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目的探讨甘油三酯(TG)、高密度脂蛋白(HDL)、甘油三酯/高密度脂蛋白(TG/HDL)变化对2型糖尿病发病的影响。方法基线人群为石家庄市6个企事业单位职工,排除标准为糖尿病、冠心病、恶性肿瘤、肾衰及空腹血糖(FPG)≥5.6 mmol/L,进行连续5年随访,比较TG、HDL、TG/HDL不同变化下FPG变化率,运用Logistic回归模型分析研究三者变化与FPG变化的关系。结果在随访过程中TG、HDL、TG/HDL未控制组FPG变化高于三者保持正常或控制组,差异有统计学意义(P<0.05)。Logistic回归分析与各组在基线正常随访过程中仍保持正常相比,FPG变化TG组边缘升高转为TG升高RR值2.642(95%CI 1.572~4.379)、保持TG升高组RR值2.136(95%CI1.455~3.135)、TG正常转为TG升高RR值1.969(95%CI 1.572~4.379)、TG升高转为TG边缘升高RR值1.954(95%CI 1.084~3.522)、保持TG边缘升高RR值1.717(95%CI 1.110~2.654)、TG正常转为TG边缘升高RR值1.64(95%CI 1.183~2.273)、TG边缘升高转为TG正常RR值1.495(95%CI 1.032~2.167);HDL组RR值最高为HDL正常转为HDL减低1.857(95%CI 1.620~2.129);TG/HDL组RR值由高至低为比值仍保持升高组(RR值7.506,95%CI 1.431~4.388)、比值正常转为升高组(RR值2.453,95%CI 1.365~4.408)。结论 TG、HDL及TG/HDL比值长期的变化与空腹血糖水平明显相关,血脂代谢异常在2型糖尿病的发生发展中可能扮演着重要角色。
Objective To investigate the effects of triglyceride (TG), high density lipoprotein (HDL), triglyceride / high density lipoprotein (TG / HDL) on type 2 diabetes. Methods The baseline population was staff from 6 enterprises and public institutions in Shijiazhuang City. The exclusion criteria were diabetes, coronary heart disease, malignant tumor, renal failure and fasting blood glucose (FPG) ≥ 5.6 mmol / L. The patients were followed up for 5 years continuously. TG, HDL, TG / HDL changes under different changes in FPG, the use of Logistic regression model analysis of changes in the relationship between the three and FPG changes. Results During follow-up, FPG changes in TG, HDL, TG / HDL uncontrolled group were higher than those in control group, with significant difference (P <0.05). Logistic regression analysis showed that compared with the normal baseline follow-up of each group, the FPG changes from the edge of TG group to TG increased 2.642 (95% CI 1.572-4.379), and the RR of TG elevated group was 2.136 (95% CI 1.584 ~ 3.135). The TG value was 1.969 (95% CI 1.572-4.379), and TG was increased to 1.954 (95% CI 1.084-3.522) The RR value of TG elevation was 1.717 (95% CI 1.110 ~ 2.654), the TG value was 1.64 (95% CI 1.183-2.273) % CI 1.032-2.167). The highest RR of HDL group was 1.857 (95% CI 1.620-2.129), the highest HDL group was HDL, and the highest RR of TG / HDL group was higher than the other (RR = 7.506 , 95% CI 1.431 ~ 4.388), the ratio of normal to elevated group (RR 2.453, 95% CI 1.365 ~ 4.408). Conclusions Long-term changes of TG, HDL and TG / HDL ratio are significantly correlated with fasting blood glucose level. Abnormal lipid metabolism may play an important role in the development of type 2 diabetes mellitus.