AIMS:Prediabetes affects 35% of Chinese adults and is associated with increased risks of cardiovascular disease and mortality. However, findings are inconsistent on the effects of lifestyle and pharmacological interventions in the prediabetes population achieving remission. This analysis aimed to compare the effects of metformin plus lifestyle intervention versus lifestyle intervention alone for prediabetes remission. MATERIALS AND METHODS:This was a secondary analysis of the China Diabetes Prevention Program (CDPP), a multicentre unblinded randomised controlled trial of 1678 participants aged 18-70 years with impaired glucose regulation from 43 hospitals across China (NCT03441750). Participants were randomly assigned (1:1) using block randomisation stratified by glucose status (impaired fasting glucose or impaired glucose tolerance), presence of hypertension and use of anti-hypertensive medication. They received either metformin plus lifestyle intervention or lifestyle intervention alone for 2 years. The primary outcome was prediabetes remission rate. RESULTS:During a median follow-up of 2.03 years, remission was achieved in 262/831 (31.5%) (138/396 men; 124/435 women) participants in the metformin plus lifestyle group versus 213/847 (25.1%) (106/397 men; 107/450 women) in the lifestyle alone group, with similar effects across subgroups. After adjusting for baseline characteristics, addition of metformin increased the rate of remission (HR 1.39, 95% CI 1.16-1.67, p < 0.001). Higher baseline HbA1c was associated with lower remission rates (HR 0.23, 95% CI 0.18-0.29, p < 0.001). CONCLUSIONS:Adding metformin to a lifestyle intervention significantly improved prediabetes remission rates over lifestyle intervention alone in Chinese adults with impaired glucose regulation. This may be an effective approach for prediabetes management.

目的:探讨社区非糖尿病人群代谢综合征(MS)与糖化血红蛋白关系.方法:采取分层整群随机抽样方法对1 283名年龄20岁以上南昌社区常住居民(排除糖尿病患者)进行问卷调查、体格检查和实验室检查,依次检测空腹血糖(FBG)、餐后2 h血糖(2hPG)、血脂、糖化血红蛋白(HbA1c),依据中华医学会糖尿病学分会诊断标准(CDS)计算MS的患病率.结果:按CDS诊断标准,社区非糖尿病人群MS的患病率为11％,且随年龄增长而增高,最高患病率出现在60～69岁年龄之间,但70岁以后MS患病率则是下降趋势,HbA1c为5.85％时对MS存在的预测值最大,敏感度为0.533,特异度为0.78,AOC值为0.709,可提示MS的存在.结论:对于社区非糖尿病人群,当检测到HbA1c＞5.85％,提示MS的存在.

目的:通过医疗失效模式与效应分析(HFMEA)优化麻醉苏醒室内全身麻醉病人术后去氧饱和干预流程,并分析其应用效果.方法:选取2021年6月—2021年12月我院麻醉苏醒室的616例全身麻醉病人为对照组,2022年1月—2022年7月我院麻醉苏醒室的 616 例全身麻醉病人为试验组.对照组采用麻醉苏醒室内全身麻醉病人术后去氧饱和常规护理方法,试验组实施基于HFMEA模式的麻醉苏醒室内全身麻醉病人术后去氧饱和干预优化流程.比较两组病人去氧饱和发生率、二次插管发生率、风险优先数值(RPN)及动脉血氧分压(PaO2).结果:实施基于HFMEA模式的麻醉苏醒室内全身麻醉病人术后去氧饱和干预优化流程后病人RPN由高风险降为低风险,试验组去氧饱和发生率为 5.36％,二次插管率为 0.49％,均低于对照组(去氧饱和发生率为23.38％,二次插管率为2.27％);试验组PaO2为(88.11±6.91)mmHg,高于对照组[(84.62±11.58)mmHg],差异均有统计学意义(P<0.05).结论:实施基于HFMEA模式的麻醉苏醒室内全身麻醉病人术后去氧饱和干预优化流程可以降低去氧饱和的发生.

