糖尿病与肥胖、脂质代谢

　　【摘要】目的 探讨HbA1c与MS及其组分的关系。 方法 采用多阶段分层随机整群抽样方法抽取常州市武进区年龄≥18岁居民600名进行问卷调查、体格检查和实验室检测。 结果 研究对象平均HbA1c(5.79±1.01)%。随HbA1c水平升高，中心性肥胖、血压升高、FPG升高、TG升高、HDL-C降低和MS者比例呈增高趋势[85(24.15%) vs 85(47.75) vs 46(65.71%);199(56.53) vs 122(68.54%) vs 60(85.71%);104(29.55%) vs 96(53.93%) vs 69(98.57%);90(25.57%) vs 56(31.46%) vs 41(58.57%);111(31.53%) vs 49(27.53%) vs 38(54.29%);56(15.91%) vs 63(35.39%) vs 45(64.29%)，P趋势<0.05]。Logistic多元回归分析结果显示，校正性别、年龄、文化程度、职业、吸烟和饮酒等因素的同时校正FPG升高，HbA1c水平升高仍是MS、中心性肥胖、TG升高的独立危险因素，HbA1c≥6.5%组发生MS、中心性肥胖和TG升高风险分别为HbA1c<5.7%组的3.07(OR=3.07，95%CI：1.60~5.89)、3.88(OR=3.88，95%CI：2.00~7.52)和3.26(OR=3.26，95%CI：1.50~5.78)倍。 结论 HbA1c水平与MS及其组分相关，HbA1c水平可能成为MS患病的预测指标。

　　【关键词】糖化血红蛋白;代谢综合征;相关性

　　【Abstract】Objective To investigate the relationships ofHbA1cwithMSand its components.MethodsA total of 600 rural residents aged≥18 years in Wujin district of Changzhou were enrolled by multi-stage cluster sampling method. All the participants were investigated by questionnaires, physical examination and laboratory monitoring. Results The average HbA1c level was (5.79±1.01)%.Along with HbA1ctertiles change(<5.7%,5.7%~6.4%,≥6.5%),the prevalence of central obesity, elevated blood pressure, elevated FPG, elevated TG, decreased HDL-C and MS were increased or decreased respectively as following: [85(24.15%)vs 85(47.75)vs46(65.71%)], [199(56.53)vs 122(68.54%)vs60(85.71%)];[104(29.55%)vs96(53.93%)vs 69(98.57%)];[90(25.57%)vs 56(31.46%)vs 41(58.57%)];[111(31.53%)vs49(27.53%)vs 38(54.29%)];[[56(15.91%)vs63(35.39%)vs 45(64.29%)]，(Ptrend<0.05).Multivariate logistic regression analysis showed that the risk of MS, central obesity and elevated TG were independently associated with HbA1c after adjusting for gender, age, education level, occupation, smoking, drinkingand additionally adjusting for elevated FPG. The risk of MS, central obesity and elevated TG in HbA1c≥6.5% group were 3.07 (OR=3.07, 95%CI：1.60~5.89), 3.88 (OR=3.88, 95%CI：2.00~7.52) and 3.26 (OR=3.26, 95%CI：1.50~5.78) times compare toHbA1c<5.7% group. ConclusionHbA1c level isassociated with MS and its components, and HbA1c may be a predictor of MS.

　　【Key words】Hemoglobin A1c (HbA1c);Metabolic syndrome (MS);Correlation