中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2008年
20期
1394-1397
,共4页
卢艳慧%陆菊明%王淑玉%李春霖%刘力生%郑润平%田慧%王先令%杨丽娟%张育青%潘长玉
盧豔慧%陸菊明%王淑玉%李春霖%劉力生%鄭潤平%田慧%王先令%楊麗娟%張育青%潘長玉
로염혜%륙국명%왕숙옥%리춘림%류력생%정윤평%전혜%왕선령%양려연%장육청%반장옥
糖尿病前期%胰岛素抗药性%糖调节受损%胰岛β细胞功能
糖尿病前期%胰島素抗藥性%糖調節受損%胰島β細胞功能
당뇨병전기%이도소항약성%당조절수손%이도β세포공능
Prediabetic state%Insulin resistance%Impaired glucose regulation%Islet β cell function
目的 采用2003年美国糖尿病协会标准分析糖尿病前期人群健康教育1年后转为正常血糖(NGT)者第2年的自然转归及影响因素.方法 北京地区中老年人群流行病学调查筛查出的糖调节受损(IGR)者健康教育1年后逆转为NGT者169例第2年再次随访.结果 基线时IGR人群1年后逆转为NGT的169例中第2年复查时90例(53.3%)仍维持NGT,77例(45.6%)又转为IGR,2例(1.2%)进展为糖尿病.IGR→NGT→NGT组第2年的胰岛素抵抗显著减轻,胰岛β细胞功能显著改善(P＜0.05).逐步回归分析显示基线及1年后的空腹血糖(FPG)与IGR向NGT的转归及维持呈负相关,基线及1年后的胰岛β细胞功能与IGR向NGT的转归及维持呈正相关.IGR→NGT→NGT组第2年时腰围超标(46例)、血压升高(41例)、甘油三酯(TG)升高(23例)、≥2项代谢异常及代谢综合征(46例)的比例均显著低于IGR→NGT→IGR组(分别为53、52、34、、68例,P＜0.05).结论 FPG、胰岛β细胞功能、TG等因素可以作为IGR逆转为NGT并维持NGT的预测指标.合并的代谢异常项目越少,改善越明显,对于IGR人群逆转为NGT并维持NGT越有益.
目的 採用2003年美國糖尿病協會標準分析糖尿病前期人群健康教育1年後轉為正常血糖(NGT)者第2年的自然轉歸及影響因素.方法 北京地區中老年人群流行病學調查篩查齣的糖調節受損(IGR)者健康教育1年後逆轉為NGT者169例第2年再次隨訪.結果 基線時IGR人群1年後逆轉為NGT的169例中第2年複查時90例(53.3%)仍維持NGT,77例(45.6%)又轉為IGR,2例(1.2%)進展為糖尿病.IGR→NGT→NGT組第2年的胰島素牴抗顯著減輕,胰島β細胞功能顯著改善(P＜0.05).逐步迴歸分析顯示基線及1年後的空腹血糖(FPG)與IGR嚮NGT的轉歸及維持呈負相關,基線及1年後的胰島β細胞功能與IGR嚮NGT的轉歸及維持呈正相關.IGR→NGT→NGT組第2年時腰圍超標(46例)、血壓升高(41例)、甘油三酯(TG)升高(23例)、≥2項代謝異常及代謝綜閤徵(46例)的比例均顯著低于IGR→NGT→IGR組(分彆為53、52、34、、68例,P＜0.05).結論 FPG、胰島β細胞功能、TG等因素可以作為IGR逆轉為NGT併維持NGT的預測指標.閤併的代謝異常項目越少,改善越明顯,對于IGR人群逆轉為NGT併維持NGT越有益.
목적 채용2003년미국당뇨병협회표준분석당뇨병전기인군건강교육1년후전위정상혈당(NGT)자제2년적자연전귀급영향인소.방법 북경지구중노년인군류행병학조사사사출적당조절수손(IGR)자건강교육1년후역전위NGT자169례제2년재차수방.결과 기선시IGR인군1년후역전위NGT적169례중제2년복사시90례(53.3%)잉유지NGT,77례(45.6%)우전위IGR,2례(1.2%)진전위당뇨병.IGR→NGT→NGT조제2년적이도소저항현저감경,이도β세포공능현저개선(P＜0.05).축보회귀분석현시기선급1년후적공복혈당(FPG)여IGR향NGT적전귀급유지정부상관,기선급1년후적이도β세포공능여IGR향NGT적전귀급유지정정상관.IGR→NGT→NGT조제2년시요위초표(46례)、혈압승고(41례)、감유삼지(TG)승고(23례)、≥2항대사이상급대사종합정(46례)적비례균현저저우IGR→NGT→IGR조(분별위53、52、34、、68례,P＜0.05).결론 FPG、이도β세포공능、TG등인소가이작위IGR역전위NGT병유지NGT적예측지표.합병적대사이상항목월소,개선월명현,대우IGR인군역전위NGT병유지NGT월유익.
Objective To investigate the natural outcome in the second year of the patients with impaired glucose regulation(IGR)that reverted to normal glucose tolerance(NGT).Methods 463 adults diagnosed as with IGR in the baseline survey based on the criteria of America Diabetic Association 2003 underwent treatment including health education.One and 2 years later blood samples were collected to examine the glucose and lipids.Blood pressure,heart rate,waist,and hip were examined.Questionnaire survey was conducted.Resuits One year later 55 of the patients(32.5%)were diagnosed as with isolated impaired glucose tolerance(I-IFG),86(50.9%)with I-IGT,and 28(16.6%)with IFG/IGT at the baseline survey had their diseases reverted to NGT.53.3%of them remained to be with NGT.45.6%of them showed the diagnosis transformed into IGR.and the disease in 1.2%of them progressed into diabetes mellitus.In the second year.insulin resistance was significanfly relieved and islet β cell function was significantly improved in the pattern IGR→NGT→NGT.Stepwise logistic regression analysis showed that fasting plasma glucose(FPG)in the baseline survey and 1 year later were negatively correlated and HBCI were positively correlated with the reversion and maintenance of NGT.In the second year,the ratio of elevated waist circumference,elevated blood pressure,elevated TG,reduced HDL-c,elevated FPG.more than two metabolic abnormalities and metabolic syndrome of the IGR→NGT→NGT group were significantly lower than in the IGR→NGT→IGR group(all P＜0.05).Conclusion FPG,islet Bcell function and TG can be considered as indicators for reversion from IGR to NGT and maintenance of NGT.Those with less metabolic abnormalities at baseline and with more obvious improvement would be more likely to revert to and maintain NGT.
