一般会社検診における耐糖能異常の発症予測因子

Abstract

There are accumulating data to show that impaired glucose tolerance (IGT) is one of the risk factors of coronary artery disease. Dysbetalipoproteinemia, hyperinsulinemia, hypertension, and obesity are associated with this metabolic abnormality, and it is important to recognize these disorders at the early stage to prevent coronary artery disease. In this study our aim was to elucidate the risk factors to predict IGT candidates in a general health check. We selected healthy men [n=294, age; 39±5 (mean±SD)] with normal glucose tolerance [NGT; fasting plasma glucose level (FPG)<110mg/dl and glycohemoglobin Alc (HbAlc)<6.1%] who underwent a general health check at their company and chemical tests in a fasting condition were taken every year for 5 years. We designated subjects with FPG≥110mg/dl or HbAlc≥6.1% as IGT, and we classified subjects as staying at NGT (NN) or changing to IGT (NI) groups at the end of the 5th year. Other factors including body mass index (BMI), blood pressure, and serum lipid levels were also measured every year. Age, BMI, systolic and diastolic blood pressure (SBP, DBP), FPG, and plasma triglyceride level (TG) in the 1st year in subjects in the NI group were significantly higher than those in NN. There were no significant differences in the levels of smoking, alcohol consumption, total and HDL-cholesterol, or uric acid between NI and NN in any year. In chi-square test, FPG≥100mg/dl, hypertension (SBP≥140mmHg or DBP≥90mmHg), and TG≥200mg/dl were significantly associated with IGT at the end of the 5th year. Groups categorized by age ≥38 years old, FPG≥100mg/dl, hypertension, and TG≥200mg/dl in the 1st year had a significantly higher relative risk for IGT in univariate logistic analysis. In multivariate logistic analysis, FPG≥100mg/dl, hypertension, and TG≥200mg/dl were significant predicting factors for the development of IGT. In conclusion, in company general health checks, age, blood pressure levels, FPG, and TG could be useful factors to predict IGT.