新型肥胖指标与中国农村人群糖尿病前期的关系研究  

Relationship between the new obesity index and pre-diabetes in rural China

作　　者：薛艺璇 李小霞[1] 党媛媛 马涛[1] 常晓玉 赵燚[1] 许红霞[1] 张毓洪[1] XUE Yi-xuan;LI Xiao-xia;DANG Yuan-yuan;MA Tao;CHANG Xiao-yu;ZHAO Yi;XU Hong-xia;ZHANG Yu-hong(School of Public Health,Ningxia medical university,Yinchuan,Ningxia 750004,China)

机构地区：[1]宁夏医科大学公共卫生学院,宁夏银川750004

出　　处：《现代预防医学》2023年第12期2239-2246,2269,共9页Modern Preventive Medicine

基　　金：国家重点研发项目西北区域自然人群队列研究宁夏队列建设(2017YFC0907204);国家自然科学基金(81860603);宁夏自然科学基金(2021AAC03128);宁夏医科大学校级科研项目(XT2019010)。

摘　　要：目的 探讨身体形态指数(A Body Shape Index, ABSI)、中国内脏脂肪指数(Chinese Visceral Adiposity Index, CVAI)、脂质蓄积指数(Lipid Accumulation Product, LAP)、身体圆度指数(Body Roundness Index, BRI)和锥削指数(Conicity Index, CI)五个肥胖指标与糖尿病前期的关系,为糖尿病前期预防提供依据。方法 以宁夏自然人群队列基线数据中13 142名研究对象为基础,采用logistic回归分析探讨以上五个新型肥胖指标与糖尿病前期的关系,同时采用C统计量分析各肥胖指标对糖尿病前期的预测价值。结果 本研究共纳入13 142例研究对象,其中男性5 222例(占39.7%),女性7 920例(占60.3%);1 481例糖尿病前期患者,患病率为11.3%。ABSI、CVAI、LAP、BRI和CI按四分位数分组,随着各指标四分位数的增加,空腹血糖水平和糖尿病前期患病率均呈上升趋势(P_(趋势)<0.05)。调整混杂因素后,经logistic回归分析显示,男女性中LAP均与糖尿病前期呈正相关,与第一四分位相比,处于第四四分位的男性OR=2.13(95%CI:1.32~3.43),女性OR=2.14(95%CI:1.42~3.21);且LAP与糖尿病前期之间存在非线性关系;ABSI、CVAI、BRI和CI与糖尿病前期未发现相关性。此外,与其他四个肥胖指标相比,LAP显著改善了常规危险因素预测糖尿病前期的C统计量(0.616,95%CI:0.601~0.631)。结论 LAP为糖尿病前期的危险因素,且存在非线性关系。Objective To explore the relationship between five obesity indexes including A Body Shape Index(ABSI),Chinese Visceral Adiposity Index(CVAI),Lipid Accumulation Product(LAP),Body Roundness Index(BRI)and Conicity Index(CI)and pre-diabetes,and to provide a basis for pre-diabetes prevention.Methods Based on the baseline data of 13142 subjects in Ningxia natural population cohort,logistic regression analysis was used to explore the relationship between the above five new obesity indexes and pre-diabetes,and C statistics was used to analyze the predictive value of each obesity index for pre-diabetes.Results A total of 13142 subjects were included,including 5222 males(39.7%)and 7920 females(60.3%).A total of 1481 patients with pre-diabetes had a prevalence of 11.3%.ABSI,CVAI,LAP,BRI and CI were grouped by quartiles.With the increase of quartiles of each index,the fasting blood glucose level and pre-diabetes prevalence rate showed an upward trend(P_(trend)0.05).After adjusting the confounding factors,logistic regression analysis showed that LAP was positively correlated with pre-diabetes in both men and women.Compared with the first quartile,the OR of men in the fourth quartile was 2.13(95%CI:1.32-3.43),and that of women was 2.14(95%CI:1.42-3.21),and there was a nonlinear relationship between LAP and prediabetes.ABSI,CVAI,BRI and CI were not correlated with pre-diabetes.In addition,compared with the other four obesity indicators,LAP significantly improved the C statistics of conventional risk factors in predicting pre-diabetes(0.616,95%CI:0.601-0.631).Conclusion LAP is a risk factor for pre-diabetes,and there is a nonlinear relationship.

关 键 词：身体形态指数 中国内脏脂肪指数 脂质蓄积指数 身体圆度指数 锥削指数 

分 类 号：R587.1[医药卫生—内分泌]