青少年%超重%肥胖症%葡萄糖代谢障碍%糖尿病,2型
青少年%超重%肥胖癥%葡萄糖代謝障礙%糖尿病,2型
청소년%초중%비반증%포도당대사장애%당뇨병,2형
Adolescent%Overweight%Obesity%Glucose metabolism disorders%Diabetesmellitus,type 2
目的 通过研究超重及肥胖对青少年空腹血糖受损(IFG)及糖耐量低减(IGT)影响的特点,了解青少年2型糖尿病(T2DM)发生和发展的过程.方法 2007年5月至11月,以东莞地区3856名11～18岁在校中学生为研究对象.根据志愿的原则,对符合超重及肥胖(b/Ob)的368例男生和326例女生再抽静脉血,检测血脂、空腹血糖(FPG)和餐后2小时血糖(2 h PC)、空腹胰岛素(Fins),然后根据体质指数(BNI)(暂定)标准Ⅱ分成超重组(b)和肥胖组(Ob),以11岁～和15～18岁年龄段对检测数据进行统计分析.结果 (1)同年龄段两组BMI、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(IR)、IFG和IGT的比较:①女生ll岁～b组的BMI值为(22.1±2.4)kg/m2、LDL-C为(2.38±0.65)mmol/L、IR为1.15±0.58,IFG和IGT的检出率分别为3.5%和1.4%;Ob组的BMI值为(24.4±3.9)kg/m2、LDL-C为(2.70±0.73)mmol/L、IR为1.36±0.67、IFG和IGT的检出率分别为14.6%和6.3%,两组相比的t或X2值分别为4.83、2.45、2.10、7.41和7.99(P值均<0.01或<0.05).15～18岁b组的BMI值为(25.8±3.1)kg/m2、LDL-C为(2.35±0.61)mmol/L、IR为1.14±0.64、IFG和IGT的检出率分别为3.1%和4.1%,Ob组的BMI值为(28.0±4.3)kg/m2、LDL-C为(2.69±0.69)mmol/L、IR为1.43±0.84、IFG和IGT的检出率分别为12.8%和15.4%,两组相比的t或X<2>值分别为3.33、2.79、1.87、4.75和5.17(P值均<0.01或<0.05).②男生11岁～b组的BMI值为(22.4±2.3)kg/m2、LDL-C为(2.36±0.67)mmol/L、IR为1.19±0.65、IFG和IGT的检出率分别为3.6%和1.8%,Ob组的BMI值为(24.6±4.2)kg/m2、LDL-C为(2.68±0.71)mmol/L、IR为1.44±0.89、IFG和IGT的检出率分别为13.3%和9.4%,两组相比的t或X2值分别为4.85、2.72、2.19、6.75和6.76(P值均<0.01或<0.05).15～18岁b组的BIM值为(26.4±2.8)kg/m2、LDL-C为(2.35±0.70)mmol/L、IR为(1.24±0.68)kg/m2、IFG和IGT的检出率分别为4.7%和5.6%,Ob组的BMI值为(28.2±4.8)kg/m2、LDL-C为(2.71±0.73)mmol/L、IR为1.50±0.95、IFG和IGT的检出率分别为17.9%和17.9%,两组相比的t或X2值分别为2.80、2.69、1.84、6.68和6.27(P值均<0.01或<0.05).男生11岁～b组FIG为(4.88±0.76)mmol/L,Ob组FPG为(5.09±0.80)mmol/L,两组相比t=1.84,P<0.05.(2)不同年龄段比较:①男生Ob组11岁～的2 h PG为(5.13±1.18)mmol/L,15～18岁的2 h PG为(5.36±1.24)mmol/L,两组相比t=1.78,P<0.05,接近成人的水平.男生11岁～(h/Ob)IGT阳性者有8例,阳性率为3.6%;15～18岁(b/Ob)IGT阳性者有13例,阳性率为8.9%,两年龄段相比X2=6.86,P<0.01.②女生11岁～(b/Oh)IGT阳性者有5例,阳性率为2.6%;15～18岁(b/Oh)IGT阳性者有10例,阳性率为7.4%,两年龄段相比X2=4.02,P<0.05.结论 青少年T2DM的预防,应从预防体重超重开始,同时对有高危因素的青少年人群进行定期筛查,并对有高危因素者及早地进行干预性治疗,防止或减少糖调节异常患者(IFG、IGT)向T2DM的转化.
