成都地区中老年高血压人群糖代谢异常流行状况及其影响因素

An epidemiological study of abnormal glucose metabolism and its risk factors among middle and aged population with hypertension in Chengdu area

目的探讨成都地区中老年高血压人群糖代谢异常流行状况及影响因素。方法于2008年采用分层整群抽样的方法，调查成都城乡地区40-79岁中老年人口4685例，进行血压、口服葡萄糖耐量试验（ocrr）等检测，已确诊糖尿病患者只测空腹血糖，开展问卷调查。比较高血压及非高血压人群糖代谢异常患病率，获取中老年高血压人群单纯性糖耐量异常及单纯性负荷后高血糖情况，分析中老年高血压人群糖代谢异常的影响因素。结果成都地区中老年高血压人群糖代谢异常患病率（53．4％）显著高于非高血压人群（25．1％）；若不行OGTT，仅依靠检测空腹血糖，将漏诊中老年高血压人群中72．9％的糖尿病前期患者和54．4％的新诊断糖尿病患者；年龄、一级亲属糖尿病史、超重或肥胖为成都地区中老年男性高血压人群发生糖代谢异常的独立危险因素，体育锻炼、文化程度高为保护因素；年龄、一级亲属糖尿病史、腹型肥胖、高TG血症为成都地区中老年女性高血压人群发生糖代谢异常的独立危险因素。结论成都地区中老年高血压人群超过半数合并糖代谢异常，需要通过OGTT及时发现这些合并糖代谢异常的患者。适当运动，了解糖尿病相关的保健知识以采取合理的生活方式，干预超重或肥胖、腹型肥胖及高TG血症等代谢性因素，对于减少中老年高血压人群糖代谢异常的发生有着较为重要的作用。

Objective To explore the epidemiological status of abnormal glucose metabolism and its influential factors among middle and aged population with hypertension in Chengdu area. Methods In 2008, after adopting the methods of stratified cluster sampling, the authors investigated 4685 subjects of the middle and aged population between the age of 40-79 in Chengdu urban and rural area by checking blood pressure and oral glucose tolerance test （OGTF）. Patients with previously known diabetes mellitus （DM） were only asked to perform fasting glucose and to carry out a questionnaire. Comparison of the prevalence rates of abnormal glucose metabolism in hypertensive and non-hypertensive subjects was carried out. The prevalence rates of isolated impaired glucose tolerance （I-IGT） and isolated postprandial hyperglycemia （IPH） among middle and aged subjects with hypertension were acquired and the influential factors of abnormal glucose metabolism among middle and aged subjects with hypertension were analyzed. Results The prevalence rate of abnormal glucose metabolism in the hypertensive subjects was obviously higher than that in the non-hypertensive subjects; without using OGTI＇, 72. 9% of the pre-diabetic and 54.4% of the new diagnosed DM patients would remain undiagnosed if fasting plasma glucose detection was used alone. Age, diabetic history of first degree relatives, overweight or obesity were the risk factors for the development of abnormal glucose metabolism among middle and aged male subjects with hypertension in Chengdu area. Exercise training and high education level were the protective factors. Age, diabetic history of first degree relatives, abdominal obesity and hypertriglyceridemia were the risk factors for the development of abnormal glucose metabolism among middle and aged female subjects with hypertension in Chengdu area. Conclusions More than 50% of middle and aged subjects with hypertension in Chengdu area has accompanying abnormal glucose metabolism. OGTF easily discloses the abnormal status and should be a routine procedure in the diagnosis of pre-diabetes or DM in such population. Appropriate exercise, learning diabetes-related knowledge to take reasonable lifestyle, and intervention of metabolic factors such as overweight or obesity are advised. Abdominal obesity and hypertriglyceridemia play important roles in leading to abnormal glucose metabolism among middle and aged population with hypertension.