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目的对安徽省蚌埠地区1980年普查出的24例糖调节受损(IGT)人群进行干预,探讨IGT发生糖尿病(DM)的危险性及其影响因素。方法25年间,指导IGT者予生活方式及药物干预,对其转归及各项临床指标进行随访调查。结果①随访到的22人按1980年WHO的DM诊断标准统计:9例(40.9%)发展成DM,年转变率为1.6%;按1999年WHO的DM诊断标准再次统计:11例(50%)发展成DM,年转变率为2.0%。②DM转归组的其基线2 h静脉血糖(2hPG)均明显高于其他转归组(P<0.05),收缩压(SBP)、体质量指数(BMI)均明显高于糖耐量正常(NGT)转归组(P<0.05)。③25年后,HBP、低HDL-C血症患病率,DM转归组>IGT转归组>NGT转归组,差异有统计学意义(P<0.01)。高TG血症患病率在DM转归组、NGT转归组间差异有统计学意义(P<0.01)。DM转归组SBP、DBP、HOMA-IR均值均明显高于NGT转归组,HBCI均值明显低于NGT转归组;DM转归组、IGT转归组的BMI、TC、UAER均值明显高于NGT转归组。结论2hPG、UAER、SBP、BMI为IGT转变为DM的危险因素,尽早发现、综合干预不仅可逆转IGT、降低DM的发病率,亦可降低代谢综合征的发生率。
Objective To investigate the risk of diabetes mellitus (IGT) and its influential factors in 24 IGT patients popularized in 1980 in Bengbu, Anhui Province. Methods During the past 25 years, IGTs were instructed to give life style and drug interventions, and follow-up investigation of their outcomes and clinical indexes were conducted. Results ①The 22 follow-up people were surveyed according to the diagnostic criteria of WHO in 1980: 9 cases (40.9%) developed into DM, the annual change rate was 1.6%; According to the WHO diagnostic criteria again in 1999, 11 cases (50% ) Into DM, the annual rate of change of 2.0%. (2) The baseline 2 h venous blood glucose (2 hPG) in DM group were significantly higher than those in other groups (P <0.05), systolic blood pressure (SBP) and body mass index (BMI) were significantly higher than normal glucose tolerance (NGT) Goes the group (P <0.05). (3) After 25 years, the prevalence of HBP, low HDL-C, DM outcome group> IGT outcome group> NGT outcome group had statistical significance (P <0.01). The prevalence of hypertriglyceridemia was significantly different between DM group and NGT group (P <0.01). The average values of SBP, DBP and HOMA-IR in DM group were significantly higher than those in NGT group, mean HBCI was significantly lower than that in NGT group, and mean of BMI, TC and UAER in DM group and IGT group were significantly higher than those in NGT group NGT to the group. Conclusions 2hPG, UAER, SBP and BMI are the risk factors for the conversion of IGT to DM. As soon as possible, comprehensive intervention can not only reverse IGT, reduce the incidence of DM, but also reduce the incidence of metabolic syndrome.