中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2010年
6期
480-483
,共4页
方福生%田慧%李春霖%邵迎红%李剑%钟文雯%刘敏燕%闫双通%杨光%成晓玲%马琴%王惠先
方福生%田慧%李春霖%邵迎紅%李劍%鐘文雯%劉敏燕%閆雙通%楊光%成曉玲%馬琴%王惠先
방복생%전혜%리춘림%소영홍%리검%종문문%류민연%염쌍통%양광%성효령%마금%왕혜선
高胰岛素血症%葡萄糖代谢障碍%转归
高胰島素血癥%葡萄糖代謝障礙%轉歸
고이도소혈증%포도당대사장애%전귀
Hyperinsulinism%Glucose metabolism disorders%Conversion
目的 探讨正常血糖-高胰岛素血症(NGT-HINS)人群向糖尿病的转归及影响因素.方法 分别于2006年5月和2008年5月对北京市某单位整体人群进行年度体检并行糖尿病筛查.由专门人员对调查人群进行体检和病史问询,除确诊糖尿病者外统一行口葡萄糖耐量试验(OGTF),检测空腹和2 h血糖(FPG、2hPG)、胰岛素,以评价糖代谢水平.高胰岛素血症(HINS)以空腹胰岛素≥15 mIU/L和(或)服糖后2 h胰岛素≥80 mIU/L判定.结果 2006年和2008年该单位NGT-HINS检出率分别为5.28%和8.76%(P<0.01);2006年糖尿病(DM)、糖调节受损(IGR)的检出率分别为3.52%、6.56%,2008年分别为4.42%、6.47%.2008年在652例复检人群中NGT-HINS转为IGR和DM的分别为18.6%和2.3%,高于正常血糖-正常胰岛素(NGT-NINS)人群的5.4%(P<0.01)和0.7%;但NGT-HINS人群转为DM的百分率仍低于IGR人群转为DM者(26.3%,P<0.01).2006年NGT-HINS人群的腰围、BMI、FPG、2hPG、TG高于NGT-NINS人群(P<0.01),HDL-C低于NGT-NINS人群(P<0.01);校正胰岛素抵抗后的胰岛细胞功能(HBCI/IR)低于NGT-NINS人群(P<0.01),但高于IGR人群(P<0.01).logistic回归分析显示,年龄、TG、HBCI/IR是影响NGT人群转归的危险因素.结论 NGT-HINS人群转为糖代谢异常的百分率明显高于NGT-NINS人群,与其合并代谢危险因素增加、胰岛β细胞功能下降有关.糖尿病早期防治应关注NGT-HINS人群.
目的 探討正常血糖-高胰島素血癥(NGT-HINS)人群嚮糖尿病的轉歸及影響因素.方法 分彆于2006年5月和2008年5月對北京市某單位整體人群進行年度體檢併行糖尿病篩查.由專門人員對調查人群進行體檢和病史問詢,除確診糖尿病者外統一行口葡萄糖耐量試驗(OGTF),檢測空腹和2 h血糖(FPG、2hPG)、胰島素,以評價糖代謝水平.高胰島素血癥(HINS)以空腹胰島素≥15 mIU/L和(或)服糖後2 h胰島素≥80 mIU/L判定.結果 2006年和2008年該單位NGT-HINS檢齣率分彆為5.28%和8.76%(P<0.01);2006年糖尿病(DM)、糖調節受損(IGR)的檢齣率分彆為3.52%、6.56%,2008年分彆為4.42%、6.47%.2008年在652例複檢人群中NGT-HINS轉為IGR和DM的分彆為18.6%和2.3%,高于正常血糖-正常胰島素(NGT-NINS)人群的5.4%(P<0.01)和0.7%;但NGT-HINS人群轉為DM的百分率仍低于IGR人群轉為DM者(26.3%,P<0.01).2006年NGT-HINS人群的腰圍、BMI、FPG、2hPG、TG高于NGT-NINS人群(P<0.01),HDL-C低于NGT-NINS人群(P<0.01);校正胰島素牴抗後的胰島細胞功能(HBCI/IR)低于NGT-NINS人群(P<0.01),但高于IGR人群(P<0.01).logistic迴歸分析顯示,年齡、TG、HBCI/IR是影響NGT人群轉歸的危險因素.結論 NGT-HINS人群轉為糖代謝異常的百分率明顯高于NGT-NINS人群,與其閤併代謝危險因素增加、胰島β細胞功能下降有關.糖尿病早期防治應關註NGT-HINS人群.
