不同诊断标准空腹血糖受损代谢特征及影响因素

Metabolic characteristics and influential factors of impaired fasting glucose by different diagnostic criteria

目的了解不同诊断标准空腹血糖受损(IFG)代谢特征及影响因素。方法选取健康体检人群8 203人,根据空腹血糖(FPG)水平,分为正常糖代谢组(NGT,FPG<5.6 mmol/L)、空腹血糖受损组1(IFGl,5.6 mmol/L≤FPG<6.1mmol/L)和空腹血糖受损组2(IFG2,6.1mmol/L≤FPG<7.0mmol/L),比较3组间代谢指标差异。采用多因素有序logistic回归分析不同诊断标准下IFG发生相关影响因素。结果 8 203人中平均年龄(52.03±16.63岁),FPG值为(5.63±0.50)mmol/L。检出IFG1、IFG2、NGT组组分别2 775、1 643、3 785人,3组间年龄、性别、体重指数、既往史、血压和血脂差异均有统计学意义(P<0.05);校正年龄、性别、BMI后,不同诊断标准下,甘油三酯(TG)、非高密度脂蛋白胆固醇(non-HDLC)、收缩压(SBP)、舒张压(DBP)均与IFG发生有统计学关联(P值均<0.05)。结论不同诊断标准下,TG、non-HDL-C、SBP、DBP均是人群IFG发生的危险因素,其中non-HDL-C与其他血脂指标相比,可能对疾病进展有更灵敏的反应。

Objective To investigate the metabolic characteristics and influential factors among patients with impaired fasting glucose （IFG） diagnosed by different criteria. Methods A total of 8 203 cases of healthy subjects were selected to conduct physical examination. According to the level of fasting blood glucose （FPG）, subjects were divided into normal glucose metabolism group （NGT, FPG〈5.6 mmol/L）, impaired fasting blood glucose group 1 （IFGl, 5.6 mmol/L≤FPG〈6.1 mmol/L） and impaired fasting blood glucose group 2 （IFG2, 6.1 mmol/L≤FPG〈7.0 mmol/L）. The differences of metabolic indexes among the 3 groups were compared. Multivariate ordinal logistic regression analysis was used to analyze the influential factors of IFG by different diagnostic criteria. Results The average age of 8 203 surveyed subjects was （52.03± 16.63 ） years, and the average FPG was （5.63±0.50） mmol/L. There were 2 775, 1 643 and 3 785 cases recruited in IFG1,IFG2 and NGT groups, respectively. The age, gender, BMI, past history, blood pressure and blood lipids levels of the 3 groups were statistically significant （all P 〈0.05）. After adjusting for age, gender and BMI, triglycerides （TG）, non-HDL-C, systolic blood pressure, and diastolic blood pressure were statistically related with IFG under different diagnostic criteria （all P 〈0.05）. Conclusion Under different diagnostic criteria, TG, non-HDL-C, systolic blood pressure and diastolic blood pressure were risk factors of IFG. Compared with other blood lipid level factors, non-HDL-C can be more sensitive to disease progress.