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空腹血糖水平与胆石症发病风险的关系
Association between fasting blood glucose and the risk of cholelithiasis
文章发布日期:2019年09月29日  来源:  作者:梁明杨,魏垚臣,王一鸣,等  点击次数:223次  下载次数:49次

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【摘要】: 目的 探讨空腹血糖与胆石症发病风险的关系。 方法 选取开滦研究中在2006-2007年度健康体检中进行空腹血糖及肝、胆超声检查的87513例观察对象,根据血糖检测结果,将观察对象分为血糖正常组(n=73456)﹑空腹血糖受损组(n=7165)和糖尿病组(n=6892)。采用log-rank检验比较不同分组间胆石症的累积发病率;采用Cox比例风险模型分析不同空腹血糖水平分组对新发胆石症的影响,计算风险比(HR)和95%可信区间(95%CI);采用分层分析比较在不同性别﹑血脂水平和BMI人群中不同空腹血糖分组间胆石症发病风险。正态分布的计量资料多组间比较采用单因素方差分析;偏态分布的计量资料多组间比较采用Krustal-willis H秩和检验。分类资料组间差异比较采用χ2检验。结果 血糖正常组、空腹血糖受损组、糖尿病组的胆石症累积发病率分别为10.91%、12.17%和18.86%,三组胆石症累积发病率差异有统计学意义(χ2=27.94, P<0.05)。在Cox比例风险模型分析中,连续校正其他因素后,与血糖正常组相比,空腹血糖受损组新发胆石症风险为0.97(95%CI: 0.85~1.11)(P=0.587)、糖尿病组新发胆石症风险为1.15(95%CI: 1.01~1.30)(P=0.019)。进一步分层分析发现,在男性(HR=1.16,95%CI:1.01~1.33,P=0.043)﹑血脂正常(HR=1.22,95%CI:1.01~1.49,P=0.044)、BMI超重(HR=1.16,95%CI:1.01~1.35,P=0.048)人群中糖尿病是新发胆石症的危险因素。结论 糖尿病会增加新发胆石症的风险。在男性、血脂正常、BMI超重人群中糖尿病是新发胆石症发病的独立危险因素。
【Abstract】: Objective To investigate the association between fasting blood glucose and the risk of cholelithiasis. Methods A total of 87513 individuals who underwent fasting blood glucose test and liver/biliary ultrasound in health examination in Kailuan from 2006 to 2007 were enrolled as subjects, and according to the results of blood glucose test, the subjects were divided into normal blood glucose group with 73456 subjects, impaired fasting blood glucose group with 7165 subjects, and diabetic group with 6892 subjects. The log-rank test was used to compare the cumulative incidence rate of cholelithiasis between groups; the Cox proportional hazards model was used to analyze the influence of different levels of fasting blood glucose on new-onset cholelithiasis and calculate hazard ratio (HR) and 95% confidence interval (CI); a stratified analysis was used to compare the risk of cholelithiasis between the individuals with different levels of fasting blood glucose in the groups with different sexes, blood lipid levels, and levels of body mass index (BMI). A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups. The chi-square test was used for comparison of categorical data between groups. Results There was a significant difference in the cumulative incidence rate of cholelithiasis between the normal blood glucose group, the impaired fasting blood glucose group, and the diabetic group (10.91% vs 12.17% vs 18.86%, χ2=27.94, P<0.05). After the continuous adjustment for the other factors in the Cox proportional hazards model analysis, compared with the normal blood glucose group, the impaired fasting blood glucose group had a risk of new-onset cholelithiasis of 0.97(95%CI: 0.85-1.11, P=0.587), and the diabetic group had a risk of new-onset cholelithiasis of 1.15(95%CI: 1.01-1.30, P=0.019). The stratified analysis showed that diabetes was a risk factor for new-onset cholelithiasis in male individuals (HR=1.16, 95%CI: 1.01-1.33, P=0.043), individuals with normal blood lipids (HR=1.22, 95%CI: 1.01-1.49, P=0.044), and individuals with overweight based on BMI (HR=1.16, 95%CI: 1.01-1.35, P=0.048). Conclusion Diabetes can increase the risk of cholelithiasis. Diabetes is an independent risk factor for cholelithiasis in men, individuals with normal blood lipids, and individuals with overweight based on BMI.
【关键字】:胆结石; 糖尿病; 血糖; 危险因素
【Key words】:cholelithiasis; diabetes mellitus; blood glucose; risk factors
【引证本文】:LIANG MY, WEI YC, WANG YM, et al. Association between fasting blood glucose and the risk of cholelithiasis[J]. J Clin Hepatol, 2019, 35(11): 2517-2522. (in Chinese)
梁明杨, 魏垚臣, 王一鸣, 等. 空腹血糖水平与胆石症发病风险的关系[J]. 临床肝胆病杂志, 2019, 35(11): 2517-2522.

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