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[心血管危险因素:一项非糖尿病患者群体的随访研究]

[Cardiovascular risk factors: a follow up study in a non-diabetic population].

作者信息

Vernet Vernet María, Sender Palacios María José, Jovell Fernández Esther, Tor Figueras Encarnació, Casals Riera Ramón, Larrosa Sàez Pere

机构信息

CAP Terrassa Nord, Consorci Sanitari de Terrassa, Barcelona, Spain.

出版信息

Aten Primaria. 2010 Jan;42(1):15-21. doi: 10.1016/j.aprim.2009.03.016. Epub 2009 Aug 6.

Abstract

OBJECTIVES

To evaluate the cardiovascular risk factors (CVRF), their relationship with insulin resistance (IR) and pancreatic beta-cell (PBC) function in a known non-diabetic population, and to follow its progress over a period of 5 years.

DESIGN

Nested case-control study developed in two phases: the identification and characterisation of the cohort to study and the follow up.

SETTING

Urban Primary Care Centre.

PARTICIPANTS

A non-diabetic population sample from 40 to 70 years.

MAIN MEASUREMENTS

History of CVRF, physical examination (body mass index, abdominal girth, blood pressure), laboratory tests (fasting glucose, lipid profile and fasting insulin) and calculation of IR and PBC using the Homeostasis Model Assessment mathematical program.

RESULTS

Identification phase: 326 subjects. CVRF 32.5% dyslipaemia, 28.8% smoking, 28.2% obesity and 24.8% increased blood pressure. Number of CVRF: 37.7% had one, 21.5% two, 10.1% three and 2.1% four. Relationship between number of CVRF and IR. More IR in hypertensive, obese and dyslipaemic subjects. Follow up phase (5 years): 121 subjects. Significant proportion of dyslipaemia and impaired fasting glucose (IFG).

CONCLUSIONS

The most common CVRF were dyslipaemia, smoking, obesity and raised blood pressure, with more IR in patients with high blood pressure, dyslipaemia and obesity and a higher number of CVRF in comparison with the rest of the population. At five years of follow up, an increase was only observed in the number of dyslipaemia and IFG and no reduction was achieved in the percentage of active smokers.

摘要

目的

评估已知非糖尿病人群的心血管危险因素(CVRF)、其与胰岛素抵抗(IR)及胰岛β细胞(PBC)功能的关系,并随访5年期间的病情进展。

设计

分两个阶段开展的巢式病例对照研究:队列研究对象的识别与特征描述以及随访。

地点

城市基层医疗中心。

参与者

年龄在40至70岁之间的非糖尿病人群样本。

主要测量指标

CVRF病史、体格检查(体重指数、腹围、血压)、实验室检查(空腹血糖、血脂谱和空腹胰岛素),并使用稳态模型评估数学程序计算IR和PBC。

结果

识别阶段:326名受试者。CVRF情况为血脂异常32.5%、吸烟28.8%、肥胖28.2%以及血压升高24.8%。CVRF数量情况为:37.7%有一项,21.5%有两项,10.1%有三项,2.1%有四项。CVRF数量与IR的关系。高血压、肥胖和血脂异常的受试者IR更高。随访阶段(5年):121名受试者。血脂异常和空腹血糖受损(IFG)的比例较高。

结论

最常见的CVRF是血脂异常、吸烟、肥胖和血压升高,高血压、血脂异常和肥胖患者的IR更高,且CVRF数量比其他人群更多。在随访5年时,仅观察到血脂异常和IFG的数量增加,活跃吸烟者的比例未降低。

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