社区居民糖调节受损和2型糖尿病相关因素的病例对照研究  

Community based case-control study of related factors in impaired glucose regulation and type 2 diabetes mellitus

作　　者：陈晓英[1] 王丛昀 苏美芳[2] 应旭华[2] 李松涛[2] 吴照帆 卫国荣[1] 姜庆五[1] 付朝伟[1] 

机构地区：[1]复旦大学公共卫生学院流行病学教研室,上海200032 [2]浙江省玉环县疾病预防控制中心,浙江台州317600

出　　处：《上海预防医学》2015年第11期669-672,677,共5页Shanghai Journal of Preventive Medicine

基　　金：上海市公共卫生重点学科建设计划(12GWZX0101);台州市科技计划项目(1401KY49)

摘　　要：目的探索我国社区居民糖调节受损和2型糖尿病的相关因素,为2型糖尿病的防治提供依据。方法在2013年浙江省玉环县健康队列基线调查基础上,选取269例新诊断2型糖尿病（T2DM）患者,按与其性别相同、年龄差小于3岁且无血缘关系的条件随机选取糖调节受损（IGR）和正常糖耐量（NGT）各269例。采用配对logistic回归分析相关危险因素,估计调整比值比（a OR）和95%可信区间（95%CI）。结果从NGT到IGR到T2DM,腹型肥胖比例（χ趋势2=20.834,P〈0.001）、血脂异常比例（χ趋势2=16.299,P〈0.001）和高血压比例（χ趋势2=10.670,P=0.005）呈增高趋势。在校正年龄、性别及其他因素后,与NGT相比,饮酒（a OR=2.06,95%CI：1.18-3.60）是IGR的独立危险因素;与IGR相比,腹型肥胖（a OR=1.63,95%CI：1.14-2.35）是T2DM的独立危险因素;与NGT相比,高血压（a OR=1.69,95%CI：1.14-2.50）、血脂异常（a OR=1.80,95%CI：1.24-3.63）和腹型肥胖（a OR=2.12,95%CI：1.46-3.08）是T2DM的独立危险因素。结论我国社区居民糖调节受损的患病风险主要与饮酒有关,而高血压、血脂异常和腹型肥胖会增加2型糖尿病的患病风险,应在社区糖尿病防治工作中加以关注。Objective To explore related factors in impaired glucose regulation（ IGR） and type 2diabetes mellitus（ T2DM） among Chinese residents and to obtain evidence for the prevention and control of T2 DM. Methods Based on the baseline information of Yuhuan Health Cohort Study in Zhejiang province,totally 269 newly diagnosed T2 DM patients were identified and then those with normal glucose tolerance（ NGT） and IGR were enrolled from the same community,matching with the same gender,age group（ ± 3 years old） and no relatives with cases. Conditional logistic regression model was used to analyze the possible related factors. Results From NGT to T2 DM,the proportions of abdominal obesity（ χtrend2=20. 834,P 〈 0. 001）,dyslipidemia（ χtrend2= 16. 299,P 〈 0. 001） and hypertension（ χtrend2= 10. 670,P =0. 005） increased significantly. After the adjustment of age, gender and other covariates, alcohol assumption（ a OR = 2. 06,95% CI： 1. 18- 3. 60） was an independent risk factor for IGR with the comparison to NGT. The independent risk factors for T2 DM were abdominal obesity（ a OR = 1. 63,95% CI：1. 14- 2. 35） with the comparison to IGR,as well as hypertension（ a OR = 1. 69,95% CI： 1. 14- 2. 50）,dyslipidemia（ a OR = 1. 80,95% CI： 1. 24- 3. 63） and abdominal obesity（ a OR = 2. 12,95% CI： 1. 46-3. 08） with the comparison to NGT. Conclusion Alcohol assumption was an independent risk factor for IGR while hypertension,dyslipidemia and abdominal obesity were independent risk factors for T2 DM among Chinese residents. It is suggested that more attentions should be paid for the prevention and control of diabetes in the communities.

关 键 词：糖调节受损 2型糖尿病 病例对照研究 相关因素 

分 类 号：R587.1[医药卫生—内分泌]