目的 通過研究超重及肥胖對青少年空腹血糖受損(IFG)及糖耐量低減(IGT)影響的特點,瞭解青少年2型糖尿病(T2DM)髮生和髮展的過程.方法 2007年5月至11月,以東莞地區3856名11～18歲在校中學生為研究對象.根據誌願的原則,對符閤超重及肥胖(b/Ob)的368例男生和326例女生再抽靜脈血,檢測血脂、空腹血糖(FPG)和餐後2小時血糖(2 h PC)、空腹胰島素(Fins),然後根據體質指數(BNI)(暫定)標準Ⅱ分成超重組(b)和肥胖組(Ob),以11歲～和15～18歲年齡段對檢測數據進行統計分析.結果 (1)同年齡段兩組BMI、低密度脂蛋白膽固醇(LDL-C)、胰島素牴抗指數(IR)、IFG和IGT的比較:①女生ll歲～b組的BMI值為(22.1±2.4)kg/m2、LDL-C為(2.38±0.65)mmol/L、IR為1.15±0.58,IFG和IGT的檢齣率分彆為3.5%和1.4%;Ob組的BMI值為(24.4±3.9)kg/m2、LDL-C為(2.70±0.73)mmol/L、IR為1.36±0.67、IFG和IGT的檢齣率分彆為14.6%和6.3%,兩組相比的t或X2值分彆為4.83、2.45、2.10、7.41和7.99(P值均<0.01或<0.05).15～18歲b組的BMI值為(25.8±3.1)kg/m2、LDL-C為(2.35±0.61)mmol/L、IR為1.14±0.64、IFG和IGT的檢齣率分彆為3.1%和4.1%,Ob組的BMI值為(28.0±4.3)kg/m2、LDL-C為(2.69±0.69)mmol/L、IR為1.43±0.84、IFG和IGT的檢齣率分彆為12.8%和15.4%,兩組相比的t或X<2>值分彆為3.33、2.79、1.87、4.75和5.17(P值均<0.01或<0.05).②男生11歲～b組的BMI值為(22.4±2.3)kg/m2、LDL-C為(2.36±0.67)mmol/L、IR為1.19±0.65、IFG和IGT的檢齣率分彆為3.6%和1.8%,Ob組的BMI值為(24.6±4.2)kg/m2、LDL-C為(2.68±0.71)mmol/L、IR為1.44±0.89、IFG和IGT的檢齣率分彆為13.3%和9.4%,兩組相比的t或X2值分彆為4.85、2.72、2.19、6.75和6.76(P值均<0.01或<0.05).15～18歲b組的BIM值為(26.4±2.8)kg/m2、LDL-C為(2.35±0.70)mmol/L、IR為(1.24±0.68)kg/m2、IFG和IGT的檢齣率分彆為4.7%和5.6%,Ob組的BMI值為(28.2±4.8)kg/m2、LDL-C為(2.71±0.73)mmol/L、IR為1.50±0.95、IFG和IGT的檢齣率分彆為17.9%和17.9%,兩組相比的t或X2值分彆為2.80、2.69、1.84、6.68和6.27(P值均<0.01或<0.05).男生11歲～b組FIG為(4.88±0.76)mmol/L,Ob組FPG為(5.09±0.80)mmol/L,兩組相比t=1.84,P<0.05.(2)不同年齡段比較:①男生Ob組11歲～的2 h PG為(5.13±1.18)mmol/L,15～18歲的2 h PG為(5.36±1.24)mmol/L,兩組相比t=1.78,P<0.05,接近成人的水平.男生11歲～(h/Ob)IGT暘性者有8例,暘性率為3.6%;15～18歲(b/Ob)IGT暘性者有13例,暘性率為8.9%,兩年齡段相比X2=6.86,P<0.01.②女生11歲～(b/Oh)IGT暘性者有5例,暘性率為2.6%;15～18歲(b/Oh)IGT暘性者有10例,暘性率為7.4%,兩年齡段相比X2=4.02,P<0.05.結論 青少年T2DM的預防,應從預防體重超重開始,同時對有高危因素的青少年人群進行定期篩查,併對有高危因素者及早地進行榦預性治療,防止或減少糖調節異常患者(IFG、IGT)嚮T2DM的轉化.
