Division of Endocrinology and Metabolism, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital and School of Medicine, Tzu Chi University, Hualian, Taiwan.
Int J Clin Pract. 2013 Oct;67(10):964-70. doi: 10.1111/ijcp.12166.
Type-2 diabetes is mainly the metabolic defect involving multiple organs. To conclude their intricate relationships, the term 'ominous octet' had been proposed to denote this phenomenon. In this study, we enrolled older men without any medications for MetS components to further elucidate the relationships between normoglycaemic state and MetS.
We enrolled male subjects with FPG less than 100 mg/dl and aged 65 and older undergoing routine health check-ups in Taiwan. After excluding subjects taking medications that might affect the components of MetS, a total of 6679 men were eligible for the analysis. Study subjects were further grouped into FPG tertiles (< 91 mg/dl, 92-95 mg/dl and > 95 mg/dl for tertil 1, tertil 2 and tertil 3, respectively).
There was a significant trend between the FPG and percentages of subjects having MetS (p = 0.009). The relationships between the MetS components were higher in FPG 2 and FPG 3 than FPG 1. In simple correlation, all of the MetS and LDL-C were positively correlated with FPG level and multiple regression further confirmed the same result except for HDL-C that became non-significant. Subjects in FPG3 had significantly higher ORs (ORs = 1.19) for having MetS than those in FPG1.
In conclusion, higher FPG still had higher risk of having MetS in normoglycaemic range in elderly male. More strict FPG level control may be valuable in CVD prevention and warrants further investigations.
2 型糖尿病主要是涉及多个器官的代谢缺陷。为了总结它们之间复杂的关系，提出了“不祥八重奏”一词来表示这种现象。在本研究中，我们招募了没有服用任何药物治疗代谢综合征成分的老年男性，以进一步阐明正常血糖状态与代谢综合征之间的关系。
我们招募了 FPG 小于 100mg/dl 且年龄在 65 岁及以上的接受常规健康检查的男性受试者。排除服用可能影响代谢综合征成分的药物的受试者后，共有 6679 名男性符合分析条件。研究对象进一步分为 FPG 三分位数（<91mg/dl、92-95mg/dl 和>95mg/dl，分别为 tertil 1、tertil 2 和 tertil 3）。
FPG 与具有代谢综合征的受试者百分比之间存在显著趋势（p=0.009）。FPG2 和 FPG3 之间的代谢综合征成分之间的关系高于 FPG1。在简单相关中，所有代谢综合征和 LDL-C 与 FPG 水平呈正相关，多元回归进一步证实了除 HDL-C 外的相同结果，HDL-C 变得不显著。FPG3 的受试者发生代谢综合征的 OR（OR=1.19）明显高于 FPG1 的受试者。
总之，在老年男性中，正常血糖范围内较高的 FPG 仍然存在较高的代谢综合征风险。更严格的 FPG 水平控制可能对心血管疾病预防有价值，值得进一步研究。
