肥胖指标和甘油三酯对中老年人群糖代谢异常的预测价值

The predictive value of obesity indexes and triglyceride for abnormal glucose metabolism in middle-aged and elderly people

目的评估体质指数(BMI)、腰围(WC)、腰臀比(WHR)、腰高比(WHtR)、脂质蓄积指数(LAP)和甘油三酯(TG)预测中老年人群糖代谢异常的能力。方法选择成都市大邑县某社区10年前糖代谢正常的中老年受试者291例,测量肥胖指标,检测血脂,并行75 g葡萄糖耐量试验。比较2018年及2008年资料的变化。结果2008年时WC、WHR、WHtR每增加1标准差,10年后糖代谢异常发生风险分别增加42.9%,40.9%,49.1%(P<0.05)。与下三分位组相比,TG和LAP上三分位组发生糖代谢异常的风险增加。BMI、WC、WHR、WHtR、TG、LAP均可预测糖代谢异常(P<0.05),其中LAP和WHtR的预测价值高于BMI(P=0.020和0.033)。BMI、WC、WHR、WHtR诊断超重或中心性肥胖联合高TG血症预测糖代谢异常的特异度均达到90%以上。结论BMI、WC、WHR、WHtR、TG、LAP均是成都蔡场社区中老年人群糖代谢异常的危险因素和预测因子。中心性肥胖指标的预测能力,尤其是LAP和WHtR,优于BMI。对于超重或中心性肥胖合并高TG血症的患者应定期随访,早期干预,预防糖代谢异常的发生。

Objective To assess the ability of body mass index(BMI),waist circumference(WC),waist-to-hip ratio(WHR),waist-to-height ratio(WHtR),lipid accumulation product(LAP)and triglyceride(TG)to predict abnormal glucose metabolism in middle-aged and elderly people in a community of Chengdu.Methods We selected 291 middle-aged and elderly people who had normal glucose metabolism 10 years ago in Caichang community of Dayi county.Obesity indicators and blood lipids were measured as well as 75g glucose oral glucose tolerance test was conducted.The changes of data in 2018 and 2008 were compared Results When WC,WHR and WHtR was increased one standard deviation,the risk of abnormal glucose metabolism after 10 years was increased by 42.9%,40.9%and 49.1%,respectively(P<0.05).Compared with the lower tertile group,the risk of abnormal glucose metabolism in the upper tertile of TG and LAP was increased.The baseline of BMI,WC,WHR,WHtR,TG and LAP were useful for the prediction of future abnormal glucose metabolism(P<0.05).Of which,LAP and WHtR were superior to BMI(P=0.020 and 0.033,respectively).When using the cut-off values of BMI,WC,WHR,and WHtR to diagnosis overweight or central obesity combined with hypertriglyceridemia,the specificity of predicting abnormal glucose metabolism was more than 90%.Conclusion BMI,WC,WHR,WHtR,TG,and LAP are all risk factors and predictors of abnormal glucose metabolism in the middle-aged and elderly population in Caichang community of Chengdu.The predictive ability of central obesity index,especially LAP and WHtR,is better than BMI.Patients with overweight or central obesity combined with hypertriglyceridemia should be followed up regularly for early intervention to prevent the occurrence of abnormal glucose metabolism.