목적 통과연구초중급비반대청소년공복혈당수손(IFG)급당내량저감(IGT)영향적특점,료해청소년2형당뇨병(T2DM)발생화발전적과정.방법 2007년5월지11월,이동완지구3856명11～18세재교중학생위연구대상.근거지원적원칙,대부합초중급비반(b/Ob)적368례남생화326례녀생재추정맥혈,검측혈지、공복혈당(FPG)화찬후2소시혈당(2 h PC)、공복이도소(Fins),연후근거체질지수(BNI)(잠정)표준Ⅱ분성초중조(b)화비반조(Ob),이11세～화15～18세년령단대검측수거진행통계분석.결과 (1)동년령단량조BMI、저밀도지단백담고순(LDL-C)、이도소저항지수(IR)、IFG화IGT적비교:①녀생ll세～b조적BMI치위(22.1±2.4)kg/m2、LDL-C위(2.38±0.65)mmol/L、IR위1.15±0.58,IFG화IGT적검출솔분별위3.5%화1.4%;Ob조적BMI치위(24.4±3.9)kg/m2、LDL-C위(2.70±0.73)mmol/L、IR위1.36±0.67、IFG화IGT적검출솔분별위14.6%화6.3%,량조상비적t혹X2치분별위4.83、2.45、2.10、7.41화7.99(P치균<0.01혹<0.05).15～18세b조적BMI치위(25.8±3.1)kg/m2、LDL-C위(2.35±0.61)mmol/L、IR위1.14±0.64、IFG화IGT적검출솔분별위3.1%화4.1%,Ob조적BMI치위(28.0±4.3)kg/m2、LDL-C위(2.69±0.69)mmol/L、IR위1.43±0.84、IFG화IGT적검출솔분별위12.8%화15.4%,량조상비적t혹X<2>치분별위3.33、2.79、1.87、4.75화5.17(P치균<0.01혹<0.05).②남생11세～b조적BMI치위(22.4±2.3)kg/m2、LDL-C위(2.36±0.67)mmol/L、IR위1.19±0.65、IFG화IGT적검출솔분별위3.6%화1.8%,Ob조적BMI치위(24.6±4.2)kg/m2、LDL-C위(2.68±0.71)mmol/L、IR위1.44±0.89、IFG화IGT적검출솔분별위13.3%화9.4%,량조상비적t혹X2치분별위4.85、2.72、2.19、6.75화6.76(P치균<0.01혹<0.05).15～18세b조적BIM치위(26.4±2.8)kg/m2、LDL-C위(2.35±0.70)mmol/L、IR위(1.24±0.68)kg/m2、IFG화IGT적검출솔분별위4.7%화5.6%,Ob조적BMI치위(28.2±4.8)kg/m2、LDL-C위(2.71±0.73)mmol/L、IR위1.50±0.95、IFG화IGT적검출솔분별위17.9%화17.9%,량조상비적t혹X2치분별위2.80、2.69、1.84、6.68화6.27(P치균<0.01혹<0.05).남생11세～b조FIG위(4.88±0.76)mmol/L,Ob조FPG위(5.09±0.80)mmol/L,량조상비t=1.84,P<0.05.(2)불동년령단비교:①남생Ob조11세～적2 h PG위(5.13±1.18)mmol/L,15～18세적2 h PG위(5.36±1.24)mmol/L,량조상비t=1.78,P<0.05,접근성인적수평.남생11세～(h/Ob)IGT양성자유8례,양성솔위3.6%;15～18세(b/Ob)IGT양성자유13례,양성솔위8.9%,량년령단상비X2=6.86,P<0.01.②녀생11세～(b/Oh)IGT양성자유5례,양성솔위2.6%;15～18세(b/Oh)IGT양성자유10례,양성솔위7.4%,량년령단상비X2=4.02,P<0.05.결론 청소년T2DM적예방,응종예방체중초중개시,동시대유고위인소적청소년인군진행정기사사,병대유고위인소자급조지진행간예성치료,방지혹감소당조절이상환자(IFG、IGT)향T2DM적전화.