目的:梳理和总结腕踝针国内外研究脉络、热点、发展趋势,为今后研究者提供依据及可行性建议.方法:国内文献以中国知网(CNKI)、万方数据库、维普为数据来源,分析纳入文献年度发文量、高频被引文献;国外文献通过检索Web of Science获取相关文献,检索时限均为自建库至2022年2月18日腕踝针相关文献.应用VOSviewer软件和CiteSpace软件进行高频关键词分析、关键词共现聚类分析和关键词时间序列分析,绘制相关关键词、文献作者、发文机构的知识图谱等,并行可视化分析.结果:国内文献共纳入685篇,国外文献共纳入19篇,涉及作者598名,其中核心作者11名,涉及研究机构416所,涉及关键词535个,形成18个具有代表性的聚类.结论:目前腕踝针研究热点集中于腕踝针的临床研究,在针刺疗法、护理及疼痛领域的运用是今后研究的发展趋势.

Objective: To compare the risk of osteoporotic fractures between the urban and urban-rural fringe populations in southern China and to explore the effect of bone turnover markers on fracture risk.Methods: Epidemiological investigations were conducted in the urban and urban-rural fringe areas of southern China in June 2018. Residents aged 40 years and over who signed informed consent forms were included. Physical examination and questionnaire collection were completed. Bone turnover markers (BTMs) including osteocalcin (OC) and beta cross-linked C-telopeptide of type 1 collagen (β-CTX) were tested. Bone mineral density (BMD) of the femoral neck and lumbar vertebrae 1–4 were measured using dual energy X-ray absorptiometry. Fracture risk assessment tool (FRAX) values were calculated to show the probability of major osteoporotic fracture (PMOF) and probability of hip fracture (PHF) over the next 10 years.Results: A total of 1,051 participants were included in this study, including 553 in the urban areas and 498 in the urban-rural fringe areas. The average PMOF and PHF were 3.4 (2.3–5.4) % and .6 (.3–1.5) %, respectively. Compared with that in the urban populations, the femoral neck BMD in the urban-rural fringe populations was lower and FRAX values were generally higher, especially for women. FRAX values in various populations were mainly negatively correlated with lumbar and femoral neck BMD and were positively correlated with β-CTX; meanwhile, only PHF was negatively correlated with OC. After adjusting for sex, elevated β-CTX levels significantly increased the risk of high PMOF in various populations and increased the risk of high PHF in the urban-rural fringe populations. In particular, the risks of increased PMOF and PHF could increase by as much as 33 times and 19.5 times, respectively, in the urban-rural fringe areas.Conclusion: The urban-rural fringe populations in Southern China may be at risk of osteoporotic fracture. In addition to being related to BMD, the FRAX value also correlates with some BTMs. Combining FRAX with BMD, and BTMs may better predict the fracture risk.

Background Low levels of Free Triiodothyronine (FT3) are associated with poor survival in chronic kidney disease, and the aim of this study was to further assess the relationship between changes in FT3 levels and renal damage in patients with type 2 diabetes based on glomerular and tubular markers. Methods We retrospectively studied 452 type 2 diabetic patients, measured glomerular damage markers (UACR, eGFR) and tubular damage markers (NAG/Cr,β2-MG), analyzed the relationship between FT3 and renal damage by logistic regression models, and plotted restrictive cubic splines. Results 41.6% of subjects had diabetic kidney disease (DKD), and the prevalence of DKD decreased progressively with increasing FT3 levels in the third quartile. Spearman correlation analysis showed that FT3 was negatively associated with UACR, NAG/Cr and β2-MG, while eGFR was positively associated with FT3. Multifactorial analysis, after adjusting for relevant confounders, revealed that compared with the lowest quartile of FT3, the highest quartile reduced the risk of developing urinary albumin (OR = 0.499,95% CI:0.289–0.856), moderate to severe impairment of glomerular filtration rate (OR = 0.106,95% CI:0.032–0.354), renal tubular marker β2 -MG positive (OR = 0.516,95% CI:0.299 to 0.883) and the risk of DKD occurrence (OR = 0.450,95% CI:0.260 to 0.774). In the sample model, FT3 levels below 4.39 pmol/L were associated with an increased risk of glomerular tubule injury and DKD occurrence. Conclusions FT3 is closely associated with glomerular tubular injury and is a protective factor. As FT3 levels (< 4.39 pmol/L) decrease, the risk of developing DKD becomes higher, and FT3 can be used as an independent predictor of developing DKD.

