糖尿病发病时间趋势及其与中国内脏脂肪指数的关系:一项前瞻性队列研究  

Trend of Onset Time of Diabetes Mellitus and Its Correlation with Chinese Visceral Adiposity Index:a Prospective Cohort Study

作　　者：刘庆平 柯居中 宋家慧 高娇娇 李智韬 王小楠 邱桦 周弋 阮晓楠 吴抗 LIU Qingping;KE Juzhong;SONG Jiahui;GAO Jiaojiao;LI Zhitao;WANG Xiaonan;QIU Hua;ZHOU Yi;RUAN Xiaonan;WU Kang(Department of Chronic Disease,Pudong New Area Center for Disease Control and Prevention/FudanUniversity Pudong Institute of Preventive Medicine,Shanghai 200132,China)

机构地区：[1]上海市浦东新区疾病预防控制中心慢性病防治科、复旦大学浦东预防医学研究院,200132

出　　处：《中国全科医学》2025年第2期183-192,共10页Chinese General Practice

基　　金：浦东新区卫生健康委员会青年科技项目(PW2021B-02);浦东新区疾病预防控制中心业务研发平台慢性病流行病学(DXZB-2024-01);上海市加强公共卫生体系建设三年行动计划重点学科(GWVI-11.1-02)。

摘　　要：背景糖尿病仍是全球重大公共卫生问题,横断面研究发现内脏脂肪与糖尿病患病密切相关,但糖尿病发病时间趋势及其与中国内脏脂肪指数(CVAI)关系的前瞻性队列研究较少。目的通过前瞻性队列研究分析上海市浦东新区居民糖尿病发病时间趋势及其与CVAI的关系,为其科学防治提供依据。方法本研究为前瞻性队列研究。选取2013年1—7月参与浦东新区慢性病危险因素监测项目的12个乡镇街道的35个村、居委的居民5236人为研究队列。收集其基线资料,内容包括CVAI、内脏脂肪指数(VAI)、BMI、腰围(WC)、腰臀比(WHR)、腰高比(WHtR)、身体形态指数(ABSI)和身体肥胖指数(BAI),分别于2016年和2019年进行追踪随访;截至随访结束(2019年10月),通过问卷调查、实验室检查、医疗系统就诊信息和生命统计信息系统判断该研究队列糖尿病新发情况。依据基线CVAI、VAI、BMI、WC、WHR、WHtR、ABSI、BAI四分位数将纳入人群分别分为第Q1~Q4四分位数:CVAI各组人数依次为1306、1307、1307、1307人;VAI各组人数依次为1300、1316、1306、1306例;BMI各组人数依次为1305、1302、1312、1311人;WC各组人数依次为1302、1273、1287、1367人;WHR各组人数依次为1180、1203、1332、1514人;WHtR各组人数依次为1199、1393、1400、1237人;ABSI各组人数依次为1316、1302、1302、1308人;BAI各组人数依次为1310、1304、1308、1307人。采用多因素Cox回归分析CVAI和其他肥胖指标与糖尿病发病的关系;采用受试者工作特征曲线(ROC曲线)比较CVAI与其他肥胖指标的预测作用。结果浦东新区居民2013—2016年糖尿病发病密度为33.55/1000人年,2017—2019年糖尿病发病密度为23.25/1000人年,随着年龄的增长,糖尿病总发病密度呈现出升高趋势(2013—2016年:χ^(2)=28.503,P_(趋势)<0.001;2017—2019年:χ^(2)=25.600,P_(趋势)<0.001)。截至2016年,基线CVAI四分位数越高,糖尿病累积发病率(CVAI:χ^(2)=13Background Diabetes mellitus is a global public health issue.Cross sectional studies have found that visceral fat is closely related to the prevalence of diabetes mellites,while prospective cohort studies on the trend of onset time of diabetes mellitus and its correlation with Chinese visceral adiposity index(CVAI)are scant.Objective To analyze the trend of onset time of diabetes mellitus and its correlation with CVAI in Pudong New Area,Shanghai,residents by the prospective cohort study,thus providing evidence for the scientific prevention and treatment of diabetes mellitus.Methods This was a prospective cohort study involving 5236 residents from 12 townships and 35 village committees who participated in the chronic disease risk factor monitoring project in Pudong New Area,from January to July,2013.Baseline data were collected,including CVAI,visceral adiposity index(VAI),body mass index(BMI),waist circumference(WC),waist-to-hip ratio(WHR),waist-to-height ratio(WHtR),a body shape index(ABSI),and body adiposity index(BAI).Follow-up was conducted in 2016 and 2019.By the end of follow-up in October 2019,the incidence of new onset of diabetes mellitus in this cohort was calculated through questionnaire survey,laboratory testing,medical system visit information and vital statistics information system.According to the baseline quartile,the CVAI,VAI,BMI,WC,WHR,WHtR,ABSI,and BAI of the included population were divided into Q1 to Q4 quartiles.The number of cases in CVAI Q1-Q4 groups was 1306,1307,1307,and 1307,respectively.The number of cases in VAI Q1-Q4 groups was 1300,1316,1306,and 1306,respectively.The number of cases in BMI Q1-Q4 groups was 1305,1302,1312,and 1311,respectively.The number of cases in WC Q1-Q4 groups was 1302,1273,1287,and 1367,respectively.The number of cases in WHR Q1-Q4 groups was 1180,1203,1332,and 1514,respectively.The number of cases in WHtR Q1-Q4 groups was 1199,1393,1400,and 1237,respectively.The number of cases in ABSI Q1-Q4 groups was 1316,1302,1302,and 1308 respectively.The number of cases in

关 键 词：糖尿病 中国内脏脂肪指数 浦东新区 前瞻性队列研究 影响因素分析 

分 类 号：R587.1[医药卫生—内分泌]