河北省任丘老年居民甘油三酯和高密度脂蛋白胆固醇比值与胰岛素抵抗的关系

The relationship between ratio of triglyceride to high-density-lipoprotein cholesterol and insulin resistance in the elderly residents of Renqiu in Hebei province

目的研究河北省任丘市老年居民甘油三酯/高密度脂蛋白胆固醇（TG/HDL-C）比值与胰岛素抵抗（IR）的关系,探索适合本地区筛查IR高危人群的预测指标,为心脑血管病防控工作提供依据。方法采用整群随机抽样法,选取任丘市5 010名60~70岁的常住居民为研究对象,其中男性2 163名,女性2 847名。调查内容包括健康调查问卷、体格检查和实验室生化指标检测。应用非条件logistic回归分析IR的相关危险因素,并采用受试者工作特征（ROC）曲线分析TG/HDL-C比值对IR的预测价值。结果 5 010名调查对象中,IR检出率为24.3%（1 218/5 010）,男性为17.2%（371/2 163）,女性为29.8%（847/2 847）,71.4%的IR者合并2个及以上的危险因素;糖尿病（OR=2.021,95%CI：1.699~2.403）、体质指数（OR=1.086,95%CI：1.052~1.121）、腰围（OR=1.047,95%CI：1.035~1.060）、TG/HDL-C（OR=1.167,95%CI：1.111~1.225）、低密度脂蛋白胆固醇（OR=1.231,95%CI：1.038~1.460）和尿酸（OR=1.002,95%CI：1.001~1.003）升高是IR的独立危险因素（P〈0.05）;女性TG/HDL-C曲线下面积为0.677,界值为1.29,其对应的敏感性为57.6%,特异性为70.4%;男性TG/HDL-C曲线下面积为0.693,界值为1.08,其对应的敏感性59.3%,特异性为72.2%。结论河北省任丘市60~70岁居民IR的检出率高,控制糖尿病、体质指数,腰围和TG/HDL-C有助于改善IR状态。TG/HDL-C可以作为老年IR高危人群的筛查指标,以识别心脑血管病高危人群。

Objective To study the relationship between ratio of triglyceride to high-density-lipoprotein cholesterol and insulin resistance （IR） in the elderly residents of Renqiu, to explore the predictive biomarker for residents with high risk of IR, and to provide the basis for preventing and controlling the cardiovascular diseases. Methods The cluster sampling method was used to select 5 010 residents （60-70 years old, 2 163 males and 2 847 females） from Renqiu city as the subjects. The investigation was performed with health questionnaire, physical examination and blood biochemical test, The logistic regression analysis was used to analyze the risk factors of IR, the predictive value of TG/HDL-C was analyzed using ROC of subjects. Results The IR detection rate was 24.3% （1 218/5 010）, male and female IR detection rates were 17.2% （371/2 163） and 29.8% （847/2 847）, respectively; 71.4% of subjects with IR have 2 risk factors at least. Diabetes （OR=2.021, 95%CI： 1.699-2.403）, BMI （OR=1.086, 95%CI： 1.052-1.121 ）, waist circumference （OR=1.047, 95%CI： 1.035-1.060）, TG/HDL-C （OR=1.167, 95%CI： 1.111- 1.225）, LDL-C （OR=1.231, 95%CI： 1.038-1.460） and uric acid （OR=1.002, 95%CI： 1.001-1.003） were independent risk factors for IR （P〈0.05）. Areas under the curve of TG/HDL-C for males and females were 0.677 and 0.693, respectively; the boundary values for males and females were 1.29 and 1.08, respectively; the corresponding sensitivity for males and females was 57.6% and 59.3%, respectively; the specificity for males and females was 70.4% and 72.2%, respectively. Conclusion IR detection rate in elderly residents （60 - 70 years old） of Renqiu city in Hebei province is high. The controlling diabetes, BMI, waist circumference and TG/HDL-C may improve IR, TG/HDL-C can serve as the screening indicator for elderly residents with high IR risk and recognizing the residents with high risk of cardiovascular diseases.