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輔仁醫學期刊

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篇名 Prediction of impaired fasting glucose: a retrospective cohort study
卷期 15:4
並列篇名 預測空腹血糖異常變化的危險因子:回溯性世代研究
作者 蔡亮如吳逸帆郭冠良戴逸昇林光洋
頁次 179-190
關鍵字 Impaired fasting glucoseprediabetesoverweightobesityhypertensionand alcohol consumption空腹血糖異常糖尿病前期過重肥胖高血壓飲酒
出刊日期 201712
DOI 10.3966/181020932017121504002

中文摘要

背景:空腹血糖異常為糖尿病前期狀態。空腹血糖異常的人相較於空腹血糖正常 的人有5 至7 倍發生糖尿病的危險性。同時,空腹血糖異常的人也有比較高的機會發 生不良心血管疾病及腦血管疾病。研究目的:本研究目的在使用常見的健檢數據來預 測空腹血糖正常者變成空腹血糖耐受不良的危險因子。研究方法:本研究採取回溯性 世代研究(retrospective cohort study),研究族群為1018 位於2003 年至2013 年於台 北市立聯合醫院仁愛院區健康中心至少接受過2 次健康檢查者。選取第一次血糖值正 常,並且排除已診斷糖尿病或服用降血糖藥物者,觀察五年內其各年之血糖變化。利 用比較在追蹤過程中發生空腹血糖異常者與血糖持續正常者其第一次受檢時的身高、 體重、身體質量指數、血脂肪、膽固醇、尿酸、超音波發現、抽菸與否、喝酒與否是 否有所差異。利用Cox proportional hazard model 評估出現空腹血糖異常的危險性。 研究結果:平均追蹤時間為36 個月。共有209 人(20.5%)發生空腹血糖異常。發生 空腹血糖的中位數時間為24 個月(IQR, 12–48 months)。年紀≧ 45 歲(HR=2.04, p <0.001),體重過重(HR=1.46, p=0.023)或肥胖(HR=1.83, p=0.004),血壓較高或 是高血壓患者(HR =1.58, p=0.003),規律飲酒習慣(HR=2.145, p=0.049)以及第一 次空腹血糖值超過90 mg/dL(HR =2.01, p<0.001)為預測空腹血糖異常的獨立危險因 子。有超過2 個上述危險因子者較具有0 個或1 個危險因子者更早並且更多發展出空 腹血糖異常(5-year IFG-free survival rate, 60% vs. 88%, p< 0.001). 結論:年紀、身體 質量指數,血壓,隨機空腹血糖測試值以及酒精的飲用狀況為辨認空腹血糖異常高危 險因子的可行方式,同時也凸顯空腹血糖高危險群者運動、密集血壓控制與減少酒精 使用的重要性。

英文摘要

Background: Impaired fasting glucose (IFG) is a condition of prediabetes. People with IFG have a 5- to 7-fold higher risk of diabetes mellitus than those with normoglycemia. People with prediabetes have higher risk of experiencing an adverse cardiovascular event and stroke. Objectives: The study investigates the risk factors of developing IFG. Methods: 1,018 participants receiving ≥2 health checkups were enrolled between 2003 and 2013. Clinical characteristics were obtained for the analysis of progression from normoglycemia to IFG. We used a Cox proportional hazard model to evaluate the risk of an IFG status. Results: The median follow-up period was 36 months. Two hundred nine people (20.5%) progressed to an IFG status with a median interval of 24 months (interquartile range, 12–48 months). Age ≥45 years old (hazard ratio [HR] = 2.04, p < 0.001), overweight (HR = 1.46, p = 0.023) or obesity (HR = 1.83, p = 0.004), elevated blood pressure (BP)/hypertension (HR = 1.58, p = 0.003), regular alcohol consumption (HR = 2.145, p = 0.049), and initial fasting blood glucose (FBG) levels above 90 mg/dl (HR = 2.01, p < 0.001) were independent risk factors predicting progression to IFG. People with ≥2 high-risk factors developed IFG earlier and more frequently than those with no or only one risk factor (5-year IFG-free survival rate, 60% vs. 88%, p < 0.001). Conclusions: Age, body mass index, BP, random FBG sampling, and alcohol drinking status are feasible screening items to identify people with have a higher risk of developing IFG, which underscores the need for exercise, intensive BP control, and alcohol cessation in high-risk people. Keywords: Impaired fasting glucose,

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