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目的分析糖耐量受损(IGT)者10a后转归情况。方法1995年普查出的30例IGT者予以生活方式及药物干预,10a后对该人群进行问卷调查、体格检查和实验室检测。结果30例IGT患者中7例(23.3%)发展成糖尿病,13例(43.3%)仍为IGT,10例(33.3%)逆转为正常糖耐量(NGT)。IGT患者初查时TG、胰岛β细胞功能指数(HBCI)糖尿病转归组高于IGT转归组、NGT转归组,差别均有统计学意义(P<0.05或P<0.01);尿白蛋白排泄率(UAER)糖尿病转归组>IGT转归组>NGT转归组,差别均有统计学意义(P<0.05或P<0.01);糖尿病转归组体质指数(BMI)、腰围(WC)、2h血糖(2hPG)、收缩压(SBP)、HOMA-IR均高于NGT转归组(P<0.05);糖尿病转归组、IGT转归组舒张压(DBP)均高于NGT转归组(P<0.05);空腹血糖(FPG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)在各组间差别无统计学意义(P>0.05)。10a后,糖尿病转归组肥胖、腹型肥胖患病率均85.7%高于NGT转归组(均为20.0%),差别有统计学意义(P<0.05);视网膜病变、肾病、神经病变检出率(71.4%,71.4%,57.1%)糖尿病转归组高于IGT转归组、NGT转归组;糖尿病转归组、IGT转归组心脑血管病检出率(85.7%,61.5%)高于NGT转归组(10.0%)。结论IGT、糖尿病转归者均合并代谢异常疾病,且IGT阶段即可有糖尿病慢性并发症发生,应尽早发现、综合干预其以逆转IGT加强控制代谢综合征相关临床指标。
Objective To analyze the outcome of patients with impaired glucose tolerance (IGT) after 10 years. Methods Thirty patients with IGT who were routinely surveyed in 1995 were given lifestyle intervention and drug intervention. The population was surveyed by questionnaire, physical examination and laboratory test after 10 years. Results Of the 30 patients with IGT, 7 (23.3%) developed diabetes, 13 (43.3%) remained IGT and 10 (33.3%) returned to normal glucose tolerance (NGT). IGT patients at the beginning of the investigation TG, pancreatic β-cell function index (HBCI) diabetes than the IGT outcome group, NGT outcome group, the difference was statistically significant (P <0.05 or P <0.01); urinary albumin (P <0.05 or P <0.01), and body mass index (BMI), waist circumference (WC), waist circumference (WC) , 2h blood glucose (2hPG), systolic blood pressure (SBP) and HOMA-IR were significantly higher than those in NGT prognosis group (P <0.05). Diastolic blood pressure (DBP) (P <0.05). There was no significant difference in fasting blood glucose (FPG), cholesterol (TC) and high density lipoprotein cholesterol (HDL-C) between the groups (P> 0.05). The prevalence of obesity and abdominal obesity in diabetic patients was 85.7% higher than that in NGT patients (all 20.0%) (all P <0.05); retinopathy, nephropathy and neuropathy (71.4%, 71.4%, 57.1%) were significantly higher in the patients with diabetes than those with IGT and NGT, those with diabetes and those with IGT were 85.7% and 61.5% ) Higher than the NGT outcome group (10.0%). Conclusions IGT and diabetes are all associated with metabolic disorders, and chronic complications of diabetes may occur at IGT stage. Early detection and comprehensive intervention of IGT to reverse IGT should be used to control the clinical indexes related to metabolic syndrome.