Abstract: Background　In recent years，the incidence of pre-diabetes and diabetes in China has increased year by year.But the incidence may be reduced by early detection of related risk factors and timely interventions.The relationship of hypertriglyceridemic waist phenotype（HTGW）and blood sugar has not yet been determined.Objective　To explore the relationship of HTGW with pre-diabetes and diabetes mellitus.Methods　 By use of multi-stage stratified cluster random sampling，2 142 community-dwelling residents aged 18-75 years were recruited from Wanchai Town，Xiangzhou District，Zhuhai City，from June to October 2012.By waist circumference（WC）and serum triglyceride（TG）level，they were stratified into three groups：group 1（WC≤90 cm in males or ≤85 cm in females with TG<2.0 mmol/L），group 2（WC≤90 cm in males or ≤85 cm in females with TG ≥2.0 mmol/L，WC>90 cm in males or >85 cm in females with TG<2.0 mmol/L），group 3（WC>90 cm in males or>85 cm in females with TG≥2.0 mmol/L）．Clinical features were compared between the three groups.The relationship of HTGW with pre-diabetes and diabetes mellitus was analyzed by Logistic regression.Results　 Of the 2 142 participants, 169 were excluded because of lacking data of triglyceride or waist circumference. Finally, 1 973 participants were enrolled, including 172 patients with diabetes and 143 patients with prediabetes. And 1 141 patients were in the group 1; 624 patients were in the group 2; and 208 patients were in the group 3.Compared with group 1，group 2 showed higher mean age，male ratio，rates of hypertension，pre-diabetes，diabetes mellitus，and drinking，mean systolic blood pressure（SBP），diastolic blood pressure（DBP），BMI，fasting blood glucose（FBG），C-reactive protein（CRP），total cholesterol（TC），TG，low-density lipoprotein cholesterol（LDL-C），serum creatinine（Scr），and serum uric acid，and longer mean WC，but lower percent of completing high school or higher levels of education，and lower mean high-density lipoprotein cholesterol（HDL-C）（P<0.05）．In comparison with groups 1 and 2，group 3 demonstrated higher mean age，rates of hypertension，pre-diabetes，diabetes mellitus，smoking，and drinking，SBP，BMI，FBG，TC，TG，Scr，and serum uric acid，and longer WC，but lower mean HDL-C（P<0.05）．Male ratio，percent of completing high school or higher levels of education，mean DBP and CRP levels were higher in group 3 than those of group 1（P<0.05）．Analysis with unadjusted Logistic regression models showed that age，sex，hypertension history，smoking，drinking and physical exercise were associated with pre-diabetes and diabetes（P<0.05）．Moreover，analysis with adjusted Logistic regression models indicated that age，sex，hypertension history，smoking，drinking，physical exercise，BMI，and HTGWP were associated with pre-diabetes and diabetes（P<0.05）．Conclusion　HTGWP is closely related to diabetes mellitus and pre-diabetes.So increased attention should be given to lipid and WC control in priority groups to reduce the prevalence of pre-diabetes and diabetes mellitus，and the occurrence of cardiovascular events.

Key words: Prediabetic state, Diabetes mellitus, Hypertriglyceridemia, Triglycerides, Waist circumference, Clinical features

摘要： 背景　近年，我国糖尿病前期和糖尿病的患病率逐年上升，若能早期发现其危险因素，予以干预可减少相关疾病的发生。高三酰甘油血症-腰围表型（HTGW）与血糖之间的关系尚未形成定论。目的　探讨HTGW的临床特征及其与糖尿病前期及糖尿病的关系。方法　于2012年6—10月在珠海市香洲区湾仔镇采用多阶段分层整群随机抽样法选取2 142例年龄18~75岁的社区居民为研究对象。根据腰围和三酰甘油水平将参与者分为3组：组1、组2及组3。组1：男性腰围≤90 cm或女性腰围≤85 cm且血清三酰甘油<2.0 mmol/L；组2：男性腰围≤90 cm或女性腰围≤85 cm且血清三酰甘油≥2.0 mmol/L或男性腰围>90 cm或女性腰围>85 cm且血清三酰甘油<2.0 mmol/L；组3：男性腰围>90 cm或女性腰围>85 cm且血清三酰甘油≥2.0 mmol/L。比较不同组别居民的临床特征，采用Logistic回归分析HTGW与糖尿病前期和糖尿病的关系。结果　2 142例参与者中169例因为缺失三酰甘油或腰围数据被剔除。最后纳入1 973例参与者，其中糖尿病172例、糖尿病前期143例，组1参与者1 141例，组2参与者624例，组3参与者208例。组2年龄、男性占比、高血压者占比、糖尿病前期者占比、糖尿病者占比、饮酒者占比、收缩压、舒张压、体质指数（BMI）、腰围、空腹血糖、C反应蛋白、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、血肌酐、血尿酸高于组1，教育状况为高中以上者占比、高密度脂蛋白胆固醇低于组1，差异有统计学意义（P<0.05）。组3年龄、高血压者占比、糖尿病前期者占比、糖尿病者占比、吸烟者占比、饮酒者占比、收缩压、BMI、腰围、空腹血糖、总胆固醇、三酰甘油、血肌酐、血尿酸高于组1和组2，高密度脂蛋白胆固醇低于组1和组2，男性占比、受教育程度为高中以上者占比、舒张压、C反应蛋白高于组1，差异有统计学意义（P<0.05）。Logistic回归分析结果显示，在未调整的模型中，调整年龄、性别、高血压病史、吸烟、饮酒、体育锻炼模型，调整年龄、性别、高血压病史、吸烟、饮酒、体育锻炼、BMI模型中，HTGW分组均为糖尿病前期及糖尿病发生的影响因素（P<0.05）。结论　HTGW与糖尿病前期和糖尿病密切相关，应注意加强对该类人群的血脂控制及腹围控制，以降低糖尿病前期和糖尿病的患病率，减少心血管事件的发生。

关键词: 糖尿病前期, 糖尿病, 高三酰甘油血症, 甘油三酯类, 腰围, 临床特征