| Objective To study the prevalence and clinical characteristics of individuals with NGT-HINS,surveys were conducted among individuals in three different communities in Beijing.Methods The data of routine clinical examination were collected from three different groups:①Subjects who received annual oral glucose tolerance test(OGTT)for diabetes screening in May,2006 in a community in Beijing(group A).②The mid-aged and senile individuals who received OGTT for diabetes screening in PLA General hospital in May, 2005～2007(group B).③The mid-aged and aged crowds living in Beijing who received OGTT for diabetes screening in June,2004(group C).All subjects were investigated,and received 75g oral glucose tolerance test(OGTT).HINS was determined if fasting serum insulin≥15mU/L(F-HINS)and/or 2-hour serum insulin after glucose burdening≥80mU/L(2h-HINS).Glucose metabolic disorders were determined according to WHO definition(1999).Metabolic syndrome and its related risk factors were determined according to IDF criteria (2005).Data were collected by a specialized person and analyzed with SPSS 13.0 software.Results①The prevalence of NGT-HINS of the three groups were 5.28%(group A),9.13%(group B)and 8.82%(group C),that of glucose metabolic disorder was 10.1%(group A),58.5%(group B),35.5%(group C).②The prevalence of metabolic risk factors in individuals with NGT-HINS in either group was much higher than individuals with NGT-NINS(P＜0.01),but there was no difference between individuals with NGT-HINS and IGR(P＞0.05)in either group.③In the subjects with NGT-H1NS,the prevalence of individuals with 2h-HINS suffered from metabolic risk factors was similar to individuals with F-HINS.However,the quantity of individuals with 2h-HINS was much more than F-HINS in either group.④Logistic regression analysis showed that FPG,2hPG, TG,HDL were the risk factors that resulted in HINS,and WC and BMI were the possible related factors.Conclusions The number of individuals with both NGT and metabolic risk factors increased remarkably when HINS was diagnosed,while there was hardly any difference between individuals with IGR and NGT-HINS. Therefore individuals with NGT-HINS should be intervened early.2h-HINS had equal importance in evaluating insulin resistance compared to F-HINS because of suffering similar metabolic risk factors.Hyperglycemia and dyslipidemia were also risk factors that resulted in HINS. Objective To study the outcomes and its influencing factors of the conversion from individuals with NGT-HINS to T2DM in a community in Beijing.Methods Subjects who were received annual oral glucose tolerance test(OGTT)for diabetes screening in May,2006 were re-investigated in April,2008.The data were calculated to analyze its outcomes and influencing factors.The study methods are similar to the former section.Results①1022 subjects received OGTT for diabetes screening at baseline,among whom 652 were investigated again two years later.The prevalence ofT2DM,IGR,NGT-HINS at baseline were 2.91%,5.83%,6.60%,and that were 4.75%,8.13%,8.74%,respectively when followed up.The prevalence of glucose metabolic disorders increased(P＜0.05).②The probability of the conversion from NGT-HINS to glucose metabolic disorders was 20.9%,which was much higher than that of the conversion from NGT-NINS(6.16%,P＜0.01).The reason might be that individuals with NGT-HINS suffered more metabolic risk factors than individuals with NGT-NINS, not only at baseline but in the follow-up.But the probability of the conversion from NGT-HINS to DM was 2.33%,which was much lower than the conversion from IGR(26.3%,P＜0.01).Individuals with IGR suffered hyperglycemia and hypertension not only at baseline but in the follow-up might contribute to it.③In the subjects with NGT-HINS,the probability of the conversion from individuals with 2h-HINS to glucose metabolic disorders was 20.7%,which was similar to the corresponding figure(14.3%)of the individuals with F-HINS (P＞0.05).Since the number of individuals with 2h-HINS was much more than F-HINS,the individuals of the conversion from 2hHINS to glucose metabolic disorders would be much more than that from F-HINS.④23 volunteers received a hyperinsulinemic-euglycemic clamp technique.The glucose infusion rate of them was much lower than normal(P＜0.01),that of 2h-HINS group was similar to F-HINS group(P＞0.05).⑤Logistic regression analysis showed that Age,FPG and TG were the major influencing factors of the conversion from NGT to glucose metabolic disorders.Conclusions The probability of the conversion to glucose metabolic disorders in two years' time was increased in the community in Beijing.The conversion from NGT to T2DM increased remarkably when HINS was diagnosed.So individuals with NGT-HINS should be intervened early also because of the lower glucose infusion rate than normal.According to the conversion and the glucose infusion rate,2h-HINS had equal importance in evaluating insulin resistance compared to F-HINS.Age,FPG and TG were the major influencing factors of the conversion from NGT to T2DM. |
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