摘要
目的探讨不同诊断标准下糖尿病前期及糖尿病的患病情况及相关影响因素。方法选取2021年3月至2022年2月于我院健康管理中心的体检者29084例,分别参照WHO及ADA糖尿病标准分为正常血糖组(NG组)、糖尿病前期组(P-DM组)和糖尿病组(DM组),分析不同诊断标准下的糖尿病前期及糖尿病的患病情况及相关危险因素。结果(1)根据WHO诊断标准,检出体检人群中糖尿病前期1493例(5.13%),患糖尿病2028例(6.97%);根据ADA诊断标准,检出体检人群中糖尿病前期13261例(45.60%),患糖尿病4218例(14.50%)。(2)基于WHO诊断标准下,与NG组比较,P-DM组和DM组的性别、年龄段、有无NAFLD、BMI分层、SBP、DBP、静息心率、ALT、FPG、HbA1c、Ur、Cr、UA、TG、TC、HDL、LDL、TyG、NLR、LMR、PLR水平间差异有统计学意义(P<0.05)。与NG组比较,P-DM组的AST水平差异有统计学意义(P<0.001)。与P-DM组比较,DM组的性别、年龄段、有无NAFLD、SBP、静息心率、AST、FPG、HbA1c、Ur、Cr、UA、TG、HDL、TyG、NLR、LMR、PLR水平差异有统计学意义(P<0.05)。基于ADA诊断标准下,与NG组比较,P-DM组和DM组的性别、年龄段、有无NAFLD、BMI分层、SBP、DBP、静息心率、AST、ALT、FPG、HbA1c、Ur、Cr、UA、TG、TC、HDL、LDL、TyG、NLR、LMR、PLR水平间差异有统计学意义(P<0.001)。与P-DM组比较,DM组的性别、年龄段、有无NAFLD、BMI分层、SBP、DBP、静息心率、ALT、FPG、HbA1c、Ur、Cr、UA、TG、HDL、TyG、NLR、LMR、PLR水平间差异有统计学意义(P<0.001)。(3)多元Logistic回归分析结果显示,在WHO诊断标准下,男性、有NAFLD、年龄≥45岁、体质量偏轻、SBP、静息心率、AST、ALT、HbA1c、UA、TG、TC、HDL、TyG、NLR及LMR水平是发展为糖尿病前期的影响因素(P<0.05);而男性、有NAFLD、年龄≥45岁、体质量异常、SBP、DBP、静息心率、HbA1c、Ur、UA、TG、TC、HDL、TyG、NLR、LMR及PLR水平是发展为糖尿病的影响因素(P<0.05)。在ADA诊断标准下,男性、有NAFLD、年龄≥45岁、超重或肥胖、SBP、DBP、静息心率、AST、ALT、Ur、Cr、TG、TC、HDL、Ty G及LMR水平是糖尿病前期发生的影响因素(P<0.05);而男性、年龄≥45岁、体质量异常、SBP、DBP、AST、ALT、Ur、Cr、UA、TG、TC、HDL、LDL、Ty G、NLR、LMR及P LR水平是糖尿病发生的影响因素(P<0.05)。结论在不同诊断标准下,糖尿病前期及糖尿病患病率有所不同,其中,男性、年龄≥45岁、体质量异常、血脂异常、血压异常(尤其是SBP)、Ty G及LMR有可能是糖尿病前期及糖尿病的共同影响因素。
Objective To study prevalence and influencing factors of pre-diabetes and diabetes mellitus in Nanchong city under different diagnostic criteria.Methods From March 2021 to February 2022,total 29,084 cases of health checkups at our hospital's health management center were selected and divided into the normoglycemic group(NG group),prediabetic group(P-DM group),and diabetic group(DM group)with reference to WHO and ADA diabetes standards,respectively,to analyze the prevalence of pre-diabetes and diabetes mellitus and the related risk factors under different diagnostic criteria in Nanchong area.Results According to WHO diagnostic criteria,1,493 cases(5.13%)of pre-diabetes and 2,028 cases(6.97%)of diabetes mellitus were detected in the physical examination population.According to ADA diagnostic criteria,13,261 cases(45.60%)of pre-diabetes and 4,218 cases(14.50%)of diabetes mellitus were detected in the physical examination population.Under the WHO diagnostic criteria,there was a statistically significant difference between the P-DM and DM groups in terms of gender,age group,presence or absence of NAFLD,BMI stratification,SBP,DBP,resting heart rate,ALT,FPG,HbA1c,Ur,Cr,UA,TG,TC,HDL,LDL,TyG,NLR,LMR,and PLR when compared with NG group(P<0.05).Compared with NG group,difference in AST levels in the P-DM group was statistically significant(P<0.001).Compared with P-DM group,there were statistically significant differences in gender,age groups,presence or absence of NAFLD,SBP,resting heart rate,AST,FPG,HbA1c,Ur,Cr,UA,TG,HDL,TyG,NLR,LMR,and PLR between DM groups(P<0.05).Based on the ADA diagnostic criteria,differences between P-DM and DM groups were statistically significant when compared with NG group in terms of gender,age group,presence or absence of NAFLD,BMI stratification,SBP,DBP,resting heart rate,AST,ALT,FPG,HbA1c,Ur,Cr,UA,TG,TC,HDL,LDL,TyG,NLR,LMR,and PLR levels(P<0.001).Compared with P-DM group,there were statistically significant differences between gender,age group,presence of NAFLD,BMI stratification,SBP,DBP,resting heart rate,ALT,FPG,HbA1c,Ur,Cr,UA,TG,HDL,TyG,NLR,LMR,and PLR in DM group(P<0.001).Results of multivariate logistic regression analysis showed that under the WHO diagnostic criteria,males,having NAFLD,age≥45 years,low body weight,SBP,resting heart rate,AST,ALT,HbA1c,UA,TG,TC,HDL,TyG,NLR,and LMR levels were the influencing factors for the development of pre-diabetes(P<0.05).While males,having NAFLD,age≥45 years,abnormal weight,SBP,DBP,resting heart rate,HbA1c,Ur,UA,TG,TC,HDL,TyG,NLR,LMR,and PLR levels were influential factors for developing diabetes(P<0.05).Under the ADA diagnostic criteria,male,having NAFLD,age≥45 years,overweight or obesity,SBP,DBP,resting heart rate,AST,ALT,Ur,Cr,TG,TC,HDL,TyG,and LMR were the influencing factors for the development of pre-diabetes(P<0.05).Whereas male,age≥45 years,abnormal weight,SBP,DBP,AST,ALT,Ur,Cr,UA,TG,TC,HDL,LDL,TyG,NLR,LMR and PLR were influential factors for the development of diabetes(P<0.05).Conclusion The prevalence of pre-diabetes and diabetes varied in Nanchong under different diagnostic criteria,in which male,age≥45 years,abnormal body mass,dyslipidemia,abnormal blood pressure(especially SBP),TyG and LMR were likely to be the common influencing factors of pre-diabetes and diabetes.
作者
杨丹
李芸
赵泓渊
雷蓉
周小燕
江毅敏
柳弥
Yang Dan;Li Yun;Zhao Hongyuan(Health Management Center,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,China)
出处
《四川医学》
CAS
2023年第12期1285-1293,共9页
Sichuan Medical Journal
基金
川北医学院附属医院科研发展项目(编号:2022SK003)。
关键词
诊断标准
糖尿病前期
糖尿病
diagnostic criteria
pre-diabetes
diabetes mellitus
