体检人群中糖尿病前期转化为2型糖尿病的影响因素分析

Analysis of Factors Influencing the Conversion of Pre-Diabetes to Type 2 Diabetes Mellitus in a Physically Examined Population

目的探究健康体检人群中糖尿病前期转化为2型糖尿病(T2DM)的影响因素。方法选取2019—2020年在宁夏医科大学总医院健康管理中心体检的空腹血糖值≥6.0 mmol·L^(-1)的人群,收集其人口学特征、一般体格检查、生化组合、尿常规和血红蛋白测定量等基础资料指标,采用非条件二分类Logistic回归分析糖尿病前期自然转化T2DM期的影响因素。结果8155例空腹血糖≥6.0 mmol·L^(-1)的体检人群中,糖尿病前期3807例(占46.7%),T2DM期4348例(占53.3%)。不同临床检测指标的单因素分析结果显示,年龄、性别、体质量指数(BMI)、收缩压、生化指标(TG、HDL-C、LDL-C、AST/ALT、Urea/Cr)、尿常规指标(尿葡萄糖、尿蛋白质、尿酮体)以及血常规指标(血红蛋白)在两组间差异均有统计学意义(P均<0.05)。非条件二分类Logistic回归分析结果显示,年龄(OR=1.022),收缩压(OR=1.003),TG(OR=1.049),Urea/Cr(OR=43.224),尿葡萄糖“+-”“1+”“2+”“3+”“4+”(OR=6.121、11.509、18.054、33.013、34.819),尿蛋白质“+-”(OR=1.130),尿酮体“+-”“1+”(OR=1.635、1.834)和AST/ALT(OR=0.682)分别是体检人群糖尿病前期向T2DM期转化的危险因素和保护因素(P均<0.05)。结论年龄、收缩压、TG、AST/ALT、Urea/Cr比值、尿葡萄糖、尿蛋白质以及尿酮体是体检基础指标中糖尿病前期向T2DM自然转化的影响因素。

Objective To explore the factors influencing the conversion of pre-diabetes population into type 2 diabetes mellitus(T2DM)in the physical examination population.Methods The population with fasting blood glucose values≥6.0 mmol·L^(-1) who were examined at General Hospital of the Health Management Center of Ningxia Medical University from 2019 to 2020 were selected to collect their demographic characteristics,general physical examination,biochemical combinations,urinary routine and hemoglobin determination amounts and other basic indicators,and the factors affecting the conversion of pre-diabetes into T2DM stage were analyzed by unconditional dichotomous logistic regression.Results Among 8155 cases with fasting glucose>6.0 mmol·L^(-1) in the physical examination population,3807 cases(46.7%)were pre-diabetic and 4348 cases(53.3%)were in the T2DM stage.The results of univariate analysis of different clinical indicators showed that the differences in age,gender,BMI,systolic blood pressure,biochemical indicators(TG,HDL-C,LDL-C,AST/ALT,Urea/Cr),urinary routine indicators(urinary glucose,urinary protein,urinary ketones),and blood routine indicators(hemoglobin measurement amount)were statistically significant between the two groups(P all<0.05).The results of unconditional dichotomous Logistic regression analysis showed that age(OR=1.022),systolic blood pressure(OR=1.003),TG(OR=1.049),Urea/Cr(OR=43.224),urinary glucose"+-""1+""2+""3+""4+"(OR=6.121,11.509,18.054,33.013,34.819),urine protein"+-"(OR=1.130),urinary ketones"+-","1+"(OR=1.635,1.834)and AST/ALT(OR=0.682)were risk and protective factors for the transition from pre-diabetes to T2DM in the examined population(P all<0.05).Conclusion Age,systolic blood pressure,TG,AST/ALT,Urea/Cr ratio,urinary glucose,urinary protein,and urinary ketone are influential factors in the natural conversion of pre-diabetes to T2DM among the basic indicators of physical examination.