Ohlson L O, Larsson B, Björntorp P, Eriksson H, Svärdsudd K, Welin L, Tibblin G, Wilhelmsen L
Gothenburg University, Section for Preventive Medicine, Sweden.
Diabetologia. 1988 Nov;31(11):798-805. doi: 10.1007/BF00277480.
This report presents data on antecedents of Type 2 (non-insulin-dependent) diabetes mellitus in a homogeneous sample of randomly selected 54-year-old men from an urban Swedish population with a diabetes incidence of 6.1% during 13.5 years of follow-up. The increased risk leading to diabetes for those in the top quintile compared to the lowest quintile of the distribution of statistically significant risk factors were: body mass index = 21.7, triglycerides = 13.5, waist-to-hip circumference ratio = 9.6, diastolic blood pressure = 6.7, uric acid = 5.8, glutamic pyruvic transaminase = 3.9, bilirubin = 3.2, blood glucose = 2.7, lactate = 2.4 and glutamic oxaloacetic transaminase = 2.0. Those with a positive family history of diabetes had 2.4-fold higher risk for developing diabetes than those without such a history. In a multivariate analysis glutamic pyruvic transaminase, blood glucose, body mass index, bilirubin, systolic blood pressure, uric acid and a family history of diabetes were all significantly associated with the development of diabetes. Our study demonstrates the great importance of adiposity and body fat distribution for the risk of diabetes. A number of established risk factors for coronary heart disease are risk factors for diabetes as well. Disturbed liver function and increased levels of lactate are early risk factors for diabetes - presumably indicators of the presence of impaired glucose tolerance and/or hyperinsulinaemia.
本报告展示了对瑞典城市中随机抽取的54岁男性进行同类样本研究的数据,这些男性在13.5年的随访期内糖尿病发病率为6.1%。与分布中最低五分位数相比,最高五分位数中导致糖尿病的风险增加因素如下:体重指数=21.7,甘油三酯=13.5,腰臀围比=9.6,舒张压=6.7,尿酸=5.8,谷丙转氨酶=3.9,胆红素=3.2,血糖=2.7,乳酸=2.4,谷草转氨酶=2.0。有糖尿病家族史者患糖尿病的风险是无家族史者的2.4倍。在多变量分析中,谷丙转氨酶、血糖、体重指数、胆红素、收缩压、尿酸以及糖尿病家族史均与糖尿病的发生显著相关。我们的研究表明肥胖和体脂分布对糖尿病风险具有极其重要的影响。一些已确定的冠心病风险因素也是糖尿病的风险因素。肝功能紊乱和乳酸水平升高是糖尿病的早期风险因素——可能是糖耐量受损和/或高胰岛素血症存在的指标。