血糖正常的成年人空腹血糖与心血管代谢危险因素的相关性

Fasting Plasma Glucose and Clustering of Cardiometabolic Risk Factors in Normoglycemic Adults

目的探讨空腹血糖(FPG)处于正常范围内的成年人血糖水平与心血管代谢异常因素的关系。方法选择2006年7月至2012年12月来自海军92474部队医院进行体检的FPG正常的2532例成年人作为研究对象,按照其血糖水平分为三组,比较三组间吸烟、运动、体质量指数(BMI)、血压、血脂、高敏C反应蛋白(hs-CRP)、胰岛素抵抗情况以及其与心血管代谢危险因素的相关性。结果随着FPG水平在正常范围内的增加,年龄越来越大(F=29.526,P<0.001),男性所占比例也越来越高(χ2=56.929,P<0.001);在生活方式上,吸烟和运动的比例随着FPG水平的增高也逐渐增高,但不同FPG水平组比较差异无统计学意义(χ2=3.279,P=0.194);随着FPG水平在正常范围内增高,BMI、腰围、收缩压、舒张压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血清肌酐、胰岛素抵抗稳态模型评估(HOMA-IR)及hs-CRP的水平也逐渐增高,比较差异均有统计学意义(P<0.05);三组间超重、肥胖、血压高、三酰甘油异常、HDL-C异常、HOMA-IR异常、hs-CRP异常个体所占的比例随FPG水平的升高也越来越多,比较差异均有统计学意义;在校正了性别、年龄、吸烟、运动和BMI后,在正常FPG中水平组高血压和三酰甘油异常是其心血管代谢危险因素(P<0.05),而HDL-C异常、HOMA-IR异常、hs-CRP异常非其心血管代谢危险因素(P>0.05);正常FPG高水平组高血压、三酰甘油异常、HDL-C异常、HOMA-IR异常、hs-CRP异常均是其心血管代谢危险因素(P<0.05)。结论在FPG水平正常的成年人中,高水平FPG值与多种心血管代谢异常因素有关,这种相关性独立于肥胖。FPG的检测有助于鉴别高心血管风险个体并开展差异化的监测管理。

ObjectiveTo explore the relationship between the level of fasting plasma glucose（FPG） within a normoglycemic range and cardiometabolic risk factors among adults.MethodsDuring Jul.2006 and Dec.2012,a total of 2532 subjects with normal FPG from Navy 92474 Hospital were divided into 3 groups.The prevalence of smoking,physical exercise,body mass index （BMI）,blood pressure,blood lipids,high-sensitivity C-reactive protein （hs-CPR） and homeostasis model assessment-insulin resistance （HOMA-IR）,and others cardiometabolic risk factors of the three groups were compared.ResultsWith FPG increasing in normoglycemic range,the subjects became older（F=29.526,P〈0.001） and the percentage of male increased（χ^2=56.929,P〈0.001）.The percentage of smoking and physical exercise increased with FPG increasing,but the differences had no statistical significance（χ^2=3.279,P=0.194）.BMI,waist circumference,blood pressure,blood lipids,HOMA-IR,Scr and hs-CPR increased with FPG（P〈0.001）.Subjects with high-normal FPG showed a higher risk of obesity,high blood pressure,abnormal blood lipids,HOMA-IR and hs-CPR compared with subjects with low-normal FPG.After adjusting sex,age,smoking,physical exercise and BMI,high blood pressure and abnormal TG were cardiovascular risk factors with intermediate-normal FPG（P〈0.05）,whereas,abnormal HDL-C,HOMA-IR and hs-CRP were not cardiovascular risk factors（P〉0.05）.High blood pressure,abnormal TG,HDL-C,HOMA-IR and hs-CRP were cardiovascular risk factors of high-normal FPG（P〈0.05）.ConclusionIn adults,higher FPG within the normal range is associated with several cardiometabolic risk factors,independent from obesity.Detection of FPG may help to identify subjects with cardiovascular risks and develop the individualized monitoring and management.