Muntner Paul, He Jiang, Chen Jing, Fonseca Vivian, Whelton Paul K
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
Ann Epidemiol. 2004 Oct;14(9):686-95. doi: 10.1016/j.annepidem.2004.01.002.
To calculate the prevalence of non-traditional cardiovascular disease (CVD) risk factors across diabetes status and for persons with and without the metabolic syndrome.
Data were analyzed from the Third National Health and Nutrition Examination Survey for normal plasma glucose [<100 mg/dl, n=4589]; impaired fasting glucose [IFG, 100-125 mg/dl, n=2008], diabetes [fasting glucose #10878; 126 mg/dl or diabetes medication, n=750]; and participants with and without the metabolic syndrome, n=1938 and n=5409, respectively.
After adjustment for age, race, sex, body mass index, physical inactivity, cigarette smoking and alcohol consumption, a higher odds (p-trend < 0.01) of the metabolic syndrome, an elevated HOMA-insulin resistance index, chronic kidney disease, elevated C-reactive protein, high fibrinogen, and high white blood cell count was observed across diabetes status. After similar adjustment, the metabolic syndrome was associated with (odds ratio; 95% confidence interval) low apolipoprotein A1 (2.27: 1.30,3.96), high apolipoprotein-B (2.97: 2.03,4.34), a higher HOMA insulin resistance index (5.25: 4.16, 6.63), chronic kidney disease (2.27: 1.42, 3.63), and elevated markers of inflammation [high white blood cell count (1.55: 1.14, 2.10), and elevated C-reactive protein (1.46: 1.06, 2.00)]. Among participants with IFG, the presence of impaired glucose tolerance (IGT) was associated with a higher prevalence of the HOMA insulin reistance index, 32.3%, high fibrinogen, 18.5%, and elevated C-reactive protein, 13.2%, compared to persons with IFG alone, 19.7%, 13.3% and 5.7%, respectively (each p <== 0.05).
In this representative of the US population, an increased prevalence of non-traditional CVD risk factors was present among persons with diabetes, IGT and IFG compared to IFG alone, and the metabolic syndrome.
计算不同糖尿病状态以及有无代谢综合征人群中，非传统心血管疾病（CVD）危险因素的患病率。
分析了第三次全国健康与营养检查调查的数据，包括血糖正常[<100mg/dl，n = 4589]；空腹血糖受损[IFG，100 - 125mg/dl，n = 2008]；糖尿病[空腹血糖≥126mg/dl或正在服用糖尿病药物，n = 750]；以及有无代谢综合征的参与者，分别为n = 1938和n = 5409。
在对年龄、种族、性别、体重指数、缺乏身体活动、吸烟和饮酒进行校正后，在不同糖尿病状态人群中，观察到代谢综合征、较高的稳态模型评估胰岛素抵抗指数（HOMA - 胰岛素抵抗指数）、慢性肾病、C反应蛋白升高、纤维蛋白原升高和白细胞计数升高的比值更高（p趋势<0.01）。经过类似校正后，代谢综合征与以下因素相关（比值比；95%置信区间）：低载脂蛋白A1（2.27：1.30，3.96）、高载脂蛋白B（2.97：2.03，4.34）、更高的HOMA胰岛素抵抗指数（5.25：4.16，6.63）、慢性肾病（2.27：1.42，3.63）以及炎症标志物升高[白细胞计数升高（1.55：1.14，2.10）和C反应蛋白升高（1.46：1.06，2.00）]。在IFG参与者中，与单纯IFG患者相比，糖耐量受损（IGT）的存在与更高的HOMA胰岛素抵抗指数患病率（32.3%对19.7%）、纤维蛋白原升高（18.5%对13.3%）和C反应蛋白升高（13.2%对5.7%）相关（各p<0.05）。
在这一美国人群代表性样本中，与单纯IFG及代谢综合征相比，糖尿病、IGT和IFG患者中非传统CVD危险因素的患病率有所增加。
