中华内分泌代谢杂志
中華內分泌代謝雜誌
중화내분비대사잡지
CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
2009年
1期
30-33
,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
糖调节受损%综合强化干预%糖尿病
糖調節受損%綜閤彊化榦預%糖尿病
당조절수손%종합강화간예%당뇨병
Impaired glucose regulation%Intensive integrated intervention%Diabetes mellitus
目的 采用2003年美国糖尿病学会(ADA)标准分析综合强化干预2年后糖尿病前期人群的转归及影响因素.方法 将北京地区中老年人群流行病学调奁筛查出的连续2年均为糖尿病前期的患者,随机分为常规治疗组(对照组)和综合强化治疗组(强化组).对照组仅给予生活方式指导,强化组在生活方式干预同时分别给予二甲双胍或阿卡波糖,并且建议根据病情选用降压及调脂药物,服用阿司匹林.随访2年,分析转归及影响因素.结果 2年后综合强化干预组的血糖、血压、体重指数、甘油三酯达标率显著高于对照组(P<0.05).强化组无1例进展为糖尿病,而对照组共8例(9.3%)进展为糖尿病;强化组逆转为正常糖耐量(NGT)的比例稍高于对照组(29.5% vs 22.1%,P>0.05).Logistic逐步回归分析,发现腰围及收缩压的增加与糖尿病的发生呈独立正相关关系,而胰岛功能的改善与糖尿病的发生呈独立负相关关系.结论 综合强化干预可显著降低糖尿病前期人群的糖尿病发生率,增加NGT的逆转率.腰围及收缩压的增加、胰岛β细胞功能的衰退是糖尿病前期人群进展为糖尿病的重要影响因素.
目的 採用2003年美國糖尿病學會(ADA)標準分析綜閤彊化榦預2年後糖尿病前期人群的轉歸及影響因素.方法 將北京地區中老年人群流行病學調奩篩查齣的連續2年均為糖尿病前期的患者,隨機分為常規治療組(對照組)和綜閤彊化治療組(彊化組).對照組僅給予生活方式指導,彊化組在生活方式榦預同時分彆給予二甲雙胍或阿卡波糖,併且建議根據病情選用降壓及調脂藥物,服用阿司匹林.隨訪2年,分析轉歸及影響因素.結果 2年後綜閤彊化榦預組的血糖、血壓、體重指數、甘油三酯達標率顯著高于對照組(P<0.05).彊化組無1例進展為糖尿病,而對照組共8例(9.3%)進展為糖尿病;彊化組逆轉為正常糖耐量(NGT)的比例稍高于對照組(29.5% vs 22.1%,P>0.05).Logistic逐步迴歸分析,髮現腰圍及收縮壓的增加與糖尿病的髮生呈獨立正相關關繫,而胰島功能的改善與糖尿病的髮生呈獨立負相關關繫.結論 綜閤彊化榦預可顯著降低糖尿病前期人群的糖尿病髮生率,增加NGT的逆轉率.腰圍及收縮壓的增加、胰島β細胞功能的衰退是糖尿病前期人群進展為糖尿病的重要影響因素.
목적 채용2003년미국당뇨병학회(ADA)표준분석종합강화간예2년후당뇨병전기인군적전귀급영향인소.방법 장북경지구중노년인군류행병학조렴사사출적련속2년균위당뇨병전기적환자,수궤분위상규치료조(대조조)화종합강화치료조(강화조).대조조부급여생활방식지도,강화조재생활방식간예동시분별급여이갑쌍고혹아잡파당,병차건의근거병정선용강압급조지약물,복용아사필림.수방2년,분석전귀급영향인소.결과 2년후종합강화간예조적혈당、혈압、체중지수、감유삼지체표솔현저고우대조조(P<0.05).강화조무1례진전위당뇨병,이대조조공8례(9.3%)진전위당뇨병;강화조역전위정상당내량(NGT)적비례초고우대조조(29.5% vs 22.1%,P>0.05).Logistic축보회귀분석,발현요위급수축압적증가여당뇨병적발생정독립정상관관계,이이도공능적개선여당뇨병적발생정독립부상관관계.결론 종합강화간예가현저강저당뇨병전기인군적당뇨병발생솔,증가NGT적역전솔.요위급수축압적증가、이도β세포공능적쇠퇴시당뇨병전기인군진전위당뇨병적중요영향인소.
Objective To investigate the outcome and related risk factors of integrated intensive intervention in participants with impaired glucose regulation (IGR) after two years by the criteria of American Diabetes Association 2003. Methods The subjects who remained to be IGR at the end of first year following 75 g oral glucose tolerance test were randomly assigned to either a routine care control group or to an intensive integrated intervention group. The control group received general dietary and exercise advice at baseline and was followed up. In addition to dietary control and exercise advice, mefformin or acarbose were administrated in the intervention group. The latter group was also advised to take antihypertensive agents, lipid-regulating agents if necessary, as well as aspirin. Results The proportion of patients who fulfilled the assigned goals of blood glucose, blood pressure, body mass index or triglycerides was significantly higher in the intensive group than those in the control group. None in the intensive group developed overt diabetes mellitus, while 8 (9.3%) in the control group did. The proportion of patients who reverted to normal glucose tolerance (NGT) was slightly higher in the intensive group than in the control group (29.5% vs 22.1%, P>0.05). Logistic analysis showed that increase of waist circumference and systolic blood pressure was positively while the improvement of islet β-cell function was negatively correlated with the development of diabetes mellitus. Conclusions The intensive integrated intervention could significantly decrease the conversion rate of IGR to diabetes mellitus, and increase the chance of reversion to NGT. The increase of waist circumference or systolic blood pressure, the deterioration of islet β-ccll function were the influencing factors of the conversion of IGR to diabetes mellitus.
