The Research On The Risk Factors For Dalian Population Of Normal Glucose Tolerance Progressing To Impaired Glucose Tolerance

Objective:To investigate the risk factors of impaired glucose tolerance in normal glucose tolerance of Dalian residents.Methods:The samples were derived from the REACTION study,initiated by the Chinese Medical Association from August 2011 to December 2011.5231 participants without diabetes,and OGTT confirmed NGT,whose data were complete were selected as the subjects of this study.Questionnaire surveys were conducted on personal histories such as age,gender,smoking,drinking,and family history.Height,weight,waist circumference,systolic blood pressure and diastolic blood pressure were measured.HbA₁c,fasting insulin and OGTT were measured.Triglycerides,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,alanine transaminase,aspartate aminotransferase,serum creatinine,urine protein,blood uric acid and other biochemical indicators were measured.Body mass index,Ratio of waist circumference to height,insulin resistance index,islet beta cell function,urinary protein and creatinine ratio were calculated.Follow-up was conducted between July 2014 and December 2014.The follow-up rate was 91%.Subjects with incomplete data were excluded.Finally,2679 subjects were included in the study analysis.According to the age,subjects were divided into five groups:age<45,age≥45-<55,age≥55-<65,age≥65-<75 and age≥75 years old.According to the average systolic blood,subjects were divided into five groups:average systolic blood<120,average systolic blood≥120-<140,average systolic blood≥140-<160,average systolic blood≥160-<180 and average systolic blood≥180mmHg.According to the average diastolic pressure,subjects were divided into five groups:average diastolic pressure blood<80,average diastolic pressure blood≥80-<90,average diastolic pressure blood≥90-<100,average diastolic pressure blood≥100-<110 and average diastolic pressure blood≥110mmHg.According to the BMI,subjects were divided into five groups:BMI<18.5,BMI≥18.5-<24,BMI≥24-<28and BMI≥28 points.The other data were divided into four groups by quartiles.Comparing of the incidence of IGT among the above indicators groups.Analyzing the correlation between various factors and IGT.Binary logistic regression analysis were performed to analyse each factor.ROC curve analysis was used to analyze the best cut-off point of risk factors of predicting IGT.Result:1.Comparing the incidence of IGT of HbA_lc,FPG,2hPG,FINS,HOMA-β,HOMA-IR,SBP,DBP,TG,TC,LDL-C,HDL-C,ALT,AST,Scr,UA,UACR,BMI,WHtR and Age showed that among the above indicators,HbA_lc（χ²=40.925,P=0.000）,FPG（χ²=52.901,P=0.000）,2hPG（χ²=86.489,P=0.000）,FINS（χ²=30.341,P=0.000）,HOMA-IR（χ²=33.053,P=0.000）,SBP（χ²=36.666,P=0.000）,TG（χ²=40.216,P=0.000）,WHtR（χ²=30.131 P=0.000）,BMI（χ²=21.453,P=0.000）and Age（χ²=14.715,P=0.005）have statistically significant differences in the incidence of IGT between groups.With the increasing of the above indicators,the incidence of IGT was gradually increasing.2.Spearman correlation analysis was performed on 2hPG,FPG,HbA₁c,HOMA-IR,TG,SBP,WHtR,FINS,BMI and Age.The results showed that the occurrence of IGT was positively correlated with the above indicators（r=0.506,r=0.478,r=0.449,r=0.372,r=0.358,r=0.341,r=0.185,r=0.184,r=0.149,r=0.121,P<0.05）.3.Substituting the above indicators into the binary logistic regression equation,the results showed that the risk factors of IGT were mainly HbA₁c（OR 2.562,95%CI1.812-3.364,P<0.01）,2hPG（OR 1.651,95%CI 1.231-2.251,P<0.01）,FPG（OR1.531,95%CI 1.043-1.924,P<0.01）,HOMA-IR（OR 1.421,95%CI 1.033-1.663,P<0.05）,TG（OR 1.342,95%CI 1.042-1.613,P<0.01）,SBP（OR 1.321,95%CI1.052-1.611,P<0.01）and age（OR 1.182,95%CI 1.031-1.484,P<0.01）.4.ROC curve analysis was used to analyze the best cut-off point of risk factors of predicting IGT.The results shows that the best cut-point values of HbA_lc is 5.4%（AUC 0.607,sensitivity 77.1%,specificity 38.7%）,and the best cut-point values of FPG is 5.2 mmol/L（AUC is 0.624,sensitivity is 70.5%,specificity is 48.4%）.Conclusion:1.According with the increasing of HbA_lc,2hPG,FPG,HOMA-IR,BMI,TG,SBP,Age,WHtR and FINS,the incidence of IGT is gradually increasing in Normal Glucose Tolerance of Dalian Residents.2.HbA_lc,2hPG,FPG,HOMA-IR,TG,SBP and Age are independent risk factors for IGT.3.The best cut-point value of HbAlc and FPG to predict IGT are HbAlc 5.4%,FPG 5.2mmol/L respectively.