克拉玛依地区糖尿病前期人群BMI和血脂水平相关性研究
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摘要
目的探讨克拉玛依地区糖尿病前期人群BMI和血脂水平的关系,并为克拉玛依地区糖尿病前期防治提供依据。方法采用病例对照研究方法,选取2016年3月—2017年10月在克拉玛依市中心医院健康管理中心进行健康检查的检查者1 020名,其中糖尿病前期组(观察组)216名,糖耐量正常组(正常对照组)804名,由研究人员对健康检查者进行体格检查和生化指标等检查。结果观察组体重(BW)、体质指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、收缩压、舒张压和低密度脂蛋白胆固醇(LDL-C)均高于正常对照组,高密度脂蛋白胆固醇(HDL-C)显著低于正常对照组,且差异均有统计学意义(均P<0.01);观察组的超重及肥胖检出率为68.8%、高甘油三酯血症检出率为39.3%、高胆固醇血症检出率为37.9%、混合型高脂血症检出率为14.8%、低高密度脂蛋白胆固醇血症检出率为41.6%和高低密度脂蛋白胆固醇血症检出率为23.1%均高于正常对照组的32.7%、13.0%、6.7%、2.4%、10.5%和12.5%,差异均有统计学意义(均P<0.01);经多因素非条件logistic回归分析结果显示:超重、肥胖、年龄>41岁、TC、TG、HDL-C和收缩压升高等均为克拉玛依区糖尿病前期人群发病的危险因素,OR值(95%CI)分别为2.9(1.87～4.50)、7.49(3.99～14.08)、0.41(0.19～0.89)、3.03(2.34～3.92)、1.20(1.01～1.43)、0.03(0.01～0.07)和1.02(1.00～1.04)。结论克拉玛依地区糖尿病前期的发生与该人群BMI和血脂水平具有关联性;健康膳食、适量运动和合理控制体重是预防克拉玛依地区糖尿病前期的发生和降低糖尿病前期转化为糖尿病的重要措施。
[Objective]To investigate the relationship between BMI and blood lipid level of prediabetic population in karamay area, and to provide evidence for the prevention and treatment of prediabetic population. [Methods] Case-control study method was adopted to select 1 020 inspectors in Health Management Center of Karamay Central Hospital from March 2016-October2017, including prediabetic group of 216 cases(observation group), normal glucose tolerance group of 804 cases(normal control group). The researcher carries on the physical examination and the biochemical index examinations to the health examination person.[Results]Body weight(BW), body mass index(BMI), total cholesterol(TC), triglyceride(TG), systolic blood pressure,diastolic blood pressure and LDL cholesterol(LDL-C) in the observation group were all higher than those in the normal control group, while HDL cholesterol(HDL-c) in the observation group was significantly lower than that in the normal control group(P<0.01). The detection rate of overweight and obesity(68.8%), hypertriglyceridemia(39.3%), hypercholesteremia(37.9%), mixed hyperlipidemia(14.8%), and low HDL cholesterol(41.6%), LDL cholesterol(23.1%) in observation group were higher than those of the normal control group(32.7%, 13.0%, 6.7%, 2.4%, 10.5% and 12.5%), with significant differences(P<0.01). The results of multivariate unconditioned logistic regression analysis showed that: overweight, obesity, age>41 years, TC, TG, HDL-C and elevated systolic blood pressure were risk factors for prediabetic population in Karamay District. OR values(95%CI) were 2.9(1.87-4.50), 7.49(3.99-14.08), 0.41(0.19-0.89), 3.03(2.34-3.92), 1.20(1.01-1.43), 0.03(0.01-0.07) and 1.02(1.00-1.04),respectively.[Conclusion]The prediabetes in karamay area is correlated with BMI and blood lipid level of prediabetic people.Healthy diet, moderate exercise and reasonable weight control are important measures to prevent the occurrence of prediabetes in Karamay area and reduce the conversion of prediabetes into diabetes.
[Objective]To investigate the relationship between BMI and blood lipid level of prediabetic population in karamay area, and to provide evidence for the prevention and treatment of prediabetic population. [Methods] Case-control study method was adopted to select 1 020 inspectors in Health Management Center of Karamay Central Hospital from March 2016-October2017, including prediabetic group of 216 cases(observation group), normal glucose tolerance group of 804 cases(normal control group). The researcher carries on the physical examination and the biochemical index examinations to the health examination person.[Results]Body weight(BW), body mass index(BMI), total cholesterol(TC), triglyceride(TG), systolic blood pressure,diastolic blood pressure and LDL cholesterol(LDL-C) in the observation group were all higher than those in the normal control group, while HDL cholesterol(HDL-c) in the observation group was significantly lower than that in the normal control group(P<0.01). The detection rate of overweight and obesity(68.8%), hypertriglyceridemia(39.3%), hypercholesteremia(37.9%), mixed hyperlipidemia(14.8%), and low HDL cholesterol(41.6%), LDL cholesterol(23.1%) in observation group were higher than those of the normal control group(32.7%, 13.0%, 6.7%, 2.4%, 10.5% and 12.5%), with significant differences(P<0.01). The results of multivariate unconditioned logistic regression analysis showed that: overweight, obesity, age>41 years, TC, TG, HDL-C and elevated systolic blood pressure were risk factors for prediabetic population in Karamay District. OR values(95%CI) were 2.9(1.87-4.50), 7.49(3.99-14.08), 0.41(0.19-0.89), 3.03(2.34-3.92), 1.20(1.01-1.43), 0.03(0.01-0.07) and 1.02(1.00-1.04),respectively.[Conclusion]The prediabetes in karamay area is correlated with BMI and blood lipid level of prediabetic people.Healthy diet, moderate exercise and reasonable weight control are important measures to prevent the occurrence of prediabetes in Karamay area and reduce the conversion of prediabetes into diabetes.
