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背景:代谢综合征指标即血压升高、腹部肥胖、三酰甘油水平升高,高密度脂蛋白胆固醇水平降低,在个体中聚集存在,是糖尿病的预测因子。但类似老年人的资料相对较少。目的:分析代谢综合征各特征指标与老年人2型糖尿病危险性的相关性,为糖尿病的一级预防提供依据。设计:横断面调查。单位:卫生部北京老年医学研究所。对象:调查于2001-02/11完成,选择北京市西城、海淀、石景山科研单位年龄60岁以上老年人共4499名作为调查对象,均自愿参加调查。排除调查资料不全者。方法:对调查人群进行观察性分析,用调查问卷收集相关信息。糖尿病的诊断标准为空腹血糖≥7.0mmol/L或有糖尿病现患史。计数资料用χ2检验进行分析,计量资料均数的比较用调整年龄、性别的协方差分析。应用非条件多因素Logistic逐步回归法分析与糖尿病独立相关的指标。分析代谢紊乱的聚集与糖尿病的关系时,以无任何因素聚集为对照,按1,2,3,4个聚集数设亚变量,用Logistic回归模型分析各种聚集数目时糖尿病的危险程度,并调整年龄、糖尿病家族史、受教育水平的影响。主要观察指标:调查对象的血糖、腹围、体质量指数、血压、血清三酰甘油、高密度脂蛋白胆固醇、糖尿病现患史及家族史。结果:有4444名老年人进入结果分析。①调查共检出556名糖尿病患者。②统计结果显示年龄、糖尿病家族史、血压、腹围和血清三酰甘油与糖尿病独立相关眼OR(95%CI)=1.02(1.00～1.04),3.48(2.76～4.39),1.02(1.01～1.02),1.03(1.00～1.03),1.13(1.05～1.21)演。③当血清三酰甘油不在模型中,高密度脂蛋白胆固醇与糖尿病成显著负相关,OR(95%CI)=0.67(0.49～0.91)。④随腹部肥胖、血压升高、三酰甘油水平升高、高密度脂蛋白胆固醇水平降低这4个变量在个体内聚集数目的增加,糖尿病的危险性亦逐渐增大。结论:除遗传和年龄因素外,代谢综合征指标尤其是指标的聚集与糖尿病密切相关,是提示糖尿病危险性的重要指征。
Background: Metabolic syndrome markers of increased blood pressure, abdominal obesity, elevated triglyceride levels, reduced levels of high-density lipoprotein cholesterol, and presence in individuals are predictors of diabetes. However, there is relatively little information on older people. OBJECTIVE: To analyze the correlation between each metabolic syndrome index and the risk of type 2 diabetes in the elderly to provide the basis for primary prevention of diabetes mellitus. Design: Cross-sectional survey. Unit: Beijing Institute of Geriatrics, Ministry of Health. PARTICIPANTS: The survey was completed on February 2, 2001 and selected 4499 seniors aged 60 and over from Xicheng, Haidian and Shijingshan research institutes in Beijing Municipality as survey subjects, all voluntarily participating in the survey. Exclude survey incomplete information. Methods: Observational analysis of the survey population, using questionnaires to collect relevant information. Diagnostic criteria for diabetes fasting blood glucose ≥ 7.0mmol / L or diabetes history of the current occurrence. Counting data were analyzed by χ2 test, and the mean of measurement data was compared with covariance analysis of adjusting age and sex. Unconditional Logistic regression was used to analyze the indexes related to diabetes independence. When analyzing the relationship between metabolic disorder and diabetes, no factors were aggregated as controls, and 1, 2, 3 and 4 aggregates were set as subvariable variables. Logistic regression model was used to analyze the risk of diabetes mellitus when the number of aggregates was Adjusting age, family history of diabetes, affected by education level. MAIN OUTCOME MEASURES: Blood glucose, abdominal circumference, body mass index, blood pressure, serum triglycerides, high density lipoprotein cholesterol, prevalence of diabetes and family history of the surveyed subjects. Results: 4444 elderly people entered the result analysis. ① survey found a total of 556 patients with diabetes. ② The statistical results showed that age, family history of diabetes, blood pressure, abdominal circumference and serum triglyceride and diabetes were independently associated with OR (95% CI) 1.02 (1.00-1.04), 3.48 (2.76-4.39), 1.02 (1.01-1.02 ), 1.03 (1.00-1.03), 1.13 (1.05-1.21). ③ When serum triglyceride was not in the model, HDL cholesterol had a significantly negative correlation with diabetes (OR 95% CI 0.67 0.49 0.91). ④ With abdominal obesity, high blood pressure, elevated triglyceride levels, high-density lipoprotein cholesterol levels reduce the four variables in the number of individuals in the accumulation of increased risk of diabetes also gradually increased. Conclusion: In addition to genetic and age factors, metabolic syndrome indicators, especially the accumulation of indicators and diabetes are closely related, is an important indicator of the risk of diabetes.