某職場空腹血糖異常與糖尿病發生率及其相關因素之研究

The Association between Impaired Fasting Glucose Level and the Risk of Developing Diabetes-A 10-year Follow-up of 1189 Employees of Single Hospital

陳筱筠(Hsiao-Yun Chen) ； 黃麗卿(Lee-Ching Hwang)

《台灣家庭醫學雜誌》 15卷4期 (2005/12) Pp. 191-201

https://doi.org/10.7023/TJFM.200512.0191

摘要

近年來，糖尿病的盛行率及死亡率不斷上升，造成龐大的醫療花費。國外研究顯示糖尿病前期顯著增加糖尿病及心血管疾病的發生率。故2003年美國糖尿病學會建議將正常空腹血糖定義由原本的110mg/dL調降為100md/dL，期能及早發現高危險群而能採取預防的措施。台灣於糖尿病前期之相關研究並不多。本研究的目的在研究空腹血糖異常的成人，經過10年追蹤，發生糖尿病的機率及其相關危險因子的探討。本研究以1993年某職場員工體檢為研究對象，經排除已患有糖尿病者共計1,189人，依空腹血糖值之高低分為三組（A組：小於100mg/dL, B組：100-109mg/dL及C組：110-125mg/dL），與2004年體檢資料進行比較分析。結果顯示與空腹血糖正常組（A組）比較，空腹血糖異常組（B及C組）在心血管疾病危險因子方面，如：總贍固醇、三酸甘油酯、身體質量指數及血壓值等，有較高的數值。追蹤10年間，A、B及C三組之糖尿病發生率分別為1.7%、7.1%及29.7%。經過多變項校正之後，B組及C組進展為糖尿病之相對危險性分別是2.8倍及10.2倍。如果將身體質量指數因子加入分組條件，與A組且不肥胖者相較，B組且肥胖者及C組且肥胖者發生糖尿病之相對危險性分別為6.8倍及10.1倍。由此可見，隨著空腹血糖數值升高，10年間進展為糖尿病的危險也越高，肥胖會增加此危險性，故應積極為此族群擬定健康促進計劃及治療性之生活習慣改變，以預防或延緩糖尿病的發生。

並列摘要

Diabetes is a costly and burdensome chronic disease of our time. The incidence and mortality of diabetes are increasing at an alarming rate. Evidence showed that at glucose levels above normal but below the threshold diagnostic for diabetes, there is a substantially increased risk of developing diabetes, as well as cardiovascular disease and mortality. The American Diabetes Association recommended that the fasting plasma glucose criterion be lowered for the diagnosis of impaired fasting glucose from 110 to 100 mg/dL. Little is known about the pre-diabetes in Taiwan. The purpose of this study was to assess the association between impaired fasting glucose level and the risk of developing diabetes.
The health examination data were collected from 1212 employees of a hospital in 1993. After excluding the subjects with diabetes, the remaining subjects were divided into 3 groups according to their fasting plasma glucose (FPG) level. (Group A: FPG＜100 mg/dL, Group B: 100-109 mg/dL and Group C: 110-125 mg/dL). The health examination data were followed up in these same subjects in 2004.
The results of this data indicated that subjects in group B and C had more cardiovascular disease risk factors when compared to subjects in Group A. These risk factors included a higher level of cholesterol, triglyceride, body mass index and blood pressure levels. After 10 years of follow-up, the risk of developing diabetes was 1.7, 7.1 and 29.7% respectively for the subjects of Group A, B and C. In comparison with the subjects in Group A, the hazard ratio of the occurrence of diabetes was 2.8 for the subjects in Group B, and 10.2 for the subjects in Group C. In comparison with subjects with BMI＜25 in Group A, the hazard ratios of the occurrence of diabetes was 6.8 for the subjects with BMI≥25 in Group B, and 10.1 for the subjects with BMI≥25 in Group C.
Statistically speaking, FPG of 100-125mg/dL is associated with increased risk of developing diabetes in 10 years. Obesity also has an important role for developing diabetes. Intensive life style intervention programs can prevent or delay the onset of diabetes in the high risk groups.

並列關鍵字

pre-diabetes ； diabetes ； fasting plasma glucose ； body mass index

參考文獻

Chou P,Liao M J,Kuo HS(1994).A population survey on the prevalence of diabetes in Kin-Ru, Kinmen.Diabetes Care.17,1055-1058.

American Diabetes Association(2004).Screening for type 2 diabetes.Diabetes Care.27(Suppl),11-14.

Accessed online

行政院衛生署衛生統計資訊網

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