成人颈围和腰围对糖尿病患病的联合效应  

Combined effect of adult neck circumference and waist circumference on diabetes mellitus

作　　者：辛鹏[1] 江国虹[1] 李静[1] 李昌昆 范莉莉 郑文龙[1] XIN Peng;JIANG Guohong;LI Jing;LI Changkun;FAN Lili;ZHENG Wenlong(Public Nutriology Department,Tianjin Centers for Disease Control and Prevention,Tianjin 300011,China)

机构地区：[1]天津市疾病预防控制中心公共营养科,天津300011

出　　处：《中华疾病控制杂志》2024年第2期171-175,197,共6页Chinese Journal of Disease Control & Prevention

基　　金：天津市医学重点学科(专科)建设项目(TJYXZDXK-051A)。

摘　　要：目的探索成人颈围(neck circumference,NC)现状及其与糖尿病关系,并分析颈围和腰围(waist circumference,WC)对糖尿病患病风险的联合效应。方法根据中国成人慢性非传染性疾病与营养监测方案,在天津市调查4136名成人,收集其NC、WC数据,并采集静脉血检测空腹血糖、服用无水葡萄糖2 h后血糖和糖化血红蛋白。将男性成人NC<37 cm或女性成人NC<33 cm者划分为NC1组,其余为NC2组。分析调查人群NC的分布状况及不同NC分组的糖尿病患病率情况,用WC将人群分为WC正常、中心型肥胖前期、中心型肥胖组,在此基础上分析其与NC对糖尿病患病率及患病风险的联合效应。结果调查人群平均NC为36.3 cm,男性平均NC高于女性,且与年龄呈正相关(t=3.452,P=0.001);NC2组糖尿病患病率为27.7%,高于NC1组的17.9%;在WC正常组和中心型肥胖组中,NC2组糖尿病患病率均高于NC1组;多因素logistic回归分析模型分析结果显示,与WC正常组+NC1组相比,随着WC、NC的增加罹患糖尿病的风险也随之增大,其中中心型肥胖组+NC2组罹患糖尿病的风险最高(OR=2.939,95%CI:2.227~3.880,P<0.001)。结论天津市颈围较大成人糖尿病患病率较高,WC和NC对糖尿病患病风险的联合效应较强,未来需要进一步研究NC与糖尿病患病的生物机制,以便应用于大人群筛查达到早期发现、控制糖尿病的效果。Objective To explore the current situation of neck circumference(NC)and its relationship with diabetes among adults,and to analyze the combined effect of NC and waist circumference(WC)on risk of diabetes.Methods According to the Chinese adult chronic disease and nutrition surveillance program,a total of 4136 inhabitants aged 18 and above were enrolled from Hexi,Nankai,Hongqiao,Wuqing,Jinnan,Baodi and Jizhou district of Tianjin.Except for measuring NC and WC,venous blood was collected to detect fasting blood glucose,glycosylated hemoglobin and blood glucose after taking sugar for 2 h.Those whose male adult NC<37 cm or female adult NC<33 cm were divided into NC1 group and the rest were NC2 group.Investigate the distribution of NC and the prevalence of diabetes in different NC groups.Divide the surveyed population into three groups with WC:normal,pre-central obesity and central obesity,on this basis,analyze the combined effect with NC on the prevalence rate and diabetes risk.Results The average NC of the investigated population in Tianjin was 36.3 cm,which was higher in males than in females,and was positively correlated with age(β=0.271,t=3.452,P=0.001).The prevalence rate of diabetes in NC2 group was 27.7%,which was significantly higher than that in NC1 group(17.9%).In WC normal group and central obesity group,the prevalence rate of diabetes in NC2 group was significantly higher than that in NC1 group.The multivariate logistic regression showed that compared with normal WC+NC1 group,the risk of diabetes increased with the increase of WC and NC,and the central obesity+NC2 group had the highest risk of diabetes(OR=2.939,95%CI:2.227-3.880,P<0.001).Conclusions The prevalence rate of diabetes is high among higher NC people(large neck circumference)in Tianjin adults,and the combined effect of WC and NC on the risk of diabetes is strong.In the future,it is necessary to further study the biological mechanism of NC and diabetes,so that it can be applied to large population screening to achieve the effect of early detectio

关 键 词：颈围 腰围 糖尿病 中心型肥胖 糖化血红蛋白 

分 类 号：R512.91[医药卫生—内科学]