肥胖指标对2型糖尿病患病关联强度剂量-反应关系分析  

Measures of adiposity for prevalence type 2 diabetes: a dose response relationship analysis

作　　者：胡文斌[1,2] 张婷 吴迎春[2] 秦威 张小花[2] 金亦徐 周杰[1] 仝岚[1] 罗晓明[1] HU Wen-bin;ZHANG Ting;WU Ying-chun;QIN Wei;ZHANG Xiao-hua;JIN Yi-xu;ZHOU Jie;TONG Lan;LUO Xiao-ming(Kunshan Center for Disease Control and Prevention,Kunshan,Jiangsu 215300,China)

机构地区：[1]昆山市疾病预防控制中心,江苏昆山215300 [2]昆山高新区江浦社区卫生服务中心,江苏昆山215300

出　　处：《现代预防医学》2018年第16期3052-3057,共6页Modern Preventive Medicine

基　　金：昆山市社会发展科技项目[编号:KS1669]

摘　　要：目的分析肥胖指标(BMI、腰围、腰臀比及腰围身高比)对2型糖尿病患病关联强度剂量-反应关系。方法采用多阶段整群随机抽样方法,于2016年对江苏省昆山市18~69岁常住居民进行问卷调查与体格检查。样本数据通过复杂加权后,估计糖尿病患病率在一般特征变量之间的分布。采用限制性立方样条分析肥胖指标与糖尿病患病关联强度剂量反应关系。结果 2016年昆山市18~69岁常住人口糖尿病患病率为8.08%,男性和女性糖尿病患病率分别为8.47%和7.75%。调整混杂因素之后,限制性立方样条分析结果显示,随着BMI、腰围、腰臀比及腰围身高比的上升,其与糖尿病患病关联强度呈现线性剂量反应关系(非线性检验,χ2值分别为3.80、4.63、4.14及3.97,P值均>0.05)。结论昆山市2016年18~69岁常住居民中糖尿病患病率较高,肥胖指标与糖尿病患病呈现线性剂量反应关系。加强生活方式干预,倡导预防和控制肥胖应是减轻糖尿病负担的首选。Objective To analyze whether higher measures of adiposity are associated with greater prevalence of type 2 diabetes, as well as dose response relationship. Methods Multi-stage cluster random sampling method was conducted in2016 in Kunshan City, Jiangsu Province. Permanent residents aged from 18 to 69 years with completed questionnaire and physical examinations was obtained. After being weighted according to complex sampling scheme and post-stratification, the sample were used to estimate the prevalence of diabetes. Restricted cubic spline was used to evaluate associations between adiposity measures and prevalence of diabetes. Results Overall, the prevalence of diabetes among both sex, male and female were 8.08%, 8.47%, and 7.75%. After adjusted confounding factors, based on restricted cubic spline model, a linear dose response association were found between measures of adiposity（BMI, waist circumference, waist to hips ratio, and waist to height ratio） and prevalent of diabetes（linearity test, χ^2=3.80, 4.63, 4.14, and 3.97, P〉0.05）. Conclusion The prevalence of diabetes among residents aged 18 to 69 in kunshan is high in 2016, and show a linear dose-response relationship between obesity index and diabetes.Strengthening programs and initiatives for preventing and controlling obesity focusing on lifestyle changes should be a priority to reduce diabetes burden.

关 键 词：糖尿病 患病率 体重指数 腹部肥胖 限制性立方样条 

分 类 号：R181-32[医药卫生—流行病学]