北京市顺义区南法信地区人群高血糖的危险因素分析

Risk Factors of Hyperglycemia in the Population of Nanfaxin Area of Shunyi District, Beijing

目的了解北京市郊区农村人群2型糖尿病(2DM)及糖调节受损(impaired glucose regulation,IGR)患病的危险因素。方法调查对象为2007年5月至10月参加北京市顺义区南法信地区村民体检的1873名当地常住人口。体检内容:问卷调查、体检和实验室检查。问卷调查包括:一般情况、既往病史和家族史等。体检:身高、体质量、腰围、臀围和血压等。实验室检查:空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)等。对无糖尿病史但空腹血糖大于5.5mmol/L者行口服75g葡萄糖耐量试验。按1999年WHO诊断标准将受试人群分为正常血糖组、IGR组及2-DM组。结果①参加体检者中2型糖尿病患者为360人,IGR129人,血糖正常者1384人。与正常血糖组比较,2DM组受试者年龄、体质量、腰围、腰臀围比值(WHR)、体质量指数(BMI)、收缩压、舒张压、TC、TG、LDL-C显著升高,HDL-C显著降低,差异有统计学意义(P<0.05);IGR组除HDL-C外其他各项与正常血糖组比较差异均有统计学意义(P<0.05)。②Logistic回归分析结果显示:年龄、糖尿病家族史、腰围、WHR、TG和LDL-C等6个因素为2DM的危险因素(OR分别为1.066、8.943、1.650、1.744、1.196和1.411,P<0.01);年龄、糖尿病家族史、BMI、TG和LDL-C等5个因素为IGR的危险因素(OR分别为1.049、3.276、1.586、1.130和1.431,P<0.05)。结论糖尿病前期及肥胖者是2DM的"后备军",并有心血管疾病的风险,应引起足够的重视。建议对农民进行必要的健康普查及健康知识普及;对超体质量、肥胖人群开展早期干预,以减少其发生糖尿病及心血管疾病的风险。

Objective To understand the main risk factors of type 2 diabetes（2DM） and impaired glucose regulation（IGR） in a rural population of Beijing suburb. Methods The study was conducted on 1 873 rural residents who participated in physical examination of Nanfaxin district of Beijing. The content of physical examination included： ① Questionnaire survey： general condition, past medical history, family history. ② Physical examination items ： body height, body mass, waist line, hip circumference and blood pressure etc. ③ Laboratory examinations ： fasting blood glucose（ FBG）, total cholesterol （ TC ）, triglyceride （ TG ）, high density lipoprotein cholesterol （ HDL-C ）, low density lipoprotein cholesterol（ LDL-C）, etc. Subjects were tested for blood glucose of 2 hours after orally taking 75 g glucose if their FBG was above 5.5 mmol/L and had no diabetic history. Subjects were divided into 2DM group, IGR group and normal glucose group（NBG） according to the diagnostic criteria of diabetes in 1999 published by WHO. Results ① 360 patients with 2DM, and 129 patients with IGR, 1 384 subjects with NBG were involved in the analysis of results. Compared to subjects with NBG, patients with 2DM and IGR were significantly higher in age, body mass, waist line, body mass index （ BMI）, waist-to hip ratio （WHR）, systolic blood pressure, diastolic blood pressure, TC, TG, LDL-C and patients with 2DM were significantly lower in HDL-C （P 〈 0.05 - 0. 01 ）. ② Analysis of relation between research factors and 2DM with logistic regression showed that there were significant differences in age, diabetic family history, waist circumference, WHR, TG and LDL-C between 2DM patients and subjects with NBG（ OR ： 1. 066, 8. 943, 1. 650, 1. 744, 1. 196, 1. 411, P 〈 0.01 ）. The 6 factors were risk factors of 2DM. Logistic regression also represented that age, diabetic family history, BMI, TG, LDL-C were risk factors of IGR（ OR： 1. 049, 3. 276, 1. 586, 1. 130, 1. 431, P 〈 0.05）. Conclusion Compared to subjects with normal glucose, patient with IGR and 2DM have similar levels of blood pressure, blood lipid and obesity. Obesity and IGR is the prelude of 2DM and has high risk of cardiovascular disease. Therefore, effective screening of rural population and control of known risk factors for 2DM, such as overweight and obesity, is good to prevent and reduce 2DM and cardiovascular disease.