目的 综述医疗失效模式与效应分析在规范护理工作流程的应用进展,为其在其他护理领域的应用提供参考.方法 检索国内外相关文献,从发展背景、实施步骤及其在规范化护理工作流程中的应用现状进行总结归纳和分析.结果 医疗失效模式与效应分析有利于护理工作流程的规范化构建,但在应用时会面临研究小组组建不规范、风险优先值评分主观化等问题.结论 以医疗失效模式与效应分析为理论框架构建的规范化护理工作流程,是一种可降低风险因素发生,保障患者安全的有效方法.未来应加强对其深入研究,制定精简、规范的研究步骤,开展多学科、多理论的联合应用,以加速推动其在复杂临床环境中构建规范化护理流程的应用进展.

Subsequently to the publication of this paper, an interested reader drew to the authors' attention that, in the wound‑healing assays portrayed in Fig. 2A on p. 6692, in the 0 h row, the 'NG + LI' and 'HG + HI' panels contained overlapping data, such that they appeared to have been derived from the same original source. After having examined their original data, the authors have realized that this figure was inadvertently assembled incorrectly. The corrected version of Fig. 2. showing the correct data for the 'HG + HI' panel, is shown on the next page. Note that this error did not significantly affect the results or the conclusions reported in this paper, and all the authors agree with the publication of this Corrigendum. Furthermore, the authors apologize to the readership for any inconvenience caused. [Molecular Medicine Reports 16: 6690‑6696, 2017; DOI: 10.3892/mmr.2017.7420].

Objective: To analyze the correlation between serum osteoprotegerin (OPG) level and chronic kidney disease (CKD) at different CKD stages in patients with type 2 diabetes. Methods: All subjects were hospitalized patients with type 2 diabetes. Medical history collection, physical examinations, and blood and urine samples testing were performed. Stages of CKD (G1-5) were defined by eGFR, groups of persistent albuminuria (normal, microalbuminuria and massive albuminuria) were divided by UACR, and categories of CKD progression risks (low, moderate and high or very high risk) were recommended by the Kidney Disease: Improving Global Outcomes (KDIGO). Serum OPG level was determined by enzyme-linked immunosorbent assay in the central laboratory. Results: Four hundred and eighty-four patients were included in the study. The average level of OPG of all subjects was 941.30 (547.53-1332.62) pg/mL. The levels of OPG decreased gradually with the aggravation of albuminuria (P = 0.007, P for trend=0.003) and CKD progression (P = 0.001, P for trend=0.001). No differences were found between OPG levels and stages of CKD (P = 0.31). After the adjustment, each 100 pg/mL increase in OPG levels could reduce the risk of massive albuminuria (OR 0.92, 95% CI 0.86-0.99, P = 0.02) and the high or very high risk of CKD progression (OR 0.94, 95% CI 0.89-0.99, P = 0.04) by multivariate logistic regression analysis. No correlations were found between OPG and stages of CKD. Conclusion: In patients with type 2 diabetes, elevated serum osteoprotegerin is associated with albuminuria and the risk of CKD progression, and may delay the progression of CKD.

