中年单纯肥胖者体重变化与高血糖关系的7年随访研究

Prospective investigation on the relationship between weight change and blood sugar in obese subjects

目的观察单纯性肥胖患者体重变化对高血糖影响特点。方法2000年至2007年间对583名中年单纯性肥胖患者进行7年随访观察，根据体重变化分组（减重组、体重增高及体重无变化组），同时测定全部受试者随访前后血糖、血管内皮功能及与肥胖有关的身体测量指标。结果共随访到524例，随访7年前后体重、BMI较前均值较前有增高，差异无统计学意义，空腹及餐后血糖均较前有所升高，血管内皮功能较前减退，差异有显著性。体重增加组空腹血糖、餐后血糖、HOMA．IR、EDD变化均值大于体重不变及体重减轻组，差异有显著性；在控制年龄、性别后，偏相关分析显示：基线体重、随访BMI及体质量（BMI）变化均与空腹及餐后血糖呈正相关。ABMI与ABG变化有显著线性关系。结论体重增加与高血糖、血管内皮功能减退等密切相关，有效控制体重是预防高血糖的有效手段之一。

Objective To study the effects of weight change on blood sugar in obesity adult in servern years to explore the role of body weight in the blood suger. Methods A severn years follow-up study was con- ducted in the 583 simple obesity adult（ BMI≥25 kg/m^2） who were chosen in 2000-2001 and were divided into three groups rely on body weight change. Before and after follow-up adiposity, weight, fasting plasma glucose （FPG）, fasting insulin （Fins） and 2 h blood glucose （2 hPG） were measured. , while insulin resistance index （HOMA-IR） and endothelial dysfunction （EDD）were caculated. Results 524 of 583 subjects were followed up in 2007 ,the average of FPG,2 hPG were significant higher than those of the former, while EDD were de- creased. Meanwhile the weight gain group have higher changes of FPG, PBG, HOMA-IR, EDD than those with weight loss group and constant weight group,in control of age, sex, the partial correlation analysis showed that： Baseline weight, BMI, and follow-up weight （BMI） changes have positively correlated with FPG, PBG. A BMI and ABG has a significant linear relationship. Conclusion The increased weight has closely relationship with high blood sugar and EDD. Effective weight control is one of the most effective means to prevent the occurring of DM in obese subjects.