中老年非糖尿病人群久坐行为与胰岛素抵抗的相关性分析  

Correlation analyses of sedentary behavior and insulin resistance in middle-aged and elderly non-diabetic population

作　　者：石兴文 尹鸿涛[2] 田高鹏 甄东户[2] SHI Xing-wen;YIN Hong-tao;TIAN Gao-peng;ZHEN Dong-hu(The First Clinical Medical College of Lanzhou University,Department of Endocrinology,First Hospital of Lanzhou University,Lanzhou,Gansu 730030,China;不详)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730030 [2]兰州大学第一医院内分泌科

出　　处：《现代预防医学》2024年第6期1063-1069,共7页Modern Preventive Medicine

基　　金：甘肃省重点研发计划(23YFFA0032);上海市医药卫生发展基金会糖尿病临床研究项目(Ⅰ期10研究);国家标准化代谢性疾病管理中心专项研究基金(2018-mmczxjj-3);甘肃省自然科学基金(21JR1RA096);医学院校硕士研究生学位论文质量提升策略研究(lzuyxcx-2022-112、820809036)。

摘　　要：目的了解兰州市中老年非糖尿病人群的久坐情况,并探讨久坐行为与胰岛素抵抗(IR)的相关性。方法使用兰州市REACTION研究2014—2016年的调查数据,利用整群随机抽样选取年龄为40~75岁的居民,对符合纳入标准的3609人进行研究,将久坐时间分为<3 h/d、3~5 h/d及>5 h/d三组,依据稳态模型评估胰岛素抵抗指数(HOMA-IR)诊断IR,采用多因素logistic回归模型分析久坐行为与IR的关联,并通过亚组分析探索不同分组下久坐时间与IR的相关性。结果研究人群平均久坐时间为4.00±1.92 h/d,总体IR患病率为25.0%,其中<3 h/d、3~5 h/d及>5 h/d人群中IR的患病率分别为21.7%、24.9%及31.0%,差异具有统计学差异(χ^(2)=24.447,P<0.05)。在调整多种混杂因素后,logistic回归分析结果显示,与久坐<3h/d对比,久坐>5 h/d是IR患病的危险因素(OR=1.468,95%CI:1.168~1.845,P<0.05)。亚组分析表明,仅在年龄<65岁(OR=1.060,95%CI:1.005~1.118)、体力活动不足(OR=1.071,95%CI:1.017~1.128)、高血脂(OR=1.071,95%CI:1.001~1.145)、无高尿酸血症(OR=1.062,95%CI:1.010~1.117)、脂肪肝(OR=1.133,95%CI:1.038~1.237)、WC≥85cm(OR=1.079,95%CI:1.017~1.144)的个体亚组中,久坐时间增加与IR患病风险增加相关(均P<0.05)。结论中老年非糖尿病人群久坐行为与IR发生呈正相关,但在不同特征人群中结果可能存在差异。Objective To investigate the sedentary behavior of middle-aged and elderly non-diabetic population in Lanzhou and explore its correlation with insulin resistance(IR).Methods A cluster random sampling method was used to select residents aged 40-75 years from the survey data of the"REACTION Study"conducted between 2014 and 2016 in Lanzhou.A total of 3609 individuals who met the inclusion criteria were included in this study.The sedentary time was divided into<3 h/d,3-5 h/d and≥5 h/d groups.Insulin resistance was diagnosed using the homeostasis model assessment of insulin resistance(HOMA-IR).Multivariate logistic regression analysis was performed to examine the association between sedentary behavior and IR,while subgroup analysis explored this relationship among different population subgroups.Results The average daily sedentary time for study population was found to be approximately 4.00±1.92 h/d,with an overall prevalence rate of IR at 25.0%.The prevalence rates of IR for those with a sedentary time<3 h/d,3-5 h/d and≥5 h/d were observed as follows:21.7%,24.9%and 31%,respectively,with statistically significant differences(χ^(2)=24.447,PSymbol|@@0.05).After adjusting for various confounding factors through logistic regression analysis,it was revealed that compared with sedentary<3 h/d,sedentary≥5 h/d was a risk factor for the prevalence of IR(OR=1.468,95%CI:1.168-1.845,PSymbol|@@0.05).Subgroup analysis indicated that only within subgroups consisting of individuals aged≥65 years old(OR=1.060,95%CI:1.005-1.118),insufficient physical activity(OR=1.071,95%CI:1.017-1.128),hyperlipidemia(OR=1.071,95%CI:1.001-1.145),no hyperuricemia(OR=1.062,95%CI:1.010-1.117),fatty liver(OR=1.133,95%CI:1.038-1.237),and WC≥85 cm(OR=1.079,95%CI:1.017-1.144),increased sedentary time was associated with increased risk of IR(all P<0.05).Conclusion Sedentary behavior is positively associated with the occurrence of IR in middle-aged and elderly non-diabetic population.However,the findings may vary across populations with distinct char

关 键 词：久坐 胰岛素抵抗 中老年人 

分 类 号：R335.6[医药卫生—人体生理学] R165[医药卫生—基础医学]