血脂指标比值对单纯餐后高血糖型糖尿病的预测价值

The Predictive Value of the Ratio of Blood Lipid Index to Simple Postprandial Hyperglycemic Diabetes

目的:研究并比较TG/HDL-C、TC/HDL-C、non-HDL-C对单纯餐后高血糖型糖尿病(IPH)的预测价值。方法:选取220例IPH者和216例糖耐量正常的健康者(NGT)作为研究对象,所有人群均行口服75g葡萄糖耐量试验,收集空腹及糖负荷后120min血样本,并对入选者进行体格检查、血脂、血糖等指标的测定,计算TG/HDL-C、TC/HDL-C和non-HDL-C。结果:IPH患者收缩压、舒张压、BMI、腰围、TC、TG、LDL-C、TG/HDL-C、TC/HDL-C、non-HDL-C和2h-PG均高于正常对照组,HDL-C低于正常对照组,且差异均有统计学意义(P<0.05),而两组患者年龄和FBG无明显差异;Logistic回归分析,校正年龄、血压、BMI、腰围和FBG后,结果显示TC(OR=1.734)、TG(OR=2.111)、LDL-C(OR=1.514)、TG/HDL-C(OR=2.535)、TC/HDL-C(OR=1.810)、和non-HDL-C(OR=1.781)是IPH的危险因素;ROC曲线分析发现,TG/HDL-C的曲线下面积最大,其截断值取1.42时,诊断IPH的灵敏度为81.90%,特异度为69.20%,故TG/HDL-C为IPH最合适的预测因子。结论:血脂指标比值是IPH的危险因素,其中TG/HDL-C对IPH诊断预测价值最大,在临床上,对于TG/HDL-C大于1.42者,需进一步行OGTT实验,有助于早期发现IPH。

Objective： To investigate and compare predictive diagnostic value of TG/HDL-C,TC/HDL-C,non-HDL-C ratios for isolated post-challenge hyperglycemia（IPH）. Methods： 220 patients with IPH and 216 normal glucose tolerances（NGT） were enrolled in this study. All subjects were underwent a75-gOGTT. Their clinical,lipid and glucose were measured and calculated TG/HDL-C,TC/HDL-C,non-HDL-C ratios. Results： Compared with NGT,patients with IPH had higher blood pressure,BMI,waist circumference,TC,TG,LDL-C,TG/HDL-C,TC/HDL-C,non-HDL-C and 2h-PG,with lower HDL-C（P 〈 0.05）. According to logistic regression analysis,after adjusted for the age,blood pressure,BMI,waist circumference and FBG,TC,TG,LDL-C,TC/HDL-C,TG/HDL-C,and non-HDL-C were all positively correlated with IPH. TG/HDL-C obtained the highest area under the curve（AUC） of 0. 832 determined by ROC curves,suggesting that TG/HDL-C has the greatest diagnostic value of IPH. The cut off value of TG/HDLC was set at 1.42,with the sensitivity of 81.90% and the specificity of 69.20%. Conclusion： TG/HDL-C has the greatest diagnostic value of IPH,patients whose TG/HDL-C is over 1.42 need further test of OGTT in order to diagnose IPH earlier.