Objective: We investigated the relationship between thyroid hormones and the risk of diabetic kidney disease (DKD) progression. Methods: A total of 452 patients with type 2 diabetes were included, and a cross-sec-tional analysis was performed. Urine albumin/creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) were used to diagnose persistent albuminuria and stage chronic kidney disease, respectively. The Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline was used to describe the risk of DKD progression (low, moderate, and high or very high risks). Results: The DKD group had higher levels of thyroid-stimulating hormone (TSH) and lower levels of free triiodothyronine (FT 3 ) and free thyroxine (FT 4 ) than the non-DKD group. The prevalence of thyroid dysfunction in the DKD group was significantly higher than in the non-DKD group, especially the prevalence of subclinical hypothyroidism. FT 3 levels decreased gradually with the deterioration of DKD. TSH levels increased with an increasing KDIGO category. FT 3 and FT 4 levels were negatively correlated with serum creatinine levels and ACR, and positively correlated with eGFR. Contrastingly, TSH was positively correlated with ACR, and negatively correlated with eGFR. After adjustment, an increase in FT 3 levels significantly reduced the risk of DKD [odds ratio, OR (95% confidence interval, CI)=0.58 (0.42–0.79)] and DKD progression [ORs (95% CIs)=0.65 (0.45–0.93) for the moderate risk group and 0.50 (0.33–0.74) for the high or very high-risk group, using the low-risk group as a reference]. FT 3 levels below 4.30 pmol/L in men and 3.99 pmol/L in women were the cut-off points for an increased risk of DKD progression. Conclusion: Low FT 3 level is an independent risk factor for DKD and DKD progression. FT 3 ≤4.30 pmol/L in men and ≤3.99 pmol/L in women will greatly increase the risk of kidney disease progression in patients with type 2 diabetes. LDL-C, low-density lipoprotein cholesterol; FT 3 , free triiodothyronine; FT 4 , free thyroxine; TSH, thyroid-stimulating hormone.

目的 探讨医护人员在隔离病房佩戴护目镜,采取6种护目镜防雾方法的临床应用效果.方法 A组使用碘伏、B组使用泳镜防雾剂、C组使用防雾酒精湿巾、D组使用洗手液、E组使用洗手液+防雾酒精湿巾、F组使用干燥剂,每组由30名医护人员完成试验,观察每组预处理的时间,工作1h、2h、3h、4h后护目镜起雾情况.结果 F组预处理时间最短,D组最长(P<0.01).2h、3h起雾最多组为B组(P<0.01).4h起雾最多组为B组,F组、A组次之;起雾最少的为D组和E组(P<0.01).在3h时,洗手液与防雾酒精湿巾比较,使起雾的风险减低了66.67％;洗手液与防雾酒精湿巾比较,使起雾的发生率减低了4％;洗手液防雾法与防雾酒精湿巾法或干燥剂法比较,每25人中,会有1人受益.结论 E组洗手液+防雾酒精湿巾法在6组中预处理时间较短,起雾最少,建议将此方法用于隔离病房中防雾的医用护目镜.

OBJECTIVE:We investigated the relationship between thyroid hormones and the risk of diabetic kidney disease (DKD) progression. METHODS:A total of 452 patients with type 2 diabetes were included, and a cross-sectional analysis was performed. Urine albumin/creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) were used to diagnose persistent albuminuria and stage chronic kidney disease, respectively. The Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline was used to describe the risk of DKD progression (low, moderate, and high or very high risks). RESULTS:The DKD group had higher levels of thyroid-stimulating hormone (TSH) and lower levels of free triiodothyronine (FT3) and free thyroxine (FT4) than the non-DKD group. The prevalence of thyroid dysfunction in the DKD group was significantly higher than in the non-DKD group, especially the prevalence of subclinical hypothyroidism. FT3 levels decreased gradually with the deterioration of DKD. TSH levels increased with an increasing KDIGO category. FT3 and FT4 levels were negatively correlated with serum creatinine levels and ACR, and positively correlated with eGFR. Contrastingly, TSH was positively correlated with ACR, and negatively correlated with eGFR. After adjustment, an increase in FT3 levels significantly reduced the risk of DKD [odds ratio, OR (95% confidence interval, CI)=0.58 (0.42-0.79)] and DKD progression [ORs (95% CIs)=0.65 (0.45-0.93) for the moderate risk group and 0.50 (0.33-0.74) for the high or very high-risk group, using the low-risk group as a reference]. FT3 levels below 4.30 pmol/L in men and 3.99 pmol/L in women were the cut-off points for an increased risk of DKD progression. CONCLUSION:Low FT3 level is an independent risk factor for DKD and DKD progression. FT3 ≤4.30 pmol/L in men and ≤3.99 pmol/L in women will greatly increase the risk of kidney disease progression in patients with type 2 diabetes.

