高甘油三酯血症是非胰岛素依赖型糖尿病发病的危险因素──432例非糖尿病人群六年前瞻性观察

BASELINE HYPERTRIGLYCERIDEMIA, A RISK FACTOR FOR NON-INSULIN DEPENDENT DIA-BETES MELLITUS: A 6-YEAR FOLLOW-UP STUDY OF 432 NONDIABETICS

为了解高甘油三酯血症与糖尿病发病的关系，在４３２例非糖尿病人群中分析了空腹血浆甘油三酯（ＦＴＧ）水平对糖尿病发病率的影响。按初检时ＦＴＧ水平从低到高，以计算机分成三组，最高甘油三酯（ＴＧ）组（为２．５ｍｍｏｌ／Ｌ，相当于２２１．４ｍｇ／ｄｌ），６年非胰岛素依赖型糖尿病发病率是最低ＴＧ组（为０．７ｍｍｏｌ／Ｌ，相当于６０．３ｍｇ／ｄｌ）的２．３倍（３８．６％对１６．６％，Ｐ＜０．０１），６年后口服葡萄糖耐量试验２小时血糖（ＯＧＴＴＢＧ２ｈ）平均值高２．４ｍｍｏｌ／以（４３ｍｇ／ｄｌ，即１８０．３ｍｇ／ｄｌ对１３７．４ｍｇ／ｄｌ）。进行多因素线性回归分析，调整年龄、性别、空腹血糖（ＦＢＧ）和体重指数诸影响因素后，ＦＴＧ水平仍与６年后ＯＧＴＴＢＧ２ｈ水平显著正相关（Ｐ＝０．０３３５）。表明ＦＴＧ水平升高是糖尿病发病的独立危险因素。

he relationship between baseline fasting plasma triglycerides level (FTG) and the incidence of non-insulin-dependent diabetes mellitus (NIDDM)within 6 years were investigated in 432 Chinese nondiabet-ics. They were identified by oral glucose tolerance test(OGTT,oral 75 g glucose) in Daqing diabetes sur-vey in 1986. 220 subjects were men and 212 women, Among them 226 had normal glucose tolerance and 206 impaired glucose tolerance. The measurement of fasting plasma lipids and glucose were performed at the baseline examination and after 6-year follow-up. Six-year incidence of NIDDM in the highest triglyc-erides tertile group (top tertile Q_3,mmol/L) was 2. 3 times(38.6%vs 16.6%,P<0. 01) as com-pared with that of the lowest triglycerides tertile group(first tertile Q_几 mmol/l), The difference of 2-hour blood glucase level in OGTT(OGTT BG2h level)between Q_1 and Q_3 was 2. 4mmol/L (～10. 0mmol/L) after 6 years. Multivariate general linear regression analysis demonstrated that the FTG level was positively associated with the OGTT BG2h level after 6 years (P=0. 0335) after controlling the age, sex, fasting blcod glucose (FBG)and body mass index(BMI); Therefore this result indicates that FTG level is an independent risk factor for the development of NIDDM in this population.