【摘要】 目的比较糖耐量正常(NGT)、单纯空腹血糖受损(I-IFG)、单纯糖耐量低减(I-IGT)、糖耐量低减合并空腹血糖受损(IGT/IFG)和新诊断的2型糖尿病(2型DM)5种不同糖代谢状态的微量白蛋白尿(MAU)发病率,并对MAU危险因素进行多因素回归分析。方法根据75 g口服葡萄糖耐量试验(75 g OGTT)结果,将898例受试者分为:NGT组162例、I-IFG组186例、I-IGT组230例、IGT/IFG组146例、新诊断的2型DM组174例。用放射免疫法测定过夜12 h尿白蛋白。UAE在20~200μg/min之间定义为MAU。结果(1)MAU的发病率在新诊断的2型DM组为19.5%、IGT/IFG组为13.0%、I-IGT组为11.7%,均高于I-IFG组的6.5%(P<0.05),I-IFG组与NGT组比较差异无统计学意义(P>0.05)。(2)多因素Logistic回归分析显示,导致MAU危险性增加的因素有OGTT 2h血糖、舒张压、体重指数的升高和高密度脂蛋白胆固醇的降低。结论I-IGT人群已经出现MAU发病率的升高,并且IGT-IFG和新诊断的2型DM人群升高更为明显;而上述指标I-IGT人群与正常人群之间的比较差异无统计学意义。提示在糖代谢异常早期,与空腹血糖的升高相比,餐后高血糖对MAU的影响更大。更多还原

【Abstract】 Objective To compare the difference of glucose tolerance(NGT),isolated impaired fasting glucose(I-IFG),isolated impaired glucose tolerance(I-IGT),impaired glucose tolerance combined with impaired fasting glucose(IGT/IFG)and newly diagnosed type 2 diabetes mellitus(T2 DM),and to probe the risks for vascular diseases by comparison of microalbuminuria(MAU)prevalence in the five subjects mentimed above. Methods A total of 898 subjects recruited in the study were divided into 5 groups based on 75g oral glucose tolerance test(OGTT)results:162 cases in NGT,186 in I-IFG,230 in I-IGT,146 in IGT-IFG,174 T2 DM cases newly diagnosed respectively.UAE was detected with radio immunoassay.MAU was defined if UAE was between 20～200μg/min.( Results (1)The prevalences) of MAU in the newly diagnosed T2 DM 19.5%,IGTIFG group 13.0%,and I-IGT group 11.7% were all higher than that in I-IFG group 6.5%(P<0.05) respectively.MAU was comparable between I-IFG group and NGT group 6.2%(P>0.05).(2)Multiple Logistic regression analysis showed that the risk factors for MAU were elevation of BMI,DBP and OGTT2HBG,while high-density lipoprotein cholesterol was a protective factor. Conclusion It is suggested that in early stage of abnormal glucose tolerance,postprandial hyperglycemia might be a more important risk factor for the prevalence of MAU than isolated fasting hyperglycemia.更多还原