Chihaoui M, Kanoun F, Ben Rehaiem B, Ben Brahim S, Ftouhi B, Mekaouar A, Fekih M, Mbazâd A, Zouari B, Ben Khalifa F
Service d'Endocrinologie-Diabetologie, Hôpital, la Rabta, Tunis.
Diabetes Metab. 2001 Sep;27(4 Pt 1):487-95.
To determine the predictive risk factors for the development of type 2 diabetes mellitus (DM) or impaired glucose tolerance (IGT) in a normoglycemic population.
This is a ten-year prospective study in a randomly selected urban population including 1835 subjects aged >=30 years living in Tunis, 1460 were normoglycemic according to 2 hours blood glucose WHO criteria, and 701 among them attended the follow-up assessment ten years later. Subjects with impaired glucose tolerance (IGT) were excluded. Subjects underwent a physical examination including weight/height, iliac circumference (IC) and blood pressure measurements. Fasting and 2-hour venous blood sampling, after a 75 g oral glucose load, were performed for the measurement of plasma glucose (G(0), G(2h)), insulin (I(0), I(2h)), total cholesterol (TC) and glycated hemoglobin (HbA(1c)) levels.
Out of the 701 normoglycemic subjects in 1985, 77 developed diabetes and 130 impaired glucose tolerance after 10 years, giving a mean annual incidence rate of 1.1% for diabetes and 1.85% for IGT. Univariate analysis showed that risk factors for diabetes were age, BMI, IC, SBP, G(0) and total cholesterol in both sexes, I(0) and I(2h) in men only and DBP G(2h) and HbA(1c) in women only. Risk factors for IGT were BMI, IC and G(2h) in both sexes, I(2h) in men only and G(0) in women only. Multivariate analysis revealed that BMI, G(0) and G(2h) were independent risk factors for conversion to diabetes or IGT in both sexes, but HbA(1c) and IC were risk factors only in men.
Early screening and prevention of diabetes must focus on obese subjects, especially those with central fat distribution, and those with moderate increase in fasting and/or two-hour blood glucose levels within the normal range.
确定正常血糖人群发生2型糖尿病（DM）或糖耐量受损（IGT）的预测风险因素。
这是一项针对随机选取的城市人群开展的为期十年的前瞻性研究，包括1835名年龄≥30岁居住在突尼斯的受试者，根据世界卫生组织2小时血糖标准，其中1460人血糖正常，十年后其中701人参加了随访评估。排除糖耐量受损（IGT）的受试者。受试者接受了包括体重/身高、腰围（IC）和血压测量在内的体格检查。在口服75克葡萄糖负荷后，进行空腹和2小时静脉血采样，以测量血浆葡萄糖（G(0)，G(2h)）、胰岛素（I(0)，I(2h)）、总胆固醇（TC）和糖化血红蛋白（HbA(1c)）水平。
1985年的701名血糖正常受试者中，10年后77人患糖尿病，130人糖耐量受损，糖尿病的年平均发病率为1.1%，IGT为1.85%。单因素分析显示，糖尿病的风险因素在两性中为年龄、体重指数、腰围、收缩压、G(0)和总胆固醇，仅在男性中为I(0)和I(2h)，仅在女性中为舒张压、G(2h)和HbA(1c)。IGT的风险因素在两性中为体重指数、腰围和G(2h)，仅在男性中为I(2h)，仅在女性中为G(0)。多因素分析显示，体重指数、G(0)和G(2h)是两性转化为糖尿病或IGT的独立风险因素，但HbA(1c)和腰围仅在男性中是风险因素。
糖尿病的早期筛查和预防必须关注肥胖受试者，尤其是那些具有中心性脂肪分布的人，以及那些空腹和/或两小时血糖水平在正常范围内适度升高的人。
