中年人群肥胖指标与新诊2型糖尿病的关联研究  

Association between obesity indictors and newly diagnosed type 2 diabetes mellitus in middle-aged Chinese population

作　　者：杨帆[1] 崔静 苑东敏 李晓静 辛化雷 孙永叶[1] 张配配 孙健平[1,2] YANG Fan;CUI Jing;YUAN Dong-min;LI Xiao-jing;XIN Hua-lei;SUN Yong-ye;ZHANG Pei-pei;SUN Jian-ping(School of Public Health, Qingdao University, Qingdao, Shandong 266021, China)

机构地区：[1]青岛大学公共卫生学院,山东青岛266021 [2]青岛市疾病预防控制中心青岛市预防医学研究院,山东青岛266033 [3]潍坊医学院公共卫生与管理学院,山东潍坊261053

出　　处：《现代预防医学》2019年第10期1795-1800,共6页Modern Preventive Medicine

基　　金：世界糖尿病基金青岛糖尿病预防项目(WDF05-108;WDF07-308);青岛市2017年度医药科研指导计划(2017-WJZD129);青岛市医疗卫生优秀人才培养项目;中国博士后科学基金(2015M580575)

摘　　要：目的研究40～59岁中年居民肥胖指标与新诊2型糖尿病(T2DM)之间的关联,并探讨各指标能否作为筛查T2DM的工具。方法采用四阶段随机抽样的方法于2006年和2009年抽取40～59岁居民4 690例。采用logistic回归分析不同肥胖指标对新诊T2DM的患病风险,采用受试者工作特征曲线分析不同肥胖指标筛查新诊T2DM效能。结果随着肥胖水平的升高,新诊T2DM患病率均升高。多因素logistic回归显示男性BMI、WC、Hip、WHR、WHt R的第4分位(Q4)组新诊T2DM患病风险分别是Q1组的2.46、2.15、1.93、1.60和1.84倍;女性BMI的Q3、Q4组新诊T2DM患病风险分别是Q1组的2.95和3.42倍;WC、Hip、WHR、WHt R的Q2、Q3、Q4组患病风险均升高,尤以Q4组的患病风险最高,分别是Q1组的3.43、2.51、3.06和3.89倍。男性与女性BMI筛查新诊T2DM的最佳切点分别为27.41 kg/m2和25.59 kg/m2,曲线下面积分别为0.60和0.64;WHt R筛查T2DM的最佳切点分别为0.55和0.52,曲线下面积分别为0.59和0.65。结论在40～59岁人群中,新诊T2DM患病风险会随着肥胖水平的增加而升高,但BMI、WC、Hip、WHR、WHt R筛查新诊T2DM患病的准确性较低。Objective To investigate the association between different indictors of obesity and newly diagnosed type 2 diabetes mellitus(T2 DM) in adults aged 40-59 years. Further, to explore whether different indictors can be used as a tool to screening for T2 DM. Methods A total of 4 690 residents aged 40-59 years were enrolled by four-stage random sampling method in2006 and 2009. Logistic regression was used to estimate the association between different indictors of obesity and newly diagnosed T2 DM. Receiver operating characteristic curve(ROC curve) was used to perform the efficacy for different indicators of obesity in screening T2 DM. Results The prevalence of newly diagnosed T2 DM was on the rise accompanied with the increase of BMI, WC, Hip, WHR and WHtR in both gender. Multivariate Logistic regression analysis revealed that Q4 of BMI, WC,Hip, WHR, WHtR in male(2.46, 2.15, 1.93, 1.60 and 1.84 times, respectively), Q3, Q4 of BMI(2.95 and 3.42 times, respectively)and Q2, Q3, Q4 of WC, Hip, WHtR in female were significantly associated with a higher risk for newly diagnosed T2 DM,especially Q4(3.43, 2.51, 3.06 and 3.89 times, respectively) after adjusted confounding factors of age, family history of diabetes,urban and rural distribution, smoking history and drinking history. The optimal cut-off values of BMI and WHtR were27.41 kg/m2,0.55 in male and 25.59 kg/m2, 0.52 in female, respectively. The ROC of BMI and WHtR were 0.60, 0.64 in male and 0.59,0.65 in female, respectively. Conclusion Elevated obesity level is risk factors for newly diagnosed T2 DM in middleaged population. However, low accuracy for screening T2 DM were found in all indicators of obesity in both genders.

关 键 词：2型糖尿病 体重指数 腰臀比 腰高比 

分 类 号：R181.3[医药卫生—流行病学]