Objective:To investigate the relationship between Chinese visceral adiposity index (CVAI) and abnormal glucose metabolism among residents of Jiangxi province.Methods:This study was based on the survey results of adult chronic diseases and their risk factors in Jiangxi province in 2018.Multivariate logistic regression analysis was used to analyze the relationship between different genders, different CVAI levels (quartile grouping) and prediabetes and diabetes. Results:There were 2 996 patients in the normal glucose tolerance group, 1 097 patients in the pre-diabetes group, and 697 patients in the diabetes group. In the 3 groups, there was a statistically significant difference in the distribution of abnormal glucose metabolism among residents of different CVAI level groups ( P<0.001), and the pre-diabetes and diabetes prevalence rates both increased with the increase of CVAI, and the increase in women was more obvious than that of men. The results of multivariate logistic regression analysis showed that with the increase of CVAI level, the pre-diabetes and diabetes prevalence rates also increased (all P<0.05). After adjusting for age, CVAI was still significantly correlated with glucose metabolism status, and male CVAI was the highest in the comparison with the lowest quartile, the OR (95% CI) of prediabetes and diabetes were 2.40(1.66-3.46) and 2.76(1.83-4.16), respectively; In the comparison between the highest and lowest quartile of female CVAI, the OR (95% CI) of prediabetes and diabetes were 4.81 (3.45-6.72) and 7.38 (4.84-11.26), respectively, and the differences were statistically significant (all P<0.05); After correcting for related confounding factors, the comparison between the highest and lowest quartile of female CVAI, the OR of prediabetes and diabetes (95% CI) were 2.23(1.14-4.38) and 3.87 (1.73-8.61), respectively, the differences were statistically significant(all P<0.05). Conclusion:CVAI is closely related to abnormal blood glucose metabolism, and it is more significant in women than men. The greater the CVAI value, the higher the risk of pre-diabetes and diabetes, and it has important clinical value for the prevention and diagnosis of abnormal glucose metabolism.

目的 评价金天格胶囊(主要成分为人工虎骨粉)治疗原发性骨质疏松症的临床疗效和安全性.方法 采用前瞻性分层区组随机方法、双盲双模拟、阳性药平行对照临床研究方法,纳入11家医院471例原发性骨质疏松受试者,以3:1比例随机分配至试验组和对照组,其中试验组356例,对照组115例.试验组口服金天格胶囊1.2g/次,3次/d,骨疏康胶囊模拟剂1.28 g/次,2次/d;对照组口服金天格胶囊模拟剂1.2g/次,3次/d,骨疏康胶囊1.28 g/次,2次/d.两组用药疗程均为24周,干预48周电话随访.干预12周和24周分别评价中医证候积分,以其作为主要结局指标并评价临床疗效;以疼痛VAS评分、单项症状评分和骨密度指改善情况作为次要结局指标.安全性评价包括试验期间骨折发生率,血常规、尿常规、便常规、肝肾功能、心电图等安生性指标.结果 ①试验组12周的总有效率为64.61％ (230/356),高于对照组的总有效率50.44％ (58/115),差异有统计学意义(x2 =11.580,P=0.000);试验组24周的总有效率为84.55％(301/356),高于对照组的总有效率71.30％ (82/115),差异有统计学意义(x2=13.114,P=0.000);(②两组24周的中医症状积分均较治疗前降低,差异有统计学意义(W=-26 974.5,2 775.00;P=0.000,0.000);试验组24周中医症状积分较基线下降的差值大于对照组的差值,差异有统计学意义(Z=2.656,P=0.008);③试验组24周腰背疼痛、腰膝酸软无力症状改善优于对照组(x2 =9.940,x2=10.004;P =0.002,P=0.002),两组24周下肢抽筋、步履艰难和持重困难症状改善差异无统计学意义(x2=1.501,x2=3.035,x2=0.619;P =0.221,P=0.082,P=0.432);④试验组24周疼痛VAS评分明显低于对照组,差异有统计学意义(Z =2.644,P=0.008);⑤试验组24周骨密度改善的总有效率为91.98％(298/324),高于对照组的总有效率75.23％(82/109),差异有统计学意义(x2=17.020,P=0.000);试验组24周腰椎L2、腰椎L3、腰椎L4、腰椎L2-4骨密度较基线提高值明显高于对照组,差异有统计学意义(Z=-2.139,Z=-3.161,Z=-2.157,Z=-3.562;P=0.032,P=0.002,P=0.031,P=0.000),两组24周股骨颈(左)、股骨颈(右)骨密度较基线提高值无统计学意义(Z=-0.131,Z=-0.419;P =0.896,P=0.675);⑥两组不良反应发生率差异无统计学意义(P＞0.05),两组患者用药及随访期间均未出现严重不良事件、无骨折情况发生.结论 金天格胶囊能改善原发性骨质疏松患者中医证候总体疗效,尤其在改善腰背疼痛、腰膝酸软无力症状方面具有优势,同时能减轻疼痛程度,增加骨密度,并且安全性较好.

