兰州市城关区糖尿病前期人群患病特点及相关因素分析

Characteristics and related factors of prediabetes mellitus in Chengguan district of Lanzhou city

目的探讨兰州市城关区社区糖尿病前期居民患病特点及相关影响因素。方法于2019年12月到2020年12月选取甘肃省兰州市城关区6个社区内居住5年及以上的成年汉族居民进行横断面研究。收集研究对象身高、体重,并计算体重指数(BMI),收集其年龄、腰围、颈围、收缩压、红细胞、白细胞、血红蛋白(Hb)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、空腹血糖(FPG)、餐后1 h血糖(1hPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA_(1c))等资料。根据《中国2型糖尿病防治指南(2020年版)》,将研究对象分为糖尿病前期(PreDM)[包括空腹血糖受损(IFG)、糖耐量受损(IGT)及IFG+IGT]组和正常糖耐量(NGT)组。两组间比较采用t检验,多组间比较采用单因素方差分析。采用Pearson相关分析法分析PreDM患者FPG、1hPG和2hPG与各临床指标的相关性。结果共纳入479例研究对象,其中,PreDM组348例(IGT、IFG、IGT+IFG患者分别为193、52和103例),NGT组131名。与NGT组相比,PreDM组患者的BMI、白细胞、ALT、AST、TG、HbA_(1c)、FPG、1hPG和2hPG等均更高(P<0.05)。PreDM患者中,IGT、IFG、IGT+IFG分别占55.5%(193/348)、14.9%(52/348)和29.6%(103/348),IGT患者占比最高。Pearson相关分析结果显示,PreDM患者FPG与BMI、TC、HbA_(1c)、Hb等呈正相关(r值分别为0.14、0.21、0.15、0.14,均P<0.001);1hPG与BMI、AST、ALT、TC、HbA_(1c)、Hb、红细胞、白细胞等呈正相关(r值分别为0.25、0.10、0.17、0.08、0.30、0.13、0.18和0.20,均P<0.05);2hPG与BMI、AST、ALT、HbA_(1c)、白细胞等呈正相关(r值分别为0.16、0.15、0.21、0.22和0.13,均P<0.05);且FPG、1hPG和2hPG均与HDL-C呈负相关(r值分别为-0.12、-0.18、-0.21,均P<0.001)。结论兰州市城关区PreDM人群较NGT人群在脂代谢、肝功能、血细胞水平已出现较大差异。PreDM患者中,IGT患者占比最高。

Objective To investigate the characteristics and related factors of prediabetes residents in Chengguan district of Lanzhou.Methods A cross-sectional study was conducted to investigate the Han residents living in 6 communities in Chengguan district,Lanzhou city,Gansu province,from December 2019 to December 2020.The height and weight were collected and the body mass index(BMI)was calculated.The age,waist circumference,neck circumference,systolic blood pressure,erythrocyte,leukocyte,hemoglobin(Hb),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),glutamic pyruvic transaminase(ALT),glutamic oxaloacetic transaminase(AST),fasting plasma glucose(FPG)and 1 h-postprandial plasma glucose(1hPG),2 h-postprandial plasma glucose(2hPG)after oral glucose tolerance test(OGTT)and glycosylated hemoglobin(HbA_(1c))were collected.According to the guideline for prevention and treatment of type 2 diabetes in China(2020 Edition),the subjects were divided into prediabetes(PreDM)[including impaired fasting glucose(IFG),impaired glucose tolerance(IGT),IFG+IGT]group and normal glucose tolerance(NGT)group.t-test and analysis of variance(ANOVA)were used to compare the groups.Pearson′s correlation analysis was used to analyze the correlation among FPG,1hPG and 2hPG and clinical indexes in PreDM patients.Results A total of 479 residents were enrolled.There were 131 patients in NGT group,348 in PreDM group(193,52 and 103 patients with IGT,IFG and IGT+IFG respectively).Compared with NGT group,BMI,leukocyte,ALT,AST,TG,HbA_(1c),FPG,1hPG and 2hPG in PreDM group were all higher(P<0.05).IGT,IFG and IGT+IFG accounted for 55.5%(193/348),14.9%(52/348)and 29.6%(103/348)respectively.The results of Pearson′s correlation analysis showed that FPG was positively correlated with BMI,TC,HbA_(1c)and Hb in the patients of PreDM group(r values were 0.14,0.21,0.15 and 0.14,respectively,all P<0.001),and 1hPG was positively correlated with BMI,AST,ALT,TC,HbA_(1c),Hb,erythrocyte and leukocyte(r values were 0.25,0.10,0.17,0.08,0.30,0.13,0.18 and 0.20,respectively,all P<0.05);2hPG was positively correlated with BMI,AST,ALT,HbA_(1c)and leukocyte(r values were 0.16,0.15,0.21,0.22 and 0.13,all P<0.05),and FPG,1hPG and 2hPG correlated with HDL-C negatively(r values were-0.12,-0.18,-0.21,respectively,all P<0.001).Conclusions There were great differences in lipid metabolism,liver function and blood cell level between PreDM and NGT patients in Chengguan district of Lanzhou city.IGT accounted for the highest proportion among the PreDM patients.