發(fā)布時間：2018-06-02 21:02

  本文選題：型糖尿病 + 腹型肥胖　； 參考：《醫(yī)學研究生學報》2017年03期

【摘要】：目的肥胖,尤其是腹型肥胖是心血管疾病和糖尿病的重要危險因素,但不同腹型肥胖指標(腰圍、腰臀比、腰圍身高比)預測糖尿病發(fā)病的作用仍有爭議。文中旨在探討應用腰圍、腰臀比和腰圍身高比預測中國人群2型糖尿病一級親屬中2型糖尿病發(fā)病的價值。方法選擇2003年1月至2005年6月北京大學首鋼醫(yī)院內(nèi)分泌科住院以及門診確診的2型糖尿病患者的一級親屬(非糖尿病)296人。采用1999年世界衛(wèi)生組織(WHO)糖尿病專家委員會提出的糖尿病診斷標準,將受試者分為糖尿病組[n=59,空腹血糖≥7.0 mmol/L或者口服葡萄糖耐量試驗(OGTT)2 h血糖或隨機血糖≥11.1 mmol/L]、糖耐量減低(IGT)/空腹血糖受損(IFG)組[n=89,IFG:6.1 mmol/L≤空腹血糖≥7 mmol/L,OGTT 2 h血糖7.8 mmol/L;IGT:空腹血糖7.0 mmol/L,7.8 mmol/L≤OGTT 2 h血糖≥11.1 mmol/L]和正常糖耐量組(n=148,空腹血糖6.1 mmol/L,OGTT 2 h血糖7.8 mmol/L)。所有受試者均測量身高、體重、腰圍、臀圍、腰臀比、腰圍身高比,并行75 g OGTT,測定空腹血糖及120 min血糖。利用受試者工作特征曲線比較不同腹型肥胖指標預測糖尿病發(fā)病的作用,并估計各腹型肥胖指標預測糖尿病發(fā)病的適宜切點值及其相應靈敏度和特異度。結(jié)果在男性中,IFG/IGT組、糖尿病組腰圍[(96.75±8.94)、(93.73±8.48)cm]、臀圍[(104.05±6.41)、(105.00±6.62)cm]、腰圍/身高[(0.56±0.05)、(0.55±0.05)]較正常糖耐量組[(88.00±7.18)cm、(99.44±5.29)cm、(0.51±0.05)]顯著增高,糖尿病組腰臀比較正常糖耐量組亦顯著增高(P0.05)。在女性中,糖尿病組腰臀比較正常糖耐量組明顯增高[(1.06±1.36)vs(0.82±0.07),P0.05]。男性腰圍、腰臀比和腰圍/身高預測糖尿病發(fā)病的ROC曲線下面積(95%CI)分別為0.706(0.575~0.837)、0.639(0.499~0.779)、0.709(0.579~0.839);女性分別為0.656(0.573~0.738)、0.611(0.527~0.696)、0.644(0.561~0.728);男性、女性腰圍、腰臀比和腰圍/身高預測糖尿病發(fā)病差異均無統(tǒng)計學意義(P0.05)。男性腰圍/身高預測糖尿病發(fā)病的最佳切點值、靈敏度和特異度分別為0.540,53.1%,82.8%;女性分別為0.505,68.4%,57.1%,在男性和女性中,腰圍/身高最佳切點值為0.5。結(jié)論中國成人2型糖尿病一級親屬中,建議腰圍/身高≥0.5切點值時進行糖尿病篩查。腰圍/身高更適用于臨床和公共衛(wèi)生實踐中用來指導腹型肥胖和糖尿病。
[Abstract]:Objective Obesity, especially abdominal obesity, is an important risk factor for cardiovascular disease and diabetes, but the role of different abdominal obesity indicators (waist circumference, waist hip ratio, waist height ratio) in predicting the onset of diabetes is still controversial. The purpose of this study was to investigate the value of waist circumference, waist hip ratio and waist height ratio in predicting the onset of type 2 diabetes among first-degree relatives of type 2 diabetes in Chinese population. Methods A total of 296 first-degree relatives (non-diabetic patients) of type 2 diabetes were selected from Department of Endocrinology, Shougang Hospital of Peking University from January 2003 to June 2005. Using the criteria for the diagnosis of diabetes presented by the World Health Organization (WHO) expert Committee on Diabetes in 1999, The subjects were divided into two groups: diabetic group [nng59, fasting blood glucose 鈮，

本文編號：1970170