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目的:探讨基线代谢综合征及其各组分与糖尿病发病风险间的相关性。方法 :对上海市宝山区淞南社区5 734名40岁及以上的非糖尿病常住居民进行问卷调查、体格检查、75 g口服葡萄糖耐量试验及血糖、血脂等生化检测。按照亚洲人特点改良的美国国家胆固醇教育计划成人治疗组第三次报告(the third report of the National Cholesterol Education Program Adult Treatment PanelⅢ,NCEP-ATPⅢ)诊断标准,在排除高血糖后,符合2项及以上者定义为代谢综合征,而空腹血糖大于7.0 mmol/L或正在服用降糖药者则定义为糖尿病。结果:4年随访期间,5 734名上海市宝山区淞南社区40岁及以上的非糖尿病常住居民中有532名新发糖尿病,累积发病率为9.3%。基线代谢综合征患者的糖尿病发病风险较非代谢综合征者增加1.49倍(OR=2.49,95%CI为1.99~3.10)。代谢综合征组分个数与糖尿病发病风险增加呈显著正相关;而代谢综合征各组分中,高血压对新发糖尿病的影响最显著(OR=2.03,95%CI为1.64~2.51),其次为中心性肥胖、高三酰甘油。结论 :上海市宝山区淞南社区40岁及以上的非糖尿病常住居民中,代谢综合征对新发糖尿病具有独立预测作用,组分个数越多,糖尿病发病风险越高,且各组分中,高血压对新发糖尿病的预测作用最显著。
Objective: To investigate the relationship between baseline metabolic syndrome and its components and the risk of diabetes mellitus. Methods: A total of 5 734 non-diabetic residents aged 40 years and over in Songnan Community, Baoshan District, Shanghai were investigated by questionnaire, physical examination, oral glucose tolerance test of 75 g and biochemical tests such as blood glucose and blood lipid. According to the diagnostic criteria of the third report of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII), which has been modified according to the characteristics of Asians, after the elimination of hyperglycemia, two or more Defined as metabolic syndrome, and fasting blood glucose greater than 7.0 mmol / L or taking hypoglycemic agents are defined as diabetes. Results: During the 4-year follow-up period, 532 out of the 5 734 non-diabetic residents 40 years of age and over in Songnan community in Shanghai Baoshan District had a cumulative incidence of 9.3%. Patients with baseline metabolic syndrome had a 1.49-fold greater risk of developing diabetes (OR = 2.49, 95% CI, 1.99-3.10) than non-metabolic syndrome. There was a significant positive correlation between the number of metabolic syndrome components and the increased risk of developing diabetes. Among the components of metabolic syndrome, hypertension had the most significant impact on new-onset diabetes (OR = 2.03, 95% CI 1.64-2.51) Followed by central obesity, high triglyceride. Conclusion: Among the non-diabetic residents 40 years old and above in Songnan community in Baoshan District, Shanghai, metabolic syndrome has an independent predictive value for new-onset diabetes. The more the number of components, the higher the risk of diabetes mellitus, Hypertension is the most significant predictor of new-onset diabetes.