总胆固醇与2型糖尿病关联性的前瞻性队列研究  

Association between total cholesterol and type 2 diabetes:a prospective cohort study

作　　者：路媛 刘焕乐[3] 马韫韬 代晓宇 王志恒 刘言训[1,2] LU Yuan;LIU Huan-le;MA Yun-tao;DAI Xiao-yu;WANG Zhi-heng;LIU Yan-xun(Department of Biostatistics,School of Public Health,Cheeloo College of Medcine,Shandong University,Jinan 250012,China;Healthcare Big Data Institute of Shandong University,Jinan 250012,China;Department of Health Care,Shengli Oilfield Central Hospital,Dongying 257000,China;The Second Hospital Lanzhou University,Lanzhou 730030,China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院生物统计系,济南250012 [2]山东大学健康医疗大数据研究院,济南250012 [3]胜利油田中心医院保健科,东营257000 [4]兰州大学第二临床医学院,兰州730030

出　　处：《中华疾病控制杂志》2020年第4期380-383,479,共5页Chinese Journal of Disease Control & Prevention

摘　　要：目的探讨总胆固醇与2型糖尿病(type 2 diabetes,T2DM)发病的关系。方法筛选20~90岁入队列时未患糖尿病并且体检次数≥2次者,应用t检验或χ^2检验比较有无发生T2DM两组人群基线特征,按总胆固醇四分位数由低到高划分4组(2.10~mmol/L组、4.16~mmol/L组、4.76~mmol/L组和5.42~13.29 mmol/L组),应用广义估计方程(generalized estimating equation,GEE)分析总胆固醇对2型糖尿病发病的影响。结果此队列共纳入12 928人,共随访45 626人年,平均随访时间为3.53年。随访期间,新发T2DM患者447人,发病密度为9.80‰,随着总胆固醇水平增高,T2DM高发病密度呈上升趋势,在多因素GEE分析中,调整年龄、高密度脂蛋白、是否患高血压、是否肥胖后,以2.10~mmol/L组为参照,4.16~mmol/L组、4.76~mmol/L组和5.42~13.29 mmol/L组的相对危险度(relative risk,RR)值分别为1.24(95%CI:0.83~1.86)、1.75(95%CI:1.19~2.56)、3.60(95%CI:2.51~5.17)。结论总胆固醇与T2DM存在相关性,随着总胆固醇水平的上升,发生T2DM的危险性逐渐增大。Objective To explore the association between total cholesterol and type 2 diabetes(T2 DM).Methods Non-diabetic people who aged 20 to 90 years at the baseline and who had physical examination more than 2 times were screened.Comparisons of the baseline characteristics were conducted with Student-t test or Pearson chi-square test.Generalized estimating equation(GEE)was used to analyze the effect of total cholesterol of quantiles groups(2.10-mmol/L,4.16-mmol/L,4.76-mmol/L and 5.42-13.29 mmol/L)to type 2 diabetes.Results The cohort with an average age of 3.53 years per person included 12928 subjects and 45626 person-years.During the follow-up,447 cases of new-onset diabetes occurred and the incidence density was 9.80‰.The high incidence of type 2 diabetes increased with the increase of total cholesterol.After adjusting the factors including age,high density lipoprotein,hypertension and obesity,based on the 2.10-mmol/L group,the relative risk(RR)of the 4.16-mmol/L,4.76-mmol/L and 5.42-13.29 mmol/L group were 1.24(95%CI:0.83-1.86),1.75(95%CI:1.19-2.56)and 3.60(95%CI:2.51-5.17),respectively.Conclusions Total cholesterol is associated with type 2 diabetes,and as the total cholesterol increases,the risk of developing type 2 diabetes increases.

关 键 词：2型糖尿病 总胆固醇 纵向数据 广义估计方程 

分 类 号：R587.1[医药卫生—内分泌]