海南省居民血脂比值与糖尿病的关系

Relationship between ratios of serum lipid and diabetes mellitus among residents in Hainan

目的分析海南省居民血脂比值水平,探讨其与糖尿病的相互关系,为糖尿病患者预防并发症提供科学依据。方法采用多阶段抽样方法在8个地区抽取18岁以上4 543名居民进行问卷调查,采集空腹静脉血检测血糖、2 h糖耐量实验和血脂四项,计算血脂比,方差统计分析血脂比值与人群一般情况和糖尿病的关系,ROC曲线确定糖尿病患者血脂比值的理想诊断界点。结果 TG/HDL-C、TC/HDL-C、LDL-C/HDL-C和Non-HDL-C/HDL-C等4项血脂比值分别是1.25±1.81、4.00±1.50、2.53±1.04和3.00±1.50,四项血脂比值城市均高于农村,除TG/HDL-C外城乡间差异有统计学意义(P<0.01);男性高于女性,性别间差异有统计学意义(P<0.01);四项血脂比除了TG/HDL-C是60岁组最低,其余三项随着年龄增长而增加,各年龄组间差异有统计学意义(P<0.01);四项血脂比糖尿病高于正常人,方差分析差异有统计学意义(P<0.01)。4项血脂比值预测糖尿病ROC曲线下面积(AUC)均>0.7,男性和女性比值理想诊断界点TG/HDL-C分别是4.12和3.98、TC/HDL-C是1.05和0.97、LDL-C/HDL-C是3.06和2.98、Non-HDL-C/HDL-C 2.85和2.69。结论海南省居民糖尿病患者血脂控制效果不理想,应采用各项血脂比值和Non-HDL-C评价糖尿病患者的风险,以积极指导降脂治疗。

Objective To analyze the ratios of serum lipid level and explore the relationship with diabetes in Hainan Province,so as to provide scientific evidence for preventing complications in diabetes.Methods Multistage sampling method was used to sample 4 543 residents in 18 years old and above from 8 districts,the data were collected with questionnaire survey,detection of fasting blood glucose,oral glucose tolerance test（2 h-OGTT）and blood lipid,and analysis the relationship between ratios of serum lipid and diabetes,to determine ideal diagnostic point of serum lipid ratios in diabetic by ROC curve.Results The 4 serum lipid ratios of TG/HDL-C,TC/HDL-C,LDL-C/HDL-C and Non-HDL-C/HDL-C were 1.25±1.81,4.00±1.50,2.53±1.04 and 3.00±1.50,respectively.Four ratios of serum lipid of city were significantly higher than that of rural（P〈0.01）,except TG/HDL-C;the ratios of male were significantly higher than that of female（P〈0.01）;TG/HDL-C was the lowest in 60 years old group,the others increased with age（P〈0.01）;four ratios of diabetes were significantly higher than that of normal people（P〈0.01）.The AUC area for prediction of diabetes with 4 ratios of serum lipid were〉0.7,ideal point of male and female for TG/HDL-C were 4.12 and 3.98,TC/HDL-C were 1.05 and 0.97,LDL-C/HDL-C were 3.06 and 2.98,Non-HDL-C/HDL-C were 2.85 and 2.69,respectively.Conclusion The blood lipid was out of control in diabetes effectively,we should evaluate the risk in diabetes with ratios of serum lipid and Non-HDL-C,and guide to therapy the lipid activelyin Hainan Province.