广州海珠区中老年人群不同血糖水平与冠心病发病风险分析

Analysis of glucose levels and the risk for coronary heart disease in elderly patients in Guangzhou Haizhu district

目的探讨广州市海珠区社区居民糖尿病前期及糖尿病的流行病学特征,与冠心病(CHD)发病风险的相关性,为血糖早期干预及CHD综合防治提供依据。方法分层随机抽样抽取该地区45岁以上社区居民1800人,以空腹指尖血糖≥5.6 mmol/L为初筛标准,对符合条件的择期进一步以问卷调查、抽血化验及体格检查等方法收集资料,将研究对象分为正常血糖组、糖尿病前期组、糖尿病组3组。比较各组CHD相关危险因素(高血压、高血脂、肥胖、中心性肥胖)患病率,应用Framingham CHD预测模型预测10年内CHD发病风险。结果 (1)海珠区中老年人群糖尿病前期组患病率为11.00%,糖尿病组发病率为7.56%。(2)糖尿病前期组与糖尿病组高血压、高血脂、肥胖及中心性肥胖患病率均显著高于正常血糖组,但糖尿病前期组与糖尿病组之间差异无统计学意义。(3)糖尿病前期组与糖尿病组的CHD 10年风险均显著高于正常组,但两组之间无统计学差异。结论糖尿病前期与糖尿病患者人群的CHD 10年危险度均明显高于正常血糖者,但两组之间差异不具有统计学意义,提示空腹血糖受损及糖耐量异常与CHD关系密切,早期控制血糖对防治CHD具有积极意义。

Objective To investigate the prevalence of diabetes and prediabetes and their association with the risk for coronary heart disease（CHD） in elderly residents in Haizhu District of Guangzhou.Methods Stratified random sampling was employed to select a total of 1800 resident aged 50 years or older in the region.The fasting fingertip blood glucose5.6 mmol/L was used as the criterion for the initial screening.The data were collected from qualified subjects via scheduled questionnaire surveys,blood collection and testing,and physical examination.The subjects were divided into the 3 groups,namely normal blood glucose,prediabetes,and diabetes groups.The combination rates of the relevant risk factors（hypertension,hyperlipemia,obesity,and central obesity） were compared among the groups by Framingham Heart Study to predict the occurrence of CHD in 10 years.Results The incidence was 11.00% for prediabetes and 7.56% for diabetes in the elderly residents in Haizhu District.The occurrence of hypertension,hyperlipemia,obesity,and central obesity was significant higher in the prediabetes and diabetes group than in the normal blood glucose group,and showed no significant differences between the former two groups.The 10-year risks for CHD were markedly higher in both the prediabetes and diabetes groups than in the normal blood glucose group,but similar between the former two groups.Conclusions Elderly patients with prediabetes and diabetes have significantly increased 10-year risk for CHD in comparison with those with normal blood glucose,but the risk is similar between the former two groups,indicating a close association of IGR（impaired fasting glucose＋ impaired fasting glucose） with CHD.Early control of blood glucose is essential to the prevention and control of CHD.