Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Eur J Intern Med. 2013 Jul;24(5):425-9. doi: 10.1016/j.ejim.2013.03.013. Epub 2013 May 3.
The prevalence of cardiovascular disease (CVD) and metabolic syndrome (MetS) increases with increasing fasting plasma glucose (FPG) levels in an elderly population with pre-diabetes or diabetes. However, it remains unknown whether the relationship between elevated FPG and increased risks of MetS exists in older women with normoglycemia (FPG<100mg/dL). Therefore, the present study was conducted to fill the lack of information in that area.
We included 6505 apparently healthy women, aged 65years and older, with normoglycemia who participated in routine health checkups at health screening centers in Taiwan. Components of MetS (FPG, waist circumference (WC), high-density lipoprotein cholesterol (HDL-C), triglycerides, and systolic/diastolic blood pressure), body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), total cholesterol, and percentage body fat (PBF) were examined in all subjects.
Subjects were sub-grouped by FPG levels (<90mg/dL, 91-95mg/dL and >95mg/dL for group 1, group 2 and group 3, respectively). Subjects in group 2 and group 3 were 1.22-fold (P=0.017) and 1.25-fold (P=0.007) more likely to have MetS compared with those in group 1. Age, WC, BMI, PBF, systolic and diastolic blood pressure, total cholesterol, triglycerides, and HDL-C were significantly correlated with FPG, whereas HDL-C was negatively correlated with FPG. In a multivariate stepwise regression analysis, PBF, LDL-C, triglycerides, and age were significantly and independently associated with FPG.
Among older women, the risk of MetS was significantly associated with elevated FPG even for subjects with normal FPG. Lifestyle interventions for reducing PBF and controlling dyslipidemia could help reduce the risk of MetS in this population.
在患有糖尿病前期或糖尿病的老年人群中，随着空腹血糖（FPG）水平的升高，心血管疾病（CVD）和代谢综合征（MetS）的患病率也会增加。然而，目前尚不清楚在血糖正常（FPG<100mg/dL）的老年女性中，升高的 FPG 是否与 MetS 风险增加有关。因此，本研究旨在填补该领域的信息空白。
我们纳入了 6505 名年龄在 65 岁及以上、血糖正常、在台湾健康筛查中心进行常规健康检查的健康女性。所有受试者均检查了 MetS 的组成部分（FPG、腰围（WC）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯、收缩压/舒张压）、体重指数（BMI）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇和体脂百分比（PBF）。
受试者按 FPG 水平分组（<90mg/dL、91-95mg/dL 和>95mg/dL 分别为组 1、组 2 和组 3）。与组 1 相比，组 2 和组 3 受试者发生 MetS 的风险分别增加了 1.22 倍（P=0.017）和 1.25 倍（P=0.007）。年龄、WC、BMI、PBF、收缩压和舒张压、总胆固醇、甘油三酯和 HDL-C 与 FPG 显著相关，而 HDL-C 与 FPG 呈负相关。多元逐步回归分析显示，PBF、LDL-C、甘油三酯和年龄与 FPG 显著相关且独立相关。
在老年女性中，即使 FPG 正常，MetS 的风险也与升高的 FPG 显著相关。减少 PBF 和控制血脂异常的生活方式干预可能有助于降低该人群发生 MetS 的风险。
