芬兰糖尿病风险评分和胰岛素抵抗的相关性分析

Relationship between Finnish diabetes risk score and insulin resistance

目的：分析探索芬兰糖尿病风险评分（Finnish Diabetes Risk Score, FINDRISC）和胰岛素抵抗的相关性。方法以来自江苏徐州地区的2477名健康体检人群为研究对象，检测受试者甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖和餐后2 h血糖等相关生化指标。FINDRISC问卷由专业营养师询问评估，包括年龄、体重指数、腰围、是否有高血压或服降压药史、是否有血糖升高史和家族糖尿病史。将HOMA-IR≥2.69定义为胰岛素抵抗。将研究对象分成两组，胰岛素抵抗组：HOMA-IR≥2.69和非胰岛素抵抗组：HOMA-IR＜2.69。结果用FINDRISC来筛检胰岛素抵抗的受试者工作曲线下面积为0.78（95%CI 0.76～0.80），其中男性为0.78（95%CI 0.75～0.80），女性为0.75（95%CI 0.71～0.80）。胰岛素抵抗组患者年龄、体质指数、腰围、臀围、体脂率、收缩压、舒张压、空腹血糖、空腹胰岛素、餐后2 h血糖、总胆固醇、甘油三酯、低密度脂蛋白、FINDRISC均高于非胰岛素抵抗组，差异有统计学意义（P＜0.05）。胰岛素抵抗组患者高密度脂蛋白低于非胰岛素抵抗组，差异有统计学意义（P＜0.05）。FINDRISC与胰岛素抵抗的发生风险相关，校正相关参数（年龄、腰围、体重指数、空腹血糖）后，这种相关性依然存在。结论 FINDRISC 和胰岛素抵抗密切相关，可作为筛查评估胰岛素抵抗患病率的一种方法。

Objective To investigate the relationship between Finnish Diabetes Risk Score（FINDRISC） and insulin resistance. Methods The study samples were from a community-based health examination survey in Xuzhou, Jiangsu province of China. A total of 2477 subjects with biomarkers available were included in the present study. Serum triglyceride（TG）, total cholesterol（TC）, high density lipoprotein cholesterol（HDL-C）, low density lipoprotein cholesterol（LDL-C）and glucose were measured. The FINDRISC questionnaire was applied by registered nutritionists. Points were attributed for the following parameters：age, self-reported use of blood pressure medication, history of high blood glucose, physical activity at least 4 ha week, daily consumption of vegetables, fruits, and berries, and measured body mass index （BMI, kg/m2） and waist circumference, and family history of diabetes. The HOMA-IR≥2.69 was defined as the insulin resistance. Subjects were divided into two groups by the HOMA-IR（2.69）, IR group：HOMA-IR≥2.69 and NON-IR group：HOMA-IR〈2.69. Results The area under the receiver operating characteristics curve for insulin resistance was 0.78（95%CI 0.76-0.80）;0.78 in men （95%CI 0.75-0.80） and 0.75（95% CI 0.71-0.80） in women. Age, BMI, waist, hip, body fat rate, systolic blood pressure, diastolic blood pressure, fasting glucose, fasting insulin, postprandial blood glucose, TC, TG, LDL-C, FINDRISC level of patients in IR group were higher than NON-IR group, the differences were statistically significant. HDL-C was lower in IR group than NON-IR group, the difference was statistically significant. FINDRISC was associated with the risk of IR. This association remained robust even after adjusting for the following parameters （age, waist circumference, body mass index, fasting blood sugar）. Conclusion FINDRISC is found to be correlated with IR. Our data suggest that the FINDRISC could be a useful primary screening tool for the presence of IR.