摘要
目的探讨高三酰甘油性腰围（HTGW）表型与空腹血糖受损（IFG）在糖尿病发病中的独立影响作用及其相关性。方法健康体检者2 351例的临床数据资料进行记录和整理,运用Cox回归模型分析HTGW、IFG、高腰围、高三酰甘油（TG）与糖尿病发病的关系,并以Cox比例回归模型分层分析IFG和HTGW之间的交互作用。结果在HTGW（＋）及HTGW（-）者中,与IGF（-）者比较,IGF（＋）者均具有较高的年龄、腰围、体质量指数（BMI）、收缩压、舒张压、总胆固醇（TC）、TG、空腹血糖（FPG）、低蛋白脂蛋白胆固醇（LDL-C）、糖尿病家族史以及较低的高蛋白脂蛋白胆固醇（HDL-C）（P〈0.05）;随访5年后新发糖尿病发病率4.36%（90/2 066）;基线时IFG（＋）者在随访时糖尿病发病率最高（6.06%,58/957）,HTGW（＋）者其次（3.18%,10/314）;多因素Cox比例风险回归分析显示,HTGW（＋）、IFG（＋）、高腰围和高TG的对象发生糖尿病的风险比（HR1）值及其95%CI分别为2.25（1.49～3.42）、3.44（2.27～5.22）、1.54（1.02～1.54）和1.81（1.19～2.74）,差异具有统计学意义（P〈0.05）。互相调整各分析变量后,多因素Cox比例回归分析显示,HTGW、IFG及高TG与糖尿病间的联系依然存在,HR2及95%CI分别为2.05（1.35～3.10）、3.37（2.23～5.11）和1.78（1.17～2.69）,差异具有统计学意义（P〈0.05）。但高腰围与糖尿病之间的关联消失（P〉0.05）。Cox分层分析结果显示,与HTGW（-）的IFG（-）对象相比,HTGW（＋）的IFG（＋）对象发生糖尿病的HR值及其95%CI为3.07（2.03～4.65）,互相调整各分析变量后,HTGW（＋）和IFG（＋）的对象发生糖尿病的HR值及其95%CI为12.33（8.14～18.68）。结论 HTGW具有独立于IFG预测糖尿病发病的作用,HTGW与IFG同时存在时具有致糖尿病的相加交互作用。
Objective To investigate the hypertriglyceridemia waist circumference phenotype（HTGW） and impaired fasting glucose（IFG）＇s independent effects on the pathogenesis of diabetes and correlation.Methods The clinical data of235 healthy people were recorded and analyzed,using Cox regression model to analyze the relationship of HTGW,IFG,high waist circumference,hypertriglyceridemia（TG） with the prevalence of diabetes mellitus,and by Cox proportional regression model to stratify the interaction between IFG and HTGW.Results In HTGW（＋） and in HTGW（-） objects,compared with IGF（-） objects,IGF（＋） objects had higher age,waist circumference,body mass index（BMI）,systolic blood pressure,diastolic blood pressure,total cholesterol（TC）,TG,fasting plasma glucose（FPG）,low density lipoprotein cholesterol（LDL-C）,family history of diabetes and lower high density lipoprotein cholesterol（HDL-C）（P〈0.05）;after 5 years of follow-up,new onset diabetes incidence was 4.36%（90/2 066）;baseline IFG（＋） objects had the highest incidence during follow-up（6.06%,58/957）,HTGW（＋） objects had the second incidence of diabetes（3.18%,10/314）;multivariate Cox proportional hazard regression analysis showed that diabetes risk（HR1） and 95%CI values of HTGW（＋）,IFG（＋）,high waist circumference and high TG objects were 2.25（1.49-3.42）,3.44（2.27-5.22）,1.54（1.02-1.54） and1.81（1.19-2.74）,there were statistically significant difference（P〈0.05）.After adjustment of each variable,multi factor Cox regression analysis showed that HTGW,IFG and high TG were still correlated with diabetes,HR2 and 95%Cl were2.05（1.35-3.10）,3.37（2.23-5.11） and 1.78（1.17-2.69）,with significant difference（P〈0.05）.But the correlation between high waist circumference and diabetes were disappeared（P〉0.05）.Cox layered analysis results show that,compared with the HTGW（-） and IFG（-） objects,diabetes HR values and the 95%CI in HTGW（＋） IFG（＋） object was3.07（2.03-4.65）,after adjustment of each variable,diabetes HR values and the 95%CI of HTGW（＋） and IFG（＋） object was 12.33（8.14- 18.68）.Conclusion HTGW had independence in the role of predicting diabetes,HTGW and IFG had adding interaction to diabetes.
出处
《疑难病杂志》
CAS
2015年第4期349-352,共4页
Chinese Journal of Difficult and Complicated Cases
基金
湖北省教育厅科学技术研究计划重点项目(No.D20112105)
关键词
高三酰甘油性腰围
空腹血糖受损
糖尿病
影响因素
队列研究
Hypertriglyceridemia waist circumference
Impaired fasting glucose
Diabetes mellitus
Influencing factors
Cohort study
