体质指数和腰围对浙江地区成年人糖尿病发生影响的前瞻性研究  

Prospective study on the effect of BMI and waist circumference on diabetes of adults in Zhejiang province

作　　者：王浩[1] 胡如英[1] 钱一建 王春梅[2] 谢开婿[2] 陈玲琍 潘东霞[2] 张益丹[2] 卞铮 郭彧 Fiona Bragg 俞敏[1] 李立明[5] 陈铮鸣[4] Wang Hao;Hu Ruying;Qian Yijian;Wang Chunmei;Xie Kaixu;Chen Lingli;Pan Dongxia;Zhang Yidan;Bian Zheng;Guo Yu;Fiona Bragg;Yu Min;Li Liming;Chen Zhengming(Department of Non-communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China;Department of Non-communicable Diseases Control and Prevention, Tongxiang City Center for Disease Control and Prevention, Tongxiang 314500, China;Department of China Kadoorie Biobank, Chinese Academy of Medical Sciences, Beijing 102308, China;Clinical Trial Service and Epidemiological Studies Unit （CTSU）, University of Oxford, Oxford OX12JD, UK;School of Public Health, Peking University, Beijing 100191, China)

机构地区：[1]浙江省疾病预防控制中心慢性非传染性疾病预防控制所,杭州310051 [2]桐乡市疾病预防控制中心慢病科,314500 [3]中国医学科学院慢性病前瞻性研究项目办公室,北京102308 [4]英国牛津大学临床与流行病学研究中心纳菲尔德人群健康系,OX12JD [5]北京大学公共卫生学院,100191

出　　处：《中华流行病学杂志》2018年第6期810-815,共6页Chinese Journal of Epidemiology

基　　金：国家重点研发计划精准医学研究重点专项（2016YFC0900500,2016YFC0900501,2016YFC0900502,2016YFC0900504）;中国香港Kadoorie Charitable基金;英国Wellcome Trust（202922/Z/16/Z,088158/Z/09/Z,104085/Z/14/Z）

摘　　要：目的 探讨BMI和腰围对成年人糖尿病发病的影响。方法 使用＂中国慢性病前瞻性研究＂（CKB）浙江省桐乡市数据，剔除基线时自报患有恶性肿瘤、心脏病、脑卒中和糖尿病患者后，纳入分析30-79岁53 916人。采用Cox比例风险模型计算糖尿病发病风险比（HR）。结果 调查对象累计随访391 512人年（平均随访7.26年）。随访期间，男性944人和女性1 643人被新诊断为糖尿病。多因素调整后，与BMI正常组的人群相比，男性超重和肥胖组糖尿病发病的HR值（95%CI）分别为2.72（95%CI：2.47-2.99）和6.27（95%CI：5.33-7.36）。女性超重和肥胖组HR值（95%CI）分别为2.19（95%CI：2.04-2.36）和3.78（95%CI：3.36-4.26）；与腰围正常组的人群相比，男性Ⅰ级（85.0-89.9）和Ⅱ级中心性肥胖（≥ 90.0）组糖尿病发病的HR值（95%CI）分别为2.56（2.22-2.95）和4.66（4.14-5.24）。女性Ⅰ级（80.0-84.9）和Ⅱ级中心性肥胖（≥ 85.0）组HR值（95%CI）分别为1.99（1.80-2.21）和3.16（2.90-3.44）。结论 超重/肥胖以及中心性肥胖人群糖尿病发病风险均会升高。在开展控制体重预防糖尿病的同时，更应控制腰围。Objective To explore the effect of BMI and waist circumference on diabetes of adults.Methods After excluding participants with heart disease, stroke, cancer and diabetes at baseline study, 53 916 people aged 30-79 in the China Kadoorie Biobank （CKB） study from Tongxiang city of Zhejiang province were recruited. Cox regression model was used to estimate the hazards ratios （HR） for the associations of baseline BMI and waist circumference with incident diabetes.Results Among 391 512 person-years of the follow-up program between 2004 and 2013 （median 7.26 years）, a total of 944 men and 1 643 women were diagnosed as having diabetes. Compared to those with normal weight, after adjusting for known or potential factors, HR of both overweight and obesity in men for incident diabetes appeared as 2.72 （95% CI：2.47-2.99） and 6.27 （95% CI：5.33-7.36）, respectively. The corresponding figures in women were 2.19 （95% CI：2.04-2.36） and 3.78 （95% CI：3.36-4.26）. Compared to those with normal waist circumference, after adjusting for known or potential factors, HR of Ⅰgrade andⅡgrade in men for diabetes were 2.56 （95% CI：2.22-2.95） and 4.66 （95% CI：4.14-5.24）, respectively. The corresponding figures in women were 1.99 （95% CI：1.80-2.21） and 3.16 （95% CI：2.90-3.44）, respectively.Conclusions Overweight, obesity and central obesity were all associated with the increased incident of diabetes. Strategies on diabetes prevention should include not only losing weight, but reducing waist circumference as well.

关 键 词：糖尿病 体质指数 腰围 前瞻性研究 

分 类 号：R587.1[医药卫生—内分泌]