筛查2型糖尿病一级亲属的腹型肥胖测量指标适宜切点分析

发布时间：2018-06-02 21:02

  本文选题：型糖尿病 + 腹型肥胖　； 参考：《医学研究生学报》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险因素,但不同腹型肥胖指标(腰围、腰臀比、腰围身高比)预测糖尿病发病的作用仍有争议。文中旨在探讨应用腰围、腰臀比和腰围身高比预测中国人群2型糖尿病一级亲属中2型糖尿病发病的价值。方法选择2003年1月至2005年6月北京大学首钢医院内分泌科住院以及门诊确诊的2型糖尿病患者的一级亲属(非糖尿病)296人。采用1999年世界卫生组织(WHO)糖尿病专家委员会提出的糖尿病诊断标准,将受试者分为糖尿病组[n=59,空腹血糖≥7.0 mmol/L或者口服葡萄糖耐量试验(OGTT)2 h血糖或随机血糖≥11.1 mmol/L]、糖耐量减低(IGT)/空腹血糖受损(IFG)组[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]和正常糖耐量组(n=148,空腹血糖6.1 mmol/L,OGTT 2 h血糖7.8 mmol/L)。所有受试者均测量身高、体重、腰围、臀围、腰臀比、腰围身高比,并行75 g OGTT,测定空腹血糖及120 min血糖。利用受试者工作特征曲线比较不同腹型肥胖指标预测糖尿病发病的作用,并估计各腹型肥胖指标预测糖尿病发病的适宜切点值及其相应灵敏度和特异度。结果在男性中,IFG/IGT组、糖尿病组腰围[(96.75±8.94)、(93.73±8.48)cm]、臀围[(104.05±6.41)、(105.00±6.62)cm]、腰围/身高[(0.56±0.05)、(0.55±0.05)]较正常糖耐量组[(88.00±7.18)cm、(99.44±5.29)cm、(0.51±0.05)]显著增高,糖尿病组腰臀比较正常糖耐量组亦显著增高(P0.05)。在女性中,糖尿病组腰臀比较正常糖耐量组明显增高[(1.06±1.36)vs(0.82±0.07),P0.05]。男性腰围、腰臀比和腰围/身高预测糖尿病发病的ROC曲线下面积(95%CI)分别为0.706(0.575~0.837)、0.639(0.499~0.779)、0.709(0.579~0.839);女性分别为0.656(0.573~0.738)、0.611(0.527~0.696)、0.644(0.561~0.728);男性、女性腰围、腰臀比和腰围/身高预测糖尿病发病差异均无统计学意义(P0.05)。男性腰围/身高预测糖尿病发病的最佳切点值、灵敏度和特异度分别为0.540,53.1%,82.8%;女性分别为0.505,68.4%,57.1%,在男性和女性中,腰围/身高最佳切点值为0.5。结论中国成人2型糖尿病一级亲属中,建议腰围/身高≥0.5切点值时进行糖尿病筛查。腰围/身高更适用于临床和公共卫生实践中用来指导腹型肥胖和糖尿病。
[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，

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