목적 탐토정상혈당-고이도소혈증(NGT-HINS)인군향당뇨병적전귀급영향인소.방법 분별우2006년5월화2008년5월대북경시모단위정체인군진행년도체검병행당뇨병사사.유전문인원대조사인군진행체검화병사문순,제학진당뇨병자외통일행구포도당내량시험(OGTF),검측공복화2 h혈당(FPG、2hPG)、이도소,이평개당대사수평.고이도소혈증(HINS)이공복이도소≥15 mIU/L화(혹)복당후2 h이도소≥80 mIU/L판정.결과 2006년화2008년해단위NGT-HINS검출솔분별위5.28%화8.76%(P<0.01);2006년당뇨병(DM)、당조절수손(IGR)적검출솔분별위3.52%、6.56%,2008년분별위4.42%、6.47%.2008년재652례복검인군중NGT-HINS전위IGR화DM적분별위18.6%화2.3%,고우정상혈당-정상이도소(NGT-NINS)인군적5.4%(P<0.01)화0.7%;단NGT-HINS인군전위DM적백분솔잉저우IGR인군전위DM자(26.3%,P<0.01).2006년NGT-HINS인군적요위、BMI、FPG、2hPG、TG고우NGT-NINS인군(P<0.01),HDL-C저우NGT-NINS인군(P<0.01);교정이도소저항후적이도세포공능(HBCI/IR)저우NGT-NINS인군(P<0.01),단고우IGR인군(P<0.01).logistic회귀분석현시,년령、TG、HBCI/IR시영향NGT인군전귀적위험인소.결론 NGT-HINS인군전위당대사이상적백분솔명현고우NGT-NINS인군,여기합병대사위험인소증가、이도β세포공능하강유관.당뇨병조기방치응관주NGT-HINS인군.
Objective To study the outcomes and influencing factors of the conversion from normal glucose tolerance -hyperinsulinemia (NCT-HINS) to diabetes in the population of a community in Beijing.Methods All the subjects investigated received 75 g oral glucose tolerance test (OGTT) for diabetes screening carried out in May, 2006 and May, 2008. Data were calculated to analyze the outcomes and influencing factors of the conversion. HINS was diagnosed if fasting serum insulin & 15 mIU/L and/or 2-hour serum insulin after glucose loading ≥ 80 mIU/L Results The prevalence of NGT-HINS in the community in 2006 and 2008 was 5.28% and 8.67% (P<0.01) respectively and that of diabetes mellitus (DM) and impaired glucose regulation (IGR) was 3.52% , 6.56% in 2006 and 4.42% ,6.47% in 2008.The probability of the conversion from NGT-HINS to IGR and DM was 18.6% and 2.3% , being much higher than that from normal glucose tolerance- normoinsulinemia (NGT-NINS) (5.4% and 0.7% , P <0.01). However, the probability of the conversion from NGT-HINS to DM was 2.3% , which was much lower than that from IGR (26.3% , P <0.01). The reason might be that individuals with NGT-HINS had a higher waist circumference, BMI, fasting plasma glucose, 2 h plasma glucose and TG but a lower HDL-C than individuals with NGT-NINS in 2006. The HOMA β-cell function index/HOMA insulin resistance index (HBCI/IR) of individuals with NGT-HINS was much lower than that of individuals with NGT-NINS, but much higher than that of individuals with IGR. Logistic regression analysis showed that age, TG and HBCI/IR were the major influencing factors of the conversion from NGT to glucose metabolic disorders.Conclusions The probability of conversion from NGT to DM was increased remarkably when HINS was diagnosed. The reason might be that individuals with NGT-HINS suffered more metabolic risk factors and had a decreased β-cell function. Therefore, individuals with NGT-HINS should be paid attention to in diabetes prevention study.