目的:探讨麻醉护士参加麻醉前评估对提升麻醉效率和患者满意度的影响.方法:选取某院行全身麻醉的择期手术患者1200例,按照随机数字表法分为研究组和对照组,每组600例.研究组采用麻醉护士参与麻醉医生主导的麻醉前评估,对照组由麻醉医生单独进行麻醉前评估.比较2组患者术日清晨心理状态[焦虑自评量表(SAS)及抑郁自测量表(SDS)评分]、麻醉相关指标及麻醉满意度.结果:研究组术日清晨SAS、SDS评分明显低于对照组,差异有统计学意义(P<0.05);研究组麻醉前准备时间和麻醉时间明显低于对照组,麻醉前准备合格率明显高于对照组,差异有统计学意义(P<0.05);研究组麻醉满意度高于对照组,差异有统计学意义(P<0.05).结论:麻醉护士参加麻醉前评估能显著改善手术患者心理状态,提升麻醉效率和患者满意度,值得临床推广应用.

糖尿病是我国发病率较高的一种慢性代谢病且有逐年升高的趋势,长期高糖状态易增加冠状动脉粥样硬化、视网膜病变、糖尿病肾病等的严重程度,给人体带来诸多危害.遗传、免疫功能异常是糖尿病发病的重要因素,近年来测序技术的运用证实,核因子κB受体活化因子配体(RANKL)/核因子κB受体活化因子(RANK)/骨保护素(OPG)信号通路不仅参与维持骨代谢平衡,还影响内分泌代谢系统.RANKL、RANK、OPG在糖尿病患者血清中表达异常,且与糖尿病相关并发症密切相关,这为糖尿病及其并发症的进一步研究提供了新思路和新靶点.

Objective: Diabetic kidney disease (DKD) and diabetic peripheral neuropathy (DPN) are both common chronic complications of type 2 diabetes mellitus (T2DM). The aim of this study was to examine whether some markers of early renal injury were associated with DPN. Methods: Retrospective hospitalization data from 471 patients with T2DM were analyzed. Subjects were divided into DPN group and non-DPN group according to clinical history, symptoms, signs and nerve conduction study. Markers of glomerular injury [urinary albumin/ creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR)] and tubular injury [urinary N-acetyl-beta-D-glucosaminidase/creatinine ratio (NAG/Cr) and urinary [beta 2 microglobulin (beta 2-MG)] were innovatively combined to assess the association with DPN. Staging of chronic kidney disease (CKD) was classified as G1, G2, G3a, G3b, G4 based on eGFR categories of >= 90, 60-89, 45-59, 30-44, 15-29 mL/min/1.73m(2). Results: DPN was detected in 71.1% of our population. Subjects in DPN group suffered from older age, longer duration of diabetes and worse blood glucose control compared with non-DPN group. The levels of UACR, NAG/Cr and [32.-MG were significantly increased in DPN group than those in non-DPN group, while eGFR was decreased. The prevalence of DPN increased gradually in G1, G2 and G3-4 of CKD, which were 66.3%, 73.2% and 82.7% (P = 0.014). After adjusting for confounding factors, NAG/Cr >1.41 U/mmol (the highest tertile) was a consistently independent risk factor for DPN [odds ratio, OR (95% confidence interval, CI) = 1.86 (1.04-3.33)]. However, UACR, eGFR and beta 2-MG did not significantly affect the risk of DPN. Conclusion: When T2DM patients suffer from CKD, DPN will be more likely to appear, accelerate or deteriorate. Some easily available urinary markers of glomerular and tubular damage can be used for early prediction of DPN, in which increased NAG/Cr is an independent risk factor for DPN.

