中国中老年人高血压与中心性肥胖对糖尿病患病的交互作用  

Interactive effects of hypertension and central obesity on the prevalence of diabetes among middle-aged and elderly in China

作　　者：韩琳 曹冰 王欣[1] 周娇 王强[1] 李晓艳[1] 刘岱 邵小莉[1] HAN Lin;CAO Bing;WANG Xin;ZHOU Jiao;WANG Qiang;LI Xiaoyan;LIU Dai;SHAO Xiaoli(The First Affiliated Hospital of Xi'an Medical University,Xi'an,Shaanxi Prorince 710077,China;不详)

机构地区：[1]西安医学院第一附属医院,陕西省西安710077 [2]西南大学心理部

出　　处：《中国慢性病预防与控制》2023年第3期165-169,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：重庆市自然科学基金(cstc2021jcyj-msxm X0574)。

摘　　要：目的了解中国中老年人高血压与中心性肥胖对糖尿病患病的交互作用,为糖尿病防治提供科学依据。方法数据来源于2015年中国健康与养老追踪调查(CHARLS),选取其中15096名≥45岁中老年人为研究对象,收集问卷调查、体格检查和实验室检测等信息。运用Stata 15.0软件进行t检验、χ^(2)检验和多因素logistic回归分析,采用相乘模型和相加模型分析高血压和中心性肥胖对糖尿病患病的交互作用。结果研究对象糖尿病患病率为15.32%。调整年龄、性别、居住地、婚姻状况、饮酒、体质指数(BMI)及血脂异常等混杂因素后,多因素logistic回归分析结果显示,高血压(OR=1.68,95%CI:1.53~1.85)和中心性肥胖(OR=1.61,95%CI:1.42~1.83)与糖尿病患病高风险相关,均有统计学意义(P<0.05,P<0.01)。交互作用分析显示,高血压和中心性肥胖对糖尿病患病不存在相乘交互作用(OR=1.15,95%CI:0.92~1.44),但存在相加交互作用,患高血压且中心性肥胖者患糖尿病的风险高于两者均不罹患者(OR=2.66,95%CI:2.27~3.12),超额相对危险度(RERI)为0.62,交互作用归因百分比(AP)为0.23,协同指数(S)为1.59。分层交互作用显示,在BMI<24 kg/m^(2)人群中,高血压与中心性肥胖对糖尿病患病存在相加交互作用(RERI=0.58,AP=0.24,S=1.71)。结论中国中老年人的高血压、中心性肥胖均增加了糖尿病患病风险,二者存在相加交互作用。控制血压与腰围可能会预防糖尿病的发生。Objective To understand the interactive effects of hypertension and central obesity on the prevalence of diabetes among middle-aged and elderly in China,and provide the scientific basis for the diabetes prevention and treatment.Methods The data were from the 2015 China Health and Retirement Longitudinal Study(CHARLS),15096 middle-aged and elderly(≥45 years old)were selected as the subjects,the investigation was performed with questionnaires,physical examination and laboratory test.The t test,χ^(2)test and multivariate logistic regression were used to analyze the data.Multiplicative and additive models were used to analyze the interactions between hypertension and central obesity on the prevalence of diabetes.The used software was Stata 15.0.Results The diabetes morbidity of subjects was 15.32%.After adjusting age,sex,residence,marital status,drinking,body mass index(BMI)and dyslipidemia,the multivariate logistic regression showed that hypertension(OR=1.68,95%CI:1.53-1.85)and central obesity(OR=1.61,95%CI:1.42-1.83)were related to the high risk of diabetes(P<0.05 or P<0.01).The interaction analysis showed,there was no multiplicative interaction between hypertension and central obesity(OR=1.15,95%CI:0.92-1.44),but there was an additive interaction effect.The risk of diabetes in hypertension patients with central obesity was significantly higher than that in residents without hypertension and central obesity(OR=2.66,95%CI:2.27-3.12),relative excess risk due to interaction(RERI)was 0.62,attributable percent of interaction(AP)was 0.23,and synergy index(S)was 1.59.Stratified interaction analysis showed that hypertension and central obesity had additive interaction on diabetes in patients with BMI<24 kg/m^(2)(RERI=0.58,AP=0.24,S=1.71).Conclusion Both hypertension and central obesity increase the risk of diabetes in middle-aged and elderly in China,there is the additive interaction between hypertension and central obesity.Controlling blood pressure and waist circumference can prevent the diabetes.

关 键 词：高血压 中心性肥胖 糖尿病 交互作用 

分 类 号：R587.1[医药卫生—内分泌]