CAJ | 학술논문

背景:代谢综合征指标即血压升高、腹部肥胖、三酰甘油水平升高,高密度脂蛋白胆固醇水平降低,在个体中聚集存在,是糖尿病的预测因子.但类似老年人的资料相对较少.目的:分析代谢综合征各特征指标与老年人2型糖尿病危险性的相关性,为糖尿病的一级预防提供依据.设计:横断面调查.单位:卫生部北京老年医学研究所.对象:调查于2001-02/11完成,选择北京市西城、海淀、石景山科研单位年龄60岁以上老年人共4 499名作为调查对象,均自愿参加调查.排除调查资料不全者.方法:对调查人群进行观察性分析,用调查问卷收集相关信息.糖尿病的诊断标准为空腹血糖≥7.0 mmol/L或有糖尿病现患史.计数资料用x2检验进行分析,计量资料均数的比较用调整年龄、性别的协方差分析.应用非条件多因素Logistic逐步回归法分析与糖尿病独立相关的指标.分析代谢紊乱的聚集与糖尿病的关系时,以无任何因素聚集为对照,按1,2,3,4个聚集数设亚变量,用Logistic回归模型分析各种聚集数目时糖尿病的危险程度,并调整年龄、糖尿病家族史、受教育水平的影响.主要观察指标:调查对象的血糖、腹围、体质量指数、血压、血清三酰甘油、高密度脂蛋白胆固醇、糖尿病现患史及家族史.结果:有4 444名老年人进入结果分析.①调查共检出556名糖尿病患者.②统计结果显示年龄、糖尿病家族史、血压、腹围和血清三酰甘油与糖尿病独立相关[OR(95%CI)=1.02(1.00～1.04),3.48(2.76～4.39),1.02(1.01～1.02),1.03(1.00～1.03),1.13(1.05～1.21)].③当血清三酰甘油不在模型中,高密度脂蛋白胆固醇与糖尿病成显著负相关,OR(95%CI)=0.67(0.49～0.91).④随腹部肥胖、血压升高、三酰甘油水平升高、高密度脂蛋白胆固醇水平降低这4个变量在个体内聚集数目的增加,糖尿病的危险性亦逐渐增大.结论:除遗传和年龄因素外,代谢综合征指标尤其是指标的聚集与糖尿病密切相关,是提示糖尿病危险性的重要指征. 揹景:代謝綜閤徵指標即血壓升高、腹部肥胖、三酰甘油水平升高,高密度脂蛋白膽固醇水平降低,在箇體中聚集存在,是糖尿病的預測因子.但類似老年人的資料相對較少.目的:分析代謝綜閤徵各特徵指標與老年人2型糖尿病危險性的相關性,為糖尿病的一級預防提供依據.設計:橫斷麵調查.單位:衛生部北京老年醫學研究所.對象:調查于2001-02/11完成,選擇北京市西城、海澱、石景山科研單位年齡60歲以上老年人共4 499名作為調查對象,均自願參加調查.排除調查資料不全者.方法:對調查人群進行觀察性分析,用調查問捲收集相關信息.糖尿病的診斷標準為空腹血糖≥7.0 mmol/L或有糖尿病現患史.計數資料用x2檢驗進行分析,計量資料均數的比較用調整年齡、性彆的協方差分析.應用非條件多因素Logistic逐步迴歸法分析與糖尿病獨立相關的指標.分析代謝紊亂的聚集與糖尿病的關繫時,以無任何因素聚集為對照,按1,2,3,4箇聚集數設亞變量,用Logistic迴歸模型分析各種聚集數目時糖尿病的危險程度,併調整年齡、糖尿病傢族史、受教育水平的影響.主要觀察指標:調查對象的血糖、腹圍、體質量指數、血壓、血清三酰甘油、高密度脂蛋白膽固醇、糖尿病現患史及傢族史.結果:有4 444名老年人進入結果分析.①調查共檢齣556名糖尿病患者.②統計結果顯示年齡、糖尿病傢族史、血壓、腹圍和血清三酰甘油與糖尿病獨立相關[OR(95%CI)=1.02(1.00～1.04),3.48(2.76～4.39),1.02(1.01～1.02),1.03(1.00～1.03),1.13(1.05～1.21)].③噹血清三酰甘油不在模型中,高密度脂蛋白膽固醇與糖尿病成顯著負相關,OR(95%CI)=0.67(0.49～0.91).④隨腹部肥胖、血壓升高、三酰甘油水平升高、高密度脂蛋白膽固醇水平降低這4箇變量在箇體內聚集數目的增加,糖尿病的危險性亦逐漸增大.結論:除遺傳和年齡因素外,代謝綜閤徵指標尤其是指標的聚集與糖尿病密切相關,是提示糖尿病危險性的重要指徵.
