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目的探讨代谢综合征(MS)各组分与2型糖尿病(T2DM)发病的关系,比较MS与空腹血糖受损(IFG)在预测T2DM时的作用。方法采用队列研究方法,对黑龙江省电业局1 318人(≥30岁)按MS和非MS分组后进行5年随访,每年定期进行问卷调查和身体检查,获取血糖(GLU)、腰围(WC)、血压(BP)等数据,进行分析比较。结果随访5年后,MS组发病73人,非MS组发病25人,2组间差异有统计学意义;MS及其组分中GLU、WC、和BP都会增加T2DM的发病风险;MS(RR=7.83,P<0.01)和GLU(RR=7.72,P<0.01)较强,WC和BP相对弱一些,而高密度脂蛋白(HDL)、甘油三酯(TG)对T2MD的发病基本无影响;灵敏度等指标分析表明,MS与GLU的灵敏度、特异度均较好,阳性预测值、正确指数较高;ROC曲线分析表明,在预测T2DM时,ROC曲线下面积(Az)MS(Az1=0.786,P=0.000)高于IFG(Az2=0.729,P=0.000),差异有统计学意义(U=2.75,P<0.05),表明MS和IFG对T2DM都有较高的预测价值,但MS稍高于IFG。结论MS及其组分中的GLU、WC和BP都会增加T2DM的发病风险,特别是MS作为一个整体时预测价值较高,稍高于IFG。
Objective To investigate the relationship between the components of metabolic syndrome (MS) and the pathogenesis of type 2 diabetes mellitus (T2DM) and to compare the effects of MS and fasting glucose (IFG) in predicting T2DM. Methods A total of 1 318 persons (≥30 years old) from Heilongjiang Electric Power Bureau underwent 5-year follow-up after a 5-year follow-up. A questionnaire survey and physical examination were conducted on a regular basis every year to obtain the blood glucose (GLU), waist circumference ), Blood pressure (BP) and other data for analysis and comparison. Results After 5 years of follow-up, 73 patients in MS group and 25 in non-MS group showed significant difference between the two groups; GLU, WC, and BP both increased the risk of T2DM in MS and its components; MS = 7.83, P <0.01) and GLU (RR = 7.72, P <0.01), while WC and BP were relatively weaker, whereas HDL and TG had no effect on the incidence of T2MD ; Sensitivity and other index analysis showed that the sensitivity and specificity of MS and GLU were better, the positive predictive value and the correct index were higher. The ROC curve analysis showed that the area under the ROC curve (Az) MS (Az1 = 0.786 , P = 0.000) was higher than IFG (Az2 = 0.729, P = 0.000), the difference was statistically significant (U = 2.75, P <0.05), indicating that MS and IFG have higher predictive value for T2DM, Higher than IFG. Conclusion Both GLU, WC and BP in MS and its components may increase the risk of T2DM. Especially, MS as a whole has higher predictive value and slightly higher IFG.