乌鲁木齐市维吾尔族居民1002人糖、脂代谢紊乱与胰岛素抵抗的关系

Relationship between insulin resistance and disorder of glucose and lipid metabolism in 1002 Uighur residents in Urumqi

目的:了解乌鲁木齐市维吾尔族胰岛素抵抗的流行病学状况及糖、脂代谢紊乱与胰岛素抵抗的关系。方法:采用整群抽样方法调查乌鲁木齐市居住5年以上的维吾尔族居民1002人,测量身高、体质量、腰围、臀围、血压,血脂,除老糖尿病患者外均做75g口服葡萄糖耐量试验,测定血糖及胰岛素水平,计算出体质量指数、腰臀比、胰岛素抵抗稳态模式评估法模型(homeostasismodelassessment-insulinresistance,HOMA-IR),比较不同代谢状态下胰岛素抵抗的情况。结果:①糖代谢异常占总人群的30.34%,高血压占31.34%,高胆固醇血症占35.33%,高三酰甘油血症占28.44%,低高密度脂蛋白(highdensitylipoproteincholesterol,HDL)血症占20.16%,肥胖占68.62%。②在不同糖代谢状态研究中发现正常糖耐量组(n=698)与糖耐量异常组(105)胰岛素抵抗比较,差异无显著性意义,而糖耐量异常组与糖尿病组(n=149),正常糖耐量组与糖尿病组胰岛素抵抗相比较,差异均有显著性意义(q=8.83,4.22;P<0.01)。③在不同脂代谢状态研究中发现正常三酰甘油组(n=724)与高三酰甘油组(n=285)胰岛素抵抗比较,差异有显著性意义(u=3.04,P<0.01),而正常总胆固醇组(n=656)与高总胆固醇组(n=354)、正常HDL组(n=800)与低HDL组(n=202)胰岛素抵抗比较,差异无显著性意义。④在不同血?

AIM:To investigate the epidemiology of insulin resistance(IR) and study the relationship between insulin resistance and disorder of glucose and lipid metabolism in Uighur Residents in Urumqi city.METHODS:One thousand and two Uighur residents in Urumqi who lived there for 5 years were surveyed with the method of cluster sampling. Stature,body mass, waist and hip circumference,blood pressure and blood lipid profile were measured in 1 002 Uighur residents and 75 g oral glucose load blood glucose and serum insulin level were measured in people without diabetes.Body mass index and ratio of waist to hip were calculated and IR was compared in different metabolic states using homeostasis model assessment-insulin resistance(HOMA-IR) model. RESULTS:①In this population,30.34%had abnormal glucose metabolism,31.34%had hypertension,35.33%had hypercholesterolemia,28.44%had hypertriglyceridemia,20.16 %had low high density lipoprotein-cholesterol(HDL) level and 68.62%was obese.②It was found that there was no difference in IR between normal glucose tolerance(NGT) group(n=698) and impaired glucose tolerance group (IGT)(n=105) in the study,but there was significant difference between IGT groupand diabetes group(n=149),NGT and diabetes mellitus(DM) group (q=8.83,4.22,P< 0.01).③It was found that there was significant difference in IR between normoltriglyceridemic group(n=724) and hypertriglyceridemic group(n=285) (u=3.04,P< 0.01) in the study of the different lipid metabolic states, but there was no difference between normolcholesterolimic group(n=656) and hypercholesterolimic group(n=354),and between normal HDL group(n=800) and low HDL group(n=202);④There was no difference in IR between hypertension group(n=314) and normal blood pressure group(n=688) under different blood pressure and body mass. Also there was no difference in normal body mass(n=205) and over mass(n=45) and obesity group(n=684).CONCLUSION:Uighur nationality in Urumqi city has high prevalence of abnormal carbohydrate and lipid metabolism, obesity and hypertesion,especially obesity.The more severe the disordered carbohydrate metabolism is,the more serious the insulin resistance is.With increase of triglyceride,insulin resistance become serious,but there is no change in insulin resistance with increased cholesterol, blood pressure and body mass and decreased HDL level.