新的空腹血糖受损切点对中老年糖尿病前期人群的研究价值

Value of new impaired fasting glucose cut-point in middle-aged patients with pre-diabetes

目的应用中老年糖尿病前期人群资料评估空腹血糖受损切点下调的有效性。方法分析2004年6月北京地区中老年人群流行病学调查中,行75g OGTT试验诊断为NGT、IGR者人群病例资料,按照2003年ADA诊断标准定义糖代谢状态NGT、IFG1、IFG2、IGT、IFG/IGT,评估IFG切点下调对IGR各组分构成的影响,分析采用新切点划分的IGR各组分合并代谢异常及其他疾病的情况。结果按照1999年WHO和2003年ADA诊断标准不同糖代谢状态构成比分别为NGT组72.2%vs 64.4%、IFG组1.9%vs 9.7%、IGT组23.0%vs 17.3%、IFG/IGT组3.0%vs 8.6%。与NGT组相比,IFG1组合并高血压(36.1%vs 30.9%,P<0.05)、血脂紊乱(46.2%vs 38.2%,P<0.05)、微量白蛋白尿(13.3%vs 6.1%,P<0.05)、心血管疾病(9.6%vs 6.0%,P<0.05)比例均显著高于NGT组。结论与1999年WHO标准相比,采用2003年ADA标准扩大了IFG和IFG/IGT人群比例,5.6≤FPG<6.1mmo1/L人群合并代谢紊乱及其他疾病比例较正常糖代谢人群已显著提高,从疾病早期防控角度,下调IFG切点有其合理性。

Objective To assess the effectiveness of impaired fasting glucose（IFG） cut-point in elderly patients with pre-diabetes.Methods Data about elderly patients with NGT and IGR diagnosed by 75g OGTT test during Beijing epidemiological survey in June 2004 were analyzed.The glucose metabolism status（NGT,IFG1,IFG2,IGT,IFG/IGT） was defined following the 2003 ADA diagnostic criteria.Effect of down-regulated IFG cut-point on IGR components was assessed.IGR accompanying abnormal metabolism and other diseases classified with the new IFG cut-point was analyzed.Results According to the 1999 WHO and 2003 ADA diagnostic criteria,the component ratio of different glucose metabolism states was 72.2% vs 64.4% for NGT group,1.9% vs 9.7% for IFG group,23.0% vs 17.3% for IGT group,and 3.0% vs 8.6% for IFG/IGT group,respectively.The ratio of hypertension,dyslipidemia,micro-albuminuria,and cardiovascular disease was significantly higher in IFG1 group accompanying hypertension than in NGT group（36.1% vs 30.9%,46.2% vs 38.2%,13.3% vs 6.1%,and 9.6% vs 6.0%,P0.05）.Conclusion Compared with the 1999 WHO criteria,the 2003 ADA criteria can expand the ratio of IFG and IFG/IGT patients.The ratio of patients with 5.6≤FPG 6.1mmo1/L accompanying metabolic disorders and other diseases is significantly higher than that of those with normal glucose metabolism.From the point of early prevention and control of the disease,the down-regulated IFG cut-point has its rationality.