引文
[1]中华医学会糖尿病分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,22(8):2-42.
[2]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2010年版)[J].中国糖尿病杂志,2012,20(1):S1-S37.
[3]GIDDING LG,MARLIES DB,LUCAS ANNELIES EM,et al. Effect of lifestyle intervention for people with diabetes or prediabetes in realworld primary care:propensity score analysis[J].BMC Family Practice,2011,13(12):95.
[4]高进,郭启煜.糖尿病与糖尿病前期患者相关危险囚素对比分析[J].武警医学,2013,24(6):477-479.
[5]车奎,赵世华,谭晓俊,等.山东沿海居民糖尿病及糖尿病前期患病率10年变迁研究[J].中华内分泌代谢杂志,2017,33(6):473-477.
[6]AMERICAN DIABETES ASSOCIATION. Diagnosis and classification of diabetes mellitus[J].Diabetes Care,2010,3(1):S62-69.
[7]中国成人血脂异常防治指南制订联合委员会.中国成人血脂异常防治指南[J].中华心血管病杂志,2007,35(5):390-419.
[8]BARR ELM,BOYKO EJ,ZIMMET PZ,et al.Continuous relationships between non-diabetic hyperglycaemia and both cardiovascular disease and all-cause mortality:the Australian Diabetes,Obesity,and Lifestyle(AusDiab)Study[J].Diabetologia,2009,52(3):415-424.
[9]YOUSEFZADEH G,SHOKOOHI M,YEGANEH M,et al.Role of gamma-glutamyl transferase(GGT)in diagnosis of impaired glucose tolerance and metabolic syndrome:A prospective cohort research from the Kerman Coronary Artery Disease Risk Study(KERCADRS)[J].Diabetes Metab Syndr,2012,6(4):190-194.
[10]O'KEEFE JH,BHATTI SK,PATIL HR,et al. Effects of habitual coffee consumption on cardiometabolic disease,cardiovascular health,and all-cause mortality[J]. J Am Coll Cardiol,2013,62(12):1043-1051.
[11]赵传志,张叶,吴咏梅.血脂水平对糖尿病前期人群转归的影响[J].现代仪器疗,2017,23(4):75-77.
[12]王连升,张力.血糖调节异常者血脂代谢的初步研究[J].检验医学,2007,22(4):425-428.
[13]TOMKIN GH.Atherosclerosis,diabetes and lipoproteins[J].Expert Rev CardiovascTher,2010,8(7):1015-1029.
[14]仲彬.空腹血糖水平与胰岛素抵抗关系的分析[J].中国医药导报,2013,10(7):68-70.
[15]李伟,张晨鑫,王玲,等.2型糖尿病合并肥胖患者腹部脂肪分布与胰岛素抵抗的相关性研究[J].重庆医学,2017,46(26):3632-3634.
[2]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2010年版)[J].中国糖尿病杂志,2012,20(1):S1-S37.
[3]GIDDING LG,MARLIES DB,LUCAS ANNELIES EM,et al. Effect of lifestyle intervention for people with diabetes or prediabetes in realworld primary care:propensity score analysis[J].BMC Family Practice,2011,13(12):95.
[4]高进,郭启煜.糖尿病与糖尿病前期患者相关危险囚素对比分析[J].武警医学,2013,24(6):477-479.
[5]车奎,赵世华,谭晓俊,等.山东沿海居民糖尿病及糖尿病前期患病率10年变迁研究[J].中华内分泌代谢杂志,2017,33(6):473-477.
[6]AMERICAN DIABETES ASSOCIATION. Diagnosis and classification of diabetes mellitus[J].Diabetes Care,2010,3(1):S62-69.
[7]中国成人血脂异常防治指南制订联合委员会.中国成人血脂异常防治指南[J].中华心血管病杂志,2007,35(5):390-419.
[8]BARR ELM,BOYKO EJ,ZIMMET PZ,et al.Continuous relationships between non-diabetic hyperglycaemia and both cardiovascular disease and all-cause mortality:the Australian Diabetes,Obesity,and Lifestyle(AusDiab)Study[J].Diabetologia,2009,52(3):415-424.
[9]YOUSEFZADEH G,SHOKOOHI M,YEGANEH M,et al.Role of gamma-glutamyl transferase(GGT)in diagnosis of impaired glucose tolerance and metabolic syndrome:A prospective cohort research from the Kerman Coronary Artery Disease Risk Study(KERCADRS)[J].Diabetes Metab Syndr,2012,6(4):190-194.
[10]O'KEEFE JH,BHATTI SK,PATIL HR,et al. Effects of habitual coffee consumption on cardiometabolic disease,cardiovascular health,and all-cause mortality[J]. J Am Coll Cardiol,2013,62(12):1043-1051.
[11]赵传志,张叶,吴咏梅.血脂水平对糖尿病前期人群转归的影响[J].现代仪器疗,2017,23(4):75-77.
[12]王连升,张力.血糖调节异常者血脂代谢的初步研究[J].检验医学,2007,22(4):425-428.
[13]TOMKIN GH.Atherosclerosis,diabetes and lipoproteins[J].Expert Rev CardiovascTher,2010,8(7):1015-1029.
[14]仲彬.空腹血糖水平与胰岛素抵抗关系的分析[J].中国医药导报,2013,10(7):68-70.
[15]李伟,张晨鑫,王玲,等.2型糖尿病合并肥胖患者腹部脂肪分布与胰岛素抵抗的相关性研究[J].重庆医学,2017,46(26):3632-3634.