배경:대사종합정지표즉혈압승고、복부비반、삼선감유수평승고,고밀도지단백담고순수평강저,재개체중취집존재,시당뇨병적예측인자.단유사노년인적자료상대교소.목적:분석대사종합정각특정지표여노년인2형당뇨병위험성적상관성,위당뇨병적일급예방제공의거.설계:횡단면조사.단위:위생부북경노년의학연구소.대상:조사우2001-02/11완성,선택북경시서성、해정、석경산과연단위년령60세이상노년인공4 499명작위조사대상,균자원삼가조사.배제조사자료불전자.방법:대조사인군진행관찰성분석,용조사문권수집상관신식.당뇨병적진단표준위공복혈당≥7.0 mmol/L혹유당뇨병현환사.계수자료용x2검험진행분석,계량자료균수적비교용조정년령、성별적협방차분석.응용비조건다인소Logistic축보회귀법분석여당뇨병독립상관적지표.분석대사문란적취집여당뇨병적관계시,이무임하인소취집위대조,안1,2,3,4개취집수설아변량,용Logistic회귀모형분석각충취집수목시당뇨병적위험정도,병조정년령、당뇨병가족사、수교육수평적영향.주요관찰지표:조사대상적혈당、복위、체질량지수、혈압、혈청삼선감유、고밀도지단백담고순、당뇨병현환사급가족사.결과:유4 444명노년인진입결과분석.①조사공검출556명당뇨병환자.②통계결과현시년령、당뇨병가족사、혈압、복위화혈청삼선감유여당뇨병독립상관[OR(95%CI)=1.02(1.00～1.04),3.48(2.76～4.39),1.02(1.01～1.02),1.03(1.00～1.03),1.13(1.05～1.21)].③당혈청삼선감유불재모형중,고밀도지단백담고순여당뇨병성현저부상관,OR(95%CI)=0.67(0.49～0.91).④수복부비반、혈압승고、삼선감유수평승고、고밀도지단백담고순수평강저저4개변량재개체내취집수목적증가,당뇨병적위험성역축점증대.결론:제유전화년령인소외,대사종합정지표우기시지표적취집여당뇨병밀절상관,시제시당뇨병위험성적중요지정.
BACKGROUND: The cluster of multiple metabolic disorders, namely raised blood pressure, overweight or obesity, raised triglyceride level, reduced high density lipoprotein cholesterol (HDL-C) level were the predictor of type 2 diabetes mellitus (DM). However, similar data especially the old people's data is relatively rare in China.OBJECTIVE: To analyze the relationship between the components of metabolic syndrome (MetS), their clusters and the risk of diabetes among Chinese old population.DESIGN: Cross-sectional study.SETTING :Beijing Institute of Geriatrics, Beijing Hospital, Ministry of Public Health.PARTICIPANTS: The study was carried out from February 2001 until November 2001.4 499 volunteers aged 60 and over were recruited from the academic institutes in Beijing Xicheng, Haidian and Shijingshan districts through cluster sampling methods. They were selected after excluding those who did not have integral data.METHODS: Diabetes was considered when fasting glucose was ≥7.0 mmol/L and was treated for or diagnosed as DM. Chi-square tests were performed to compare the categorical data. Age and sex adjustment were taken in the comparison of the levels of blood pressure, waist circumference (WC), The body mass index (BMI), and lab variables, Multifactor stepwise (backward)Logistic regression analyses were used to select the factors which would have association with the risk of DM. When analyzing the relationship between number of clustering of the traits of MetS and DM, the group without any metabolic abnormalities was set as control group. The dummy variables were set for 1,2,3,4 clusters of metabolic abnormalities. The Logistic regression model was used again to test the relationship and adjusted by age and the family history of DM.MAIN OUTCOME MEASURES: The blood glucose, waist, BMI, blood pressure, triglyceride (TG), HDL-C, and family history of diabetes of subjects.RESULTS: 4 444 people in the mean age of 65±5 were retrieved. 556cases of DM were found in this survey. Age, family history of diabetes,systolic blood pressure, waist and TG were independently associated with the risk of DM, with OR (95%CI) being 1.02 (1.00-1.04), 3.48(2.76-4.39), 1.02 (1.01-1.02), 1.03 (1.00-1.03), 1.13 (1.05-1.21), respectively. When TG was not in the model, HDL-C was also inversely associated with DM (OR=0.67, 95%CI 0.49-0.91). The risk of DM increased with clustering of abdominal obesity, raised blood pressure, raised TG, and reduced HDL-C level in individuals.CONCLUSION: In addition to age and genetic factors, metabolic factors, especially their clusters are closely related to the risk of diabetes. Therefore, the features of MetS are important indicators for the risk of DM in aged people.