Objective:To explore the relationship between lipid accumulation product (LAP) and abnormal glucose metabolism in the participants recruited from Jiangxi Province.Methods:This study conducted a cross-sectional survey on community neighborhood communities in 14 cities and towns in Jiangxi Province from March to July 2018. A multi-stage stratified random sampling method was used to recruit 4 790 residents aged 18 and above, and a questionnaire survey (including demography, subject characteristics, drug history, lifestyle and psychological conditions, etc.), physical examination[measure and calculate height, weight, waist circumference, blood pressure, body mass index (BMI), waist to height ratio (WHtR), LAP and visceral adiposity index (VAI)] and laboratory examination [fasting plasma glucose (FPG), 2-hour plasma glucose (2hPG), total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C)] were conducted on all subjects. Diagnose diabetes and pre-diabetes according to the diagnostic criteria of the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2017 edition). Kruskal-Wallis H method and multivariate logistic regression model were used to analyze the relationship between different LAP levels (quartiles) with pre-diabetes and diabetes. Results:There were 2 996 patients in the normal glucose tolerance group, 1 097 patients in the pre-diabetes group, and 697 patients in the diabetes group. In the 3 groups, age, systolic blood pressure, diastolic blood pressure, BMI, waist circumference, LAP, VAI, FPG, 2hPG, TC, TG and LDL-C increased with the increase of glucose metabolism severity, while HDL-C decreased (all P<0.05). According to the LAP quartile, there were 1 196 cases in group Q1 (LAP<16.52), 1 198 cases in group Q2 (16.52≤LAP<29.52), 1 195 cases in group Q3 (29.52≤LAP<50.22) and 1 201 cases in group Q4 (LAP≥50.22).With the increase of LAP level, the prevalence of pre-diabetes and diabetes showed an increasing trend, and the difference was statistically significant ( P<0.01). After adjusting for gender, age, education, family history of diabetes, family income, smoking and drinking histories, exercise status, blood pressure, and BMI, the highest LAP level group showed higher risk for pre-diabetes and diabetes with OR(95%CI) 2.94 (2.26 to 3.83) and 5.00 (3.58 to 6.97), respectively. Conclusions:LAP is closely related to abnormal glucose metabolism. The individuals with higher LAP showed higher risk of pre-diabetes and diabetes, and it has certain clinical value for early warning of abnormal glucose metabolism.

目的 分析江西省成人肥胖测量指标与糖脂代谢紊乱的相关性.方法 分析2018年3～7月江西省糖尿病流行病学调查中4790名成人的完整资料,探讨BMI、WC、腰高比(WHtR)、脂质蓄积指数(LAP)和内脏脂肪指数(VAI)5项指标与血糖和血脂的相关性.采用Logistic回归分析,通过比较受试者工作特征曲线(ROC)确定该5项指标对DM和高脂血症的最佳切点.结果 江西省成年人DM患病率为14.6％,血脂异常患病率为30.0％,肥胖患病率为9.3％,中心性肥胖患病率为31.3％.BMI、WC、WHtR、LAP和VAI均与血糖和血脂指标相关(P<0.05),且随着各肥胖测量指标增高,DM和高脂血症患病率及风险不断升高.多因素校正后,LAP和VAI评估DM和高脂血症的OR值最高,最高四分位组DM患病风险分别为最低四分位组的3.805和3.640倍,高脂血症患病风险分别为32.056和82.952倍.ROC曲线分析显示,DM和高脂血症的曲线下面积以LAP、VAI为最大,分别为(0.65、0.63)、(0.84、0.88),LAP筛检DM和高脂血症的最佳切点分别为30.60和36.84,VAI最佳切点为1.95和2.26.结论 BMI、WC、WHtR、LAP和VAI与糖脂代谢紊乱关系密切,其中以LAP和VAI预测DM和高脂血症的价值为最佳.