[Relationship between metabolic syndrome and 10-year risk for incident type 2 diabetes mellitus].
[Relationship between metabolic syndrome and 10-year risk for incident type 2 diabetes mellitus].
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DOI：
10.3760/j:issn:0376-2491.2007.18.007
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发表时间：
2007-05
影响因子：
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通讯作者：
Yan Li;Dong Zhao;Wei Wang;Jing Liu;Jun Cheng;Qun Liu;Jun Liu;Yan-na Jia;Jia-yi Sun;L. Qin;Zhao-su Wu
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文献类型：
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作者：
Yan Li;Dong Zhao;Wei Wang;Jing Liu;Jun Cheng;Qun Liu;Jun Liu;Yan-na Jia;Jia-yi Sun;L. Qin;Zhao-su Wu
目的分析基线代谢综合征(MS)及其构成因素与糖尿病10年发病率的关系。方法采用整群抽样方法，于1992年在北京大学和首钢两个社区(北京大学和首都钢铁公司区)抽取4 154名年龄约35岁的，对其心血管疾病危险因素进行问卷调查、体检和实验室检查，应答率为82.0%，获得基线数据。2002年，对这些年龄在45岁左右、当时约为74岁的人群进行了一次跟踪调查，应答率为70.0%。在两次调查中，2740名受试者获得了完整的数据。对基线调查中确诊为非2型糖尿病(T2 DM)的2659例受试者进行分析，其中男性1177例(44.3%)，女性1482例(55.7%)。结果(1)随访期间发现T2 DM患者112例，患病率为4.2%，其中男性为5.0%，女性为3.6%。(2)T2 DM组MS成分不同者所占比例高于非T2 DM组。在随访期间被诊断为T2 DM的人群中，基线高血糖的比例为71.43%。在MS组分中，高空腹血糖在T2 DM患者中所占比例最高。(3)调整年龄和性别后，Logistic回归模型显示腹型肥胖、甘油三酯和空腹血糖是除血压和高密度脂蛋白胆固醇外与T2 DM相关的独立因素。其中，空腹血糖对T2 DM的影响最大，相对危险度为7.14(4.62，11.03)。(4)与既无MS又无高空腹血糖者相比，有MS但无高空腹血糖者发生T2 DM的相对危险度是无MS且空腹血糖正常者的2.91倍。结论MS是T2 DM发病的独立指标。在MS组分中，高空腹血糖对T2 DM的影响最大，但高空腹血糖不能完全解释MS对T2 DM的预测作用。空腹血糖正常但合并MS者应及早采取干预措施，预防T2 DM的发生。
OBJECTIVE To analyze the relationship of metabolic syndrome (MS) and its components at baseline to the 10-year incidence of diabetes mellitus. METHODS An investigation on cardiovascular disease (CVD) risk factors, including questionnaire survey, physical examination, and laboratory examination, was carried out in the populations of 4154 subjects, aged 35 approximately 64, in 2 communities (Peking University and Capital Iron and Steel Company area) collected by cluster sampling in the year 1992, with a response rate of 82.0%, so as to obtain baseline data. In 2002 a follow-up survey was conducted among these same populations, aged 45 approximately 74 then with a response rate of 70.0%. Complete data were obtained from 2740 subjects during the 2 investigations. The data of 2659 subjects who were diagnosed as without diabetes mellitus type 2 (T2DM) during the baseline survey, 1177 males (44.3%) and 1482 females (55.7%), were analyzed. RESULTS (1) 112 patients with T2DM were discovered during the follow-up survey with an incidence of 4.2%, the incidence being 5.0% in males and 3.6% in females. (2) The proportions of those with different MS components were higher among the T2DM patients than those without T2DM. The proportion of baseline high fasting glucose was 71.43% among those who were diagnosed as with T2DM during the follow-up survey. Of the MS components high fasting glucose had the highest proportion among the T2DM patients. (3) Adjusted for age and sex, the results using a logistic regression model showed that abdominal obesity, triglycerides and fasting glucose were the independent factors associated with T2DM in addition of blood pressure and HDL cholesterol. Among them, fasting glucose contributed mostly to T2DM with a relative risk (RR) of 7.14 (4.62, 11.03). (4) Compared with those without both MS and high fasting glucose, the relative risk of T2DM for persons with MS but without high fasting glucose was 2.91 times that for those without MS and with normal fasting glucose. CONCLUSION MS is an independent indicator for incidence of T2DM. Among the MS components, high fasting glucose contributes mostly to T2DM; however, the prediction of MS for T2DM cannot be entirely explained by high fasting glucose. Those without high fasting glucose but with MS should take early intervention measures to prevent the incidence of T2DM.