 years were examined in our hospital,including body mass index (BMI),blood pressure,fasting plasma glucose,lipid profiles,uric acid and fibrinogens (FIB). They were divided into three groups based on the criteria for fasting blood glucose level set by American Diabetes Association (ADA): normal fasting blood glucose (NFG)?impaired fasting blood glucose (IFG) and type-2 diabetes (2-DM) and their cardiovascular risk factors were compared and analyzed. Results There were 284 elderly people in NFG,54 in IFG and 40 in 2-DM (newly diagnosed) groups. BMI,diastolic blood pressure (DBP), total cholesterol (TC),triglyceride (TG) and FIB were much higher in 2-DM group than those in NFG group ( P <0.05). Level of high-density lipoprotein cholesterol (HDL-C) was lower in 2-DM group than that in NFG group ( P <0.05. BMI in IFG group was significantly higher than that in NFG group ( P <0.05). DBP,TC,TG and FIB in 2-DM group were significantly higher and HDL-C was significantly lower than those in IFG group,respectively ( P <0.05). Conclusions The results mentioned above clearly show that the ADA criteria for pre-diabetes status (at the stage with abnormal fasting blood glucose) would significantly underestimate cardiovascular risk factors in the elderly.A new diagnosis of pre-diabetes status is needed to identify high-risk individuals and reduce prevalence of cardiovascular diseases in elderly.