广义相加模型和广义线性模型在糖尿病相关因素分析中的应用  

Generalized additive and generalized linear models in analysis of diabetes-related factors

作　　者：陈玉柱[1] 唐振柱[1] 方志峰[1] 陆武韬[1] 李忠友[1] 周为文[1] 李晓鹏[1] CHEN Yu-zhu;TANG Zhen-zhu;FANG Zhi-feng;LU Wu-tao;LI Zhong-you;ZHOU Wei-wen;LI Xiao-peng(Guangxi Autonomous Regional Center for Disease Control and Prevention, Nanning, Guangxi 530028, Chin)

机构地区：[1]广西壮族自治区疾病预防控制中心,广西南宁530028

出　　处：《实用预防医学》2018年第5期628-631,共4页Practical Preventive Medicine

摘　　要：目的利用广义相加模型和广义线性模型探讨糖尿病与相关因素的关系。方法 2010-2012年在广西5市/县采用分层整群抽样的方法,选取18岁及以上常住居民作为研究对象。3 827名被调查者均接受问卷调查,测量身高、体重、血压、腰围(WC),检测空腹血糖(FPG)。结果糖尿病患病率为9.4%,男性和女性患病率分别为10.3%、8.8%,差异无统计学意义(χ~2=2.629,P=0.105)。单因素结果显示年龄、城乡、民族、文化程度、婚姻状况、饮酒、肥胖类型(OBPH)7个因素与糖尿病有关(P<0.01)。多因素logistic回归分析结果显示,农村相对城市有降低患糖尿病的风险(OR=0.633,95%CI:0.499~0.802,P=0.000);60岁及以上人群与35岁以下人群相比患糖尿病风险高(OR=14.037,95%CI:6.538~30.134,P=0.000);中心型肥胖+超重、中心型肥胖+肥胖分别与正常体重比较,患糖尿病风险高(分别OR=2.259,95%CI:1.705~2.994,P=0.000;OR=2.068,95%CI:1.368~3.125,P=0.001)。广义相加模型和广义线性模型结果显示饮酒与糖尿病呈现J型非线性关系(χ~2=7.712,P=0.019),饮酒<1次/周和≥6次/周增加患糖尿病的风险;肥胖类型与糖尿病呈现为平躺∽型曲线关系(χ~2=13.547,P=0.008),中心肥胖和低体重患糖尿病的风险增加。结论广义相加模型和广义线性模型能直观呈现饮酒、肥胖类型与糖尿病的非线性关系。Objective To explore the correlation between diabetes mellitus and its related factors based on generalized additive model and generalized linear model. Methods A stratified cluster sampling method was used to select permanent residents aged 18 years and above in 5 cities/counties of Guangxi from 2010 to 2012, and 3,827 selected residents served as the research subjects. A questionnaire survey was conducted, and the residents’ height, weight, blood pressure, waist circumference （WC）and fasting plasma glucose（FPG）were measured. Results The prevalence rate of diabetes mellitus was 9.4%, and no statistically significant difference was found in the prevalence rate between males and females （10.3% vs. 8.8%, χ^2=2.629, P=0.105）. Single factor analysis showed that 7 factors, including age, urban and rural areas, ethnic origin, educational background, marital status, drinking, and obesity phenotypes （OBPH）, were associated with diabetes mellitus （P〈0.01）. Multivariate logistic regression analysis indicated that the risk of diabetes mellitus was higher in urban areas than in rural areas （OR=0.633,95%CI：0.499-0.802, P=0.000）, higher in residents aged 60 years and above than in ones aged 35 years and below （OR=14.037, 95%CI：6.538-30.134, P=0.000） as well as higher in the residents with central obesity ＆ overweight or central obesity ＆ obesity than in ones with normal-weight （OR=2.259, 95%CI：1.705-2.994, P=0.000; OR=2.068, 95%CI：1.368-3.125, P=0.001）. Generalized additive model and generalized linear model revealed that a type-J non-linear relationship was found between drinking and diabetes mellitus （χ^2=7.712, P=0.019）, and residents with drinking 〈once per week or ≥ 6 times per week were at an increased risk of developing diabetes mellitus. A type-reversed-tilde linear relationship was found between obesity phenotypes and diabetes mellitus （χ^2=13.547, P=0.008）, and residents with central obesity or low weight were at an increased risk of developing diabetes m

关 键 词：糖尿病 广义相加模型 广义线性模型 肥胖 

分 类 号：R587.1[医药卫生—内分泌]