Research On Natural Sequelae Of Different Glycometabolism Statuses Groups And Risk Factors Of Death

Purpose:To analyze natural sequelae of people with different glycometabolism status and risk factors of death. Method:The middle and old aged groups were engaged in the epidemiology research conducted in 2004 in Shijing Mountain area in Beijing as research object.75g OGTT experiment was conducted on groups not diagnosed as type 2 diabetes. For people who didn't reach the the diagnostic criteria of diabetes, glycometabolism status were defined as NGT, IFG1, IFG2, IGT and IFG/IGT in accordance with the ADA standard of diagnosis in 2003. These group of people were followed up from April to June in 2008 and April to June in 2010. The changing trends of the major metabolic indexes after the two visits, the sequelae of groups with different glycometabolism status, and factors affecting NGT and IGR sequelae were all compared. Risk factors of death were analyzed according to different glucose level. Targeting diabetic patients under observation, analysis was also conducted on course of disease, reason of death and whether the heart and cerebrovascular events were related. Moreover, natural transformation rate, cause of death and cardiovascular and cerebrovascular occurrence of groups with different glycometabolism statuses were counted. Results:The yearly transformation rate of DM for all non-diabetic groups was 1.9%, and that of the NGT group when developed into DM wasl.01%; the yearly transformation rate of the IGR group was 3.76%. The order of transformation rate between groups, from high to low was:IFG/IGT(6.14%)>IFG2(4.17%)>IGT(2.93 %)>IFG1(2.86%)>NGT(1.01%). Take the relative risk of NGT developing into DM as 1, the risk of groups IFG1, IFG2, IGT and IFG/IGT rises by 1.8,3.10,1.88 and 5.04 times, respectively. After adjusted baseline age, waistline, WHR, BMI, SBP, DBP, FPG, 2hPG, TC, TG, UA and HDL-C, it was showed that waistline, FPG,2HPG and UA were the mainly risk factors for NGT to transform into IGR or DM. For waistline, OR=1.035 (95%CI:1.008-1.062); FPG OR=9.684 (95%CI:4.365-21.485); 2HPG OR =1.663 (95%CI:1.343-2.057); UAOR=1.003 (95%CI:1.000-1.006). The risk factors for IGR to transform into T2DM are waistline, FPG and 2HPG, with waistline OR=1.039 (95%CI is:1.009-1.070); FPG OR=2.500 (95%CI is:1.381-4.524); 2HPG OR=1.368 (95%CI is:1.123-1.667). During the visits, a total of 131 people died, including 40 died of heart disease, taking up 30.54%of the number of deaths; 11 died of cerebrovascular disease, taking up 8.40%; 43 died of cancer, taking up 32.82%; 37 died of other reasons, taking up 28.24%of the total. Age, smoking and serum creatinine level are risk factors of both all groups and all non-diabetic groups. Age, smoking and FPG are risk factors of diabetic group.Conclusion:FPG and 2HPG are both factors predicting worsening of glycometabolism in NGT and IGR groups. The predicting ability of 2HPG grows as time goes. Smoking status and renal function are risk factors of death in community.