摘要
目的依据"中国成人血脂异常防治指南(2007版)",分析社区血脂紊乱人群合并高血糖的临床特征。方法2818例≥20岁人群纳入分析,并按体质指数(BMI)、血压、血脂谱及血糖分为无代谢异常组、单纯血脂边缘异常及异常组、血脂边缘异常及异常伴糖调节受损(IGR)组及血脂边缘异常及异常伴糖尿病组,比较各组的临床特征。结果血脂边缘异常及异常人群的IGR及糖尿病的发生频率均显著高于血脂正常人群(P值分别<0.05、0.01),血糖表现类型以单纯餐后2h血糖(2hPG)升高者居多,在IGR与糖尿病患者中分别占73.9%、48.9%;②在血脂异常的临床类型中,伴发IGR或糖尿病频率最高的是高胆固醇(TC)/低密度脂蛋白胆固醇(LDL-C)合并高三酰甘油(TG)及低高密度脂蛋白胆固醇(HDL-C)亚组,分别为14.6%和13.5%;③单纯血脂边缘异常及异常组的体质指数(BMI)、腰围(W)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、2hPG、空腹胰岛素(FIN)、餐后2h胰岛素(2hIN)、C反应蛋白(CRP)、稳态模式评估法的胰岛素抵抗指数(HOMA-IR)均显著高于无代谢异常组(P值均<0.01);血脂边缘异常及异常伴IGR及血脂边缘异常及异常伴糖尿病组的BMI、W、SBP、FIN、2hIN、CRP、HOMA-IR均显著高于单纯血脂边缘异常及异常组(P值分别<0.05、0.01);血脂边缘异常及异常伴糖尿病组的HOMA-IR显著高于血脂边缘异常及异常伴IGR组(P<0.01)。结论①血脂异常人群中高血糖人群患病率显著升高,其高血糖表现类型以2hPG升高者居多;②高TC/LDL-C合并高TG及低HDL-C是最常见的伴发糖代谢紊乱的血脂异常临床类型;③血脂异常者无论伴或不伴糖代谢异常,其总体脂、局部体脂及CRP水平明显增高,发生高血糖后,体脂聚积程度更为显著;④血脂异常人群的胰岛素抵抗程度随糖代谢异常程度的加剧而增加。
Objective To investigate the clinical characteristics of individuals with dyslipidemia and hyperglycemia in Shanghai communities based on ＂Guidelines on Prevention and Treatment of Dyslipidemia for Chinese Adults （2007 ed）＂. Methods Totally 2818 individuals aged over 20 were included in the present study. The subjects were divided into normal group, pure borderline dyslipidemia and dyslipidemia group, borderline dyslipidemia and dyslipidemia with impaired glucose regulation （IGR） group, and borderline dyslipidemia and dyslipidemia with diabetes mellitus （DM） group based on the body mass index （BMI）, blood pressure, glucose concentration, and lipid profile. The clinical characteristics of subjects with dyslipidemia and hyperglycemia were compared between different groups. Results ① The frequencies of IGR and DM were significantly higher in subjects with borderline dyslipidemia and dyslipidemia than those with normolipidemia （P〈0.05, 0.01）. Isolated post prandial hyperglycemia was the most common type of hyperglycemia in individuals with dyslipidemia combined with hyperglycemia, and the frequencies were 73.9% in IGR and 48.9% in DM subjects. ② The dyslipidemia subjects with combined hypercholesterolemia （h-TC）/high low density lipoprotein cholesterol （h-LDL-C） with hypertriglyceridemia （h-TG） and low high density lipoprotein cholesterol （I-HDL-C） had the hiohest incidences of IGR （14.6%） and DM （13.5%）. ③ The BMI, waist circumference （W）, blood pressure （BP）, fasting plasma glucose （FPG）, post prandial glucose （2hPG）, fasting insulin （FIN）, post prandial insulin （2hlNS）, C-reactive protein （CRP） and HOMA-IR in pure dyslipidemia group were all higher than those in the normal group （ P〈0.01 ）. the BMI, W, systolic BP, FIN, 2h1N, CRP and HOMA-IR in borderline dyslipidemia and dyslipidemia with IGR group and borderline dyslipidemia and dyslipidemia with DM group were higher than those in pure borderline dyslipidemia and dyslipidemia group （P〈0.01）. HOMA-IR in borderline dyslipidemia and dyslipidemia with DM group was increased compared with borderline dyslipidemia and dyslipidemia with IGR group. Conclusions ① The proportion of hyperglycemia is higher in subjects with dyslipidemia than in those with normolipidemia in Shanghai communities. The most common type of hyperglycemia in individuals with combined dyslipidemia and hyperglycemia is pure post prandial hyperglycemia. ② The most common clinical type of dyslipidemia with hyperglycemia is combined h-TC/ h-LDL-C with h-TG and I-HDL-C. ③ The total body fat, regional body fat, and CRP in subjects with dyslipidemia are increased regardless of hyperglycemia. Body fat is further increased when the subjects with combined dyslipidemia and hyperglycemia. ④ The degree of insulin resistance is increased with the progression of hyperglycemia. （Shanghai Med J, 2009, 32： 388-392）
出处
《上海医学》
CAS
CSCD
北大核心
2009年第5期388-392,共5页
Shanghai Medical Journal
基金
上海市医学发展基金资助重点项目[01ZD002(1)]
上海市教育委员会科研资助项目(06BZ061)
关键词
血脂异常
糖调节异常
糖尿病
Dyslipidemia
Impaired glucose regulation
Diabetes
