脂质蓄积指数和体重指数与糖尿病关系比较的前瞻性研究  

A prospective study on the association between lipid accumulation product or body mass index and diabetes

作　　者：杨晨[1] 郭志荣[1] 胡晓抒[2] 周正元[3] 武鸣[4] 

机构地区：[1]苏州大学放射医学与公共卫生学院流行病与卫生统计教研室,215123 [2]苏州大学放射医学与公共卫生学院江苏省卫生厅,215123 [3]江苏省常熟市疾病预防控制中心 [4]江苏省疾病预防控制中心

出　　处：《中华流行病学杂志》2010年第1期5-8,共4页Chinese Journal of Epidemiology

基　　金：卫生部科学研究基金（WKJ2004-2-014）

摘　　要：目的探讨基线脂质蓄积指数（LAP）与体重指数（BMI）不同水平与随访糖尿病（DM）发病的关系。方法运用前瞻性研究方法，以江苏省多代谢异常和代谢综合征（MS）防治队列研究人群为研究对象，分析并比较基线LAP和BMI不同水平与DM的关系，计算LAP、BMI、腰围（WC）、腰臀比（WHR）对预测随访DM的ROC曲线下面积。结果与BMI相比，不论男女DM发病人数及累计患病率随LAP水平增高而增加的趋势更为明显；调整年龄、DM一般危险因素后，相对危险度（艘）分别随BMI水平和LAP水平增加而增高，但后者更具有统计学意义（P〈0．05）；4种肥胖指标中，预测随访DM的ROC曲线下面积从大到小依次为LAP、WHR、WC、BMI。结论高LAP比高BMI更容易导致DM；相对于体重增加，DM的形成可能与体内脂质蓄积关系更为密切。Objective To measure the association between lipid accumulation product （LAP） or body mass index （BMI） and diabetes. Methods In this prospective study, subjects were recruited and followed up for more than five years from the program ＂Prevention of Multiple Metabolic Disorders and MS in Jiangsu Province＂ （PMMJS）. A total number of 3598 people participating in the follow-up program, with complete information. Incidence rates of diabetes and relative risk in different levels of LAP and BMI were compared and analyzed. Areas under the receiver operation characteristic curve for obesity indicators such as LAP, BMI, waist circumference （WC）, waist-to-hip ratio（WHR） in predicting diabetes of cohort population were calculated. Results The number and the cumulative incidence of diabetes increased with the LAP levels in both men and women. After adjusting for age and other traditional risk factors on diabetes, the adjusted risk ratios （aRR） value of diabetes were 4.33 （ 1.34-14.01 ） for men and 5.04（2.06-12.34） for women, between the highest and the lowest level of LAP groups. When further adjusted for BMI, the aRR value decreased to 3.15 （1.13-8.80） for men and 4.84 （2.16-10.84） for women. The number and the cumulative incidence of diabetes also increased with the BMI levels in both men and women but not significantly as the LAP showed, and the aRR values were 1.34 （0.61-2.93） for men and 1.69 （0.91-3.06） for women in the highest level of BMI group, when compared with the lowest level group. Again, when further adjusted for LAP, the aRR values decreased to 1.23 （0.59-2.69） for men and 1.39（0.74-2.60） for women. The area under the ROC curve（AUC） for the four kinds of obesity indicators in predicting diabetes in the descending order were LAP, WHR, WC, BMI in both men and women. Conclusion LAP seemed more associated to diabetes than to BMI. When comparing with weight gain, diabetes might be more closely associated with the lipid accumulation product.

关 键 词：糖尿病 脂质蓄积指数 体重指数 前瞻I生研究 

分 类 号：R587.1[医药卫生—内分泌]