Objective To understand the occurrence and development of adolescent students' type 2 diabetes mellitus (T2DM) by researching the characteristics of the adolescent students' impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) effected by overweight or obesity. Methods From May to November 2007,3856 middle school students aged 11 to 18 years old in Dongguan city were enrolled in the study. Overweight or obesity (b/Ob)depended on three indexes: the national unified school-age children and adolescent students' body mass index (BMI) and the temporary screening classification standard Ⅱ established by the Working Group on Obesity in China, BP≥ 140/90 mm Hg (1mm Hg =0.133 kPa) and fasting capillary whole glucose which was greater than or equal to 5.6 mmoL/L. The fasting capillary whole glucose was screened by blood glucose meter from fingertips. Students who had any abnormal indexes were brought into this study. On basis of voluntary principle, blood lipid, fasting blood glucose (FPG) and 2-hour postprandial blood glucose (2 h PG) ,fasting insulin (Fins) of 368 male and 326 female students who conformed to these conditions were measured using their venous blood. By temporary BMI standard Ⅱ, they were divided into overweight group (b) and obesity group (Oh). Data of different age groups (11 to 14; 15 to 18 years old) was analyzed. Results The BMI, low density lipoprotein cholesterol (LDL-C), insulin resistance index (IR),IFG and IGT of the same age stage in two groups were compared. The BMI value was (22.1±2.4) kg/m2, LDL-C was (2.38±0.65 ) mmol/L, IR was 1.15±0.58 and the detection rates of IFG and IGT were 3.5% and 1.4% respectively in female students aged 11 to 14 years old in b group. In Oh group, BMI value was (24.4±3.9) kg/m2, LDL-C was (2.70±0.73) mmol/L, IR was 1.36±0.67 and the detection rates of IFG and IGT were 14.6% and 6.3% respectively, t or X2 values of two groups which were compared were 4.83,2.45,2.10,7.41 and 7.99(P<0.01 or P <0.05). BMI value was (25.8±3.1) kg/m±2, LDL-C was(2.35±0.62) mmol/L, IR was 1.14±0. 64 and the detection rates of IFG and IGT were 3.1% and 4.1% respectively in 15 to 18 years old in b group. In Ob group,BMI value was (28.0±4.3 ) kg/m2, LDL-C was (2.69±0.69) mmol/L, IR was 1.43±0.84 and the detection rates of IFG and IGT were 12.8% and 15.4% respectively, t or X2 values of two groups which were compared were 3.33,2.79,1.87,4.75 and 5.17 ( P < 0.01 or P <0.05 ). BMI value was (22.4±2.3 ) kg/m2, LDL-C was (2.36±0.67) mmol/L,IR was 1.19±0.65 and the detection rates of IFG and IGT were 3.6% and 1.8% respectively in male students of 11 to 14 years old in b group. In Ob group,BMI value was (24.6±4.2)kg/m 2, LDL-C was (2.68±0.71 ) mmol/L, IR was 1.44±0.89 and the detection rates of IFG and IGT were 13.3% and 9.4% respectively, t or X 2 values of two groups which were compared were 4.85,2.72,2.19, 6.75 and 6.76(P<0.01 or P<0.05). BMI value was (26.4±2.8) kg/m22,LDL-C was(2.35±0.70) mmol/L,IR was 1.24±0.68 and the detection rates of IFG and IGT were 4.7% and 5.6% respectively in 15 to 18 years old in b group. In Ob group, BMI value was (28.2±4.8)kg/m<,2>, LDL-C was (2.71±0.73) mmol/L,IR was 1.50±0.95 and the detection rates of IFG and IGT were 17.9% and 17.9% respectively, t or X2 values of two groups which were compared were 2.80,2.69,1.84,6.68 and 6.27(P<0.01 or P< 0.05). The male students' FPG of 11 to 14 years old in b group was(4.88±0.76)mmoL/L and Flag of Ob group was (5.09±0.80) mmol/L . Two groups were compared and t =1.84 (P<0.05). The statistical differences were all observed. We compared different age stages and found that the male students' 2-hour PG of 11 to 14 years old in Ob group was(5.13±1.18)mmol/L and the 2-hour PG of 15 to 18 years old was (5.36±1.24) mmoL/L . Two groups were compared and t = 1.78 ( P<0.05 ) near the adults value. Male students' IGT of 11 to 14 years old (b/Ob) had 8 positive cases and the positive detection rate was 3.6%. IGT of 15 to 18 years old (b/Ob) had 13 positive cases and the positive detection rate was 8.9%. Two age stages were compared and X2=6.86(P<0.01). Female students' IGT of 11 to 14 years old (b/Ob) had 5 positive cases and the positive detection rate was 2.6%. IGT of 15 to 18 years old (b/Ob) had 10 positive cases and the positive detection rate was 7.4%. Two age stages were compared and X2=4.02(P<0.05). All had statistical significance. The high IGT incidence rate of b/Oh group's male and female students was in the stage of 15-18 years old. Male students were more obvious. Conclusion T2DM prevention among adolescent students should start with body overweight control. Meanwhile, the adolescent students with high risk factors should be screened regularly and early measures should be taken to prevent the impaired glucose regulation (IFG,IGT) transforming into T2DM.
