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目的分析中老年人群正常糖耐量者血糖水平与胰岛素敏感性的相互关系。方法在流行病学调查中选择上海市杨浦区部分街道2098例30岁以上居民,根据口服葡萄糖耐量试验中空腹血糖值和2h血糖值,分别诊断为正常糖耐量、糖耐量低减、空腹血糖受损、糖耐量低减合并空腹血糖受损和糖尿病。在正常糖耐量范围者按年龄分成5组,按空腹和2h血糖值分成6组,观察采用稳态模式胰岛素抵抗指数(HOMAIR),并对各组的年龄、血糖与胰岛素抵抗指标进行统计学分析。结果在正常糖耐量者中60～69年龄组空腹血糖值[(5.2±0.5)mmol/L]较50～59年龄组[(5.1±0.4)mmol/L]高(P<0.05),50～59年龄组空腹血糖值较40～49年龄组高(P<0.05);各组空腹胰岛素值、胰岛素敏感性有升高趋势,但无统计学意义(P>0.05);而平均空腹血糖值>5.0mmol/L组较空腹血糖<5.0mmol/L组胰岛素敏感性升高;胰岛素敏感性与腰围、糖化血红蛋白、体重指数呈显著正相关。结论中老年正常糖耐量人群随着年龄的增长,空腹血糖可能增高,空腹血糖≥5.0mmol/L可能存在胰岛素敏感性下降。
Objective To analyze the relationship between blood glucose level and insulin sensitivity in the middle-aged and elderly patients with normal glucose tolerance. Methods 2098 residents over the age of 30 in some streets in Yangpu District of Shanghai were selected for epidemiological investigation. According to the fasting blood glucose and 2h blood glucose levels in oral glucose tolerance test, the patients were diagnosed as normal glucose tolerance, impaired glucose tolerance, fasting blood glucose Loss, impaired glucose tolerance and impaired fasting glucose and diabetes. The patients with normal glucose tolerance were divided into 5 groups according to age and divided into 6 groups according to fasting and 2h blood glucose levels. The steady-state insulin resistance index (HOMAIR) was observed and the age, blood glucose and insulin resistance index of each group were statistically analyzed . Results In normal glucose tolerance group, the fasting blood glucose level was (5.2 ± 0.5) mmol / L in 60-69 age group (P <0.05) The fasting blood glucose of 59 age group was higher than that of 40 ~ 49 age group (P <0.05); fasting insulin and insulin sensitivity of each group had an increasing trend, but no statistical significance (P> 0.05); while the average fasting blood glucose> 5.0mmol / L group than fasting blood glucose <5.0mmol / L group insulin sensitivity; insulin sensitivity and waist circumference, glycosylated hemoglobin, body mass index was significantly positively correlated. Conclusions The fasting blood glucose may increase with the increase of age in normal glucose tolerance group and the insulin sensitivity may be decreased when the fasting blood glucose≥5.0mmol / L.