Yang Zhao-jun, Yang Wen-ying, Li Guang-wei
Department of Endocrinology, China-Japan Friendship Hospital, Beijing 100029, China.
Zhonghua Yi Xue Za Zhi. 2003 Dec 25;83(24):2128-31.
To clarify the frequencies and clinical features of different impaired glucose metabolism subcategories in Chinese adults.
A cross-sectional analysis of the data of 15,637 Chinese adults (aged >or= 25 years) who underwent standard 75 g oral glucose tolerance test from the National Diabetes Mellitus Survey (1994) was conducted. According to the 1999 WHO criteria for diabetes, the subjects were divided into 7 groups: normal glucose tolerance (NGT, FPG < 6.1 mmol/L and PG 2 h < 7.8 mmol/L), isolated impaired fasting glucose (i-IFG, 6.1 <or= FPG < 7.0 mmol/L and PG 2 h < 7.8 mmol/L), isolated impaired glucose tolerance (i-IGT, FPG < 6.1 mmol/L and 7.8 <or= PG 2 h < 11.1 mmol/L), combined i-IFG and i-IGT (IFG/IGT, 6.1 <or= FPG < 7.0 mmol/L and 7.8 <or= PG 2 h < 11.1 mmol/L), isolated fasting hyperglycemia (IFG, FPG >or= 7.0 mmol/L and PG 2 h < 11.1 mmol/L), isolated postload hyperglycemia (IPH, FPG < 7.0 mmol/L and PG 2 h >or= 11.1 mmol/L), and combined IFH and IPH (IFH/IPH, FPG >or= 7.0 mmol/L and PG 2 h >or= 11.1 mmol/L). The frequencies of the above subcategories were calculated and the clinical characteristics were compared.
(1) The frequencies of NGT, i-IFG, i-IGT, IFG/IGT, IFG, IPH, and IFH/IPH were 50.8%, 8.8%, 12.3%, 6.1%, 6.4%, 5.2%, and 10.4% respectively. (2) The frequencies of i-IGT, IFG/IGT, IPH, and IFH/IPH increased with age, whereas the frequencies of i-IFG and IFH tended to plateau in the age groups of 25 - 34 years and 55 - 64 years. (3) The mean age and blood pressure were significantly lower in the i-IFG group (vs the i-IGT or IFG/IGT group) and the IFH group (vs IPH or IFH/IPH group). Compared with the IPH group, the IFH group had higher homeostasis model assessment (HOMA) insulin resistance index (HOMA-IR) and lower beta cell function index (BCI).
i-IGT is the most common impaired glucose regulation (IGR) subcategory, and IFH/IPH is the most common diabetes subcategory in Chinese adults. The frequencies of i-IGT and IFH/IPH increase with age. The clinical features of i-IFG (IFG) are greatly different from those of i-IGT (IPH), suggesting that the determinants of FPG and PG 2 h differ.
明确中国成年人中不同糖代谢受损亚类的发生率及临床特征。
对全国糖尿病调查（1994年）中15637名接受标准75克口服葡萄糖耐量试验的中国成年人（年龄≥25岁）的数据进行横断面分析。根据1999年世界卫生组织糖尿病诊断标准，将研究对象分为7组：正常糖耐量（NGT，空腹血糖（FPG）<6.1 mmol/L且餐后2小时血糖（PG 2 h）<7.8 mmol/L）、单纯空腹血糖受损（i-IFG，6.1≤FPG<7.0 mmol/L且PG 2 h<7.8 mmol/L）、单纯糖耐量受损（i-IGT，FPG<6.1 mmol/L且7.8≤PG 2 h<11.1 mmol/L）、合并i-IFG和i-IGT（IFG/IGT，6.1≤FPG<7.0 mmol/L且7.8≤PG 2 h<11.1 mmol/L）、单纯空腹血糖升高（IFG，FPG≥7.0 mmol/L且PG 2 h<11.1 mmol/L）、单纯负荷后血糖升高（IPH，FPG<7.0 mmol/L且PG 2 h≥11.1 mmol/L）以及合并IFH和IPH（IFH/IPH，FPG≥7.0 mmol/L且PG 2 h≥11.1 mmol/L）。计算上述亚类的发生率并比较临床特征。
（1）NGT、i-IFG、i-IGT、IFG/IGT、IFG、IPH和IFH/IPH的发生率分别为50.8%、8.8%、12.3%、6.1%、6.4%、5.2%和10.4%。（2）i-IGT、IFG/IGT、IPH和IFH/IPH的发生率随年龄增长而升高，而i-IFG和IFH的发生率在25 - 34岁和55 - 64岁年龄组趋于平稳。（3）i-IFG组（与i-IGT或IFG/IGT组相比）和IFH组（与IPH或IFH/IPH组相比）的平均年龄和血压显著更低。与IPH组相比，IFH组的稳态模型评估胰岛素抵抗指数（HOMA-IR）更高，β细胞功能指数（BCI）更低。
i-IGT是中国成年人中最常见的糖调节受损（IGR）亚类，IFH/IPH是最常见的糖尿病亚类。i-IGT和IFH/IPH的发生率随年龄增长而升高。i-IFG（IFG）的临床特征与i-IGT（IPH）有很大差异，提示FPG和PG 2 h的决定因素不同。
