BMI、腰围和腰身比与2型糖尿病发病关系的队列研究  

Body mass index, waist circumference and waist-to-height ratio associated with the incidence of type 2 diabetes mellitus： a cohort study

作　　者：杨香玉[1] 张明[2] 罗新萍[2] 王瑾瑾[3] 尹磊 庞超 王国安[2] 沈艳霞[2] 吴东亭[2] 张璐[1] 任永成[1] 王炳源[1] 张红艳[1] 周俊梅[2] 韩成义 赵阳[1] 冯天平 胡东生[2] 赵景志 

机构地区：[1]郑州大学公共卫生学院,450001 [2]深圳大学医学院 [3]河南中医学院基础医学院 [4]河南省军区医院预防保健科

出　　处：《中华预防医学杂志》2016年第4期328-333,共6页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金（81373074、81402752）

摘　　要：目的 探讨BMI、腰围和腰身比与2型糖尿病（T2DM）发病风险的关系。方法 于2007年7—8月和2008年7—8月选择河南省某县的两个乡（镇）为研究现场，以自然村为单位，采用整群抽样的方法，对20 194名18岁以上居民进行问卷调查、体格检查，以及空腹血糖及脂质谱检测，共有17 236名进入队列。2013年7—8月和2014年7—10月随访到14 720名（应答率为85.4%），最后11 643名（男性4 301名，女性7 342名）研究对象被纳入随访研究。应用发病密度及Cox比例风险回归模型分析基线时BMI、腰围、腰身比及其不同组合，以及各指标基线和随访时的动态变化与T2DM发病风险的关系。结果 在11 643名随访研究对象中，新发T2DM 613例，平均随访时间为6.01年，发病密度为0.89/100人年。调整基线时性别、年龄、吸烟、饮酒、糖尿病家族史，以及FPG、TC、TG、HDL-C、SBP、DBP基线与随访的差值后，Cox比例风险回归分析显示，基线时BMI超重组、BMI肥胖组、腰围异常组及腰身比异常组人群的T2DM发病风险均高于基线相应指标正常组人群，HR（95%CI）值分别为2.05 （1.62~2.59）、3.01（2.33~3.90）、2.34（1.89~2.90）、2.88（2.21~3.74）；且基线。BMI、腰围及腰身比均异常组人群的T2DM发病风险最高，HR （95%CI）值为3.32 （2.50~4.40）；无论基线。BMI或腰围正常与否，基线。腰身比异常人群的T2DM发病风险均有所增加，BMI正常且腰身比异常组、BMI异常且腰身比异常组、腰围正常且腰身比异常组、腰围异常且腰身比异常组的HR （95 %CI）值分别为1.88（1.29~ 2.74）、3.08（2.34~4.05）、2.15（1.53~3.00）、3.22（2.45~4.23）；基线和随访时动态变化分析结果显示，基线时腰围或腰身比正常组人群中，随访时腰围或腰身比转变为异常均增加T2DM的发病风险，HR（95% CI）值分别为1.79（1.26~2.55）、2.12（1.32~3.39）；而在基线时。腰围�Objective To investigate the association between body mass index （BMI）, waist circumference （WC）, waist-to-height ratio （WHtR）, and the incidence risk of type 2 diabetes mellitus （T2DM）.Methods In total, 20 194 participants ≥18 years old were selected randomly by cluster sampling from two township （town） of the county in Henan province from July to August of 2007 and July to August of 2008 and the investigation included questionnaires, anthropometric measurements, fasting plasma glucose, and lipid profile examination were performed at baseline; 17 236 participants were enrolled in this cohort study. 14 720 （85.4%） were followed up from July to August 2013 and July to October 2014. Finally, 11 643 participants （4 301 males and 7 342 females） were included in this study. Incidence density and Cox proportional hazards regression models were used to evaluate the risk of T2DM associated with baseline BMI, WC, WHtR, and their dynamic changes.Results After average of 6.01 years following up for 11 643 participants, 613 developed T2DM and the incidence density was 0.89 per 100 person-years. After adjusted for baseline sex, age, smoking, drinking, family history of diabetes, as well as the difference of fasting plasma-glucose （FPG）, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, systolic blood pressure （SBP）, diastolic blood pressure （DBP） between baseline and follow-up, Cox Proportional-Hazards regression analysis indicated that T2DM risk of baseline BMI overweight group, BMI obesity group, abnormal WC group and abnormal WHtR group were significantly higher than that of the corresponding baseline normal groups , and the incidence risk of T2DM reached the highest for those whose baseline BMI, WC and WHtR were all abnormal, the corresponding HR （95%CI） were 2.05 （1.62-2.59）, 3.01 （2.33-3.90）, 2.34 （1.89-2.90）, 2.88 （2.21-3.74）, 3.32 （2.50-4.40）, respectively. Whether baseline BMI/WC was normal or not, T2D

关 键 词：人体质量指数 腰围 糖尿病 队列研究 

分 类 号：R587.1[医药卫生—内分泌]