血糖正常中老年人胰岛素抵抗指数分布及影响因素分析

A study on the correlations study among HOMA-IR, obesity and inflammatory factors among middle aged and elderly population

目的了解血糖正常中老年人群中稳态胰岛素评估模型胰岛素抵抗(HOMA-IR)指数分布及其影响因素,为2型糖尿病的早期筛查和预防提供依据。方法选取某社区2012年7月—2015年6月体检档案显示血糖正常且≥40岁的居民229人为研究对象,测量身高、体重、腰围和臀围,并检测空腹血糖(FPG)、胰岛素(FINS)、低密度脂蛋白(LDL)、尿酸、肿瘤坏死因子(TNF)和白介素-6(IL-6)等,计算并分析HOMA-IR指数的分布及其影响因素。结果 229名研究对象中男性113人,占49.34%,女性116人,占50.66%;平均年龄(63.58±8.85)岁。HOMA-IR指数中位数为0.94(1.08),HOMA-IR指数超标21人,占9.17%。多元线性回归分析显示,HOMA-IR指数与女性、腰围和IL-6呈正相关(P<0.01)。结论在血糖正常的中老年人群中,女性、中心性肥胖及IL-6水平高者IR发生的可能性高。

Objective To investigate the distribution of insulin resistance（HOMA-IR） index and its influencing factors among middle and old aged people with normal glucose and to provide the basis for early screening and prevention of type 2diabetes. Methods A total of 229 residents were selected with health records showed normal blood glucose（fasting blood glucose 〈 7.0mmol/L,postprandial 2h blood glucose〈11.1 mmol/L） and more than 40 years old from July, 2012 to June,2015. Height, weight, waist and hip circumference, and the fasting plasma glucose（FPG）, insulin（FINS）, low density lipoprotein（LDL）,uric acid,tumor necrosis factor（TNF） and interleukin-6（IL-6） were recorded to analyze the distribution of HOMA-IR and its influencing factors. Results Totally 229 people were included,of which 113 were male（49.34%）,116 female（50.66%）. The average age was（63.58 ＋ 8.85） years old. The average HOMA-IR index was 0.94（1.08） and there were 21 people that HOMA-IR exceed the standard（HOMA-IR≥2.68）,accounting for 9.17%.The HOMA-IR index of different gender,age,waist circumference,hip circumference,uric acid in the elderly had significant difference（P 〈 0.05）.Multiple linear regression analysis showed that HOMA-IR index was positively correlated with female,waist circumference and IL-6 and was negatively correlated with age. Conclusion The possibility of IR was higher in women with relatively low age,female,central obesity and high IL-6 levels among the middle and old aged people with normal blood glucose.