| 陈晓英,吴照帆,王学才,董晓莲,朱建福,Chen Yue,肖甜,姜庆五,付朝伟.体质指数动态变化与2型糖尿病发病关系的前瞻性研究[J].中华流行病学杂志,2016,37(10):1332-1335 |
| 体质指数动态变化与2型糖尿病发病关系的前瞻性研究 |
| Association between body mass index and its change and type 2 diabetes mellitus risk in a prospective study |
| 收稿日期:2016-05-23 出版日期:2016-10-13 |
| DOI：10.3760/cma.j.issn.0254-6450.2016.10.003 |
| 中文关键词: 体质指数 糖尿病,2型 前瞻性研究 |
| 英文关键词: Body mass index Diabetes mellitus, type 2 Prospective study |
| 基金项目:国家自然科学基金（81473038）；上海市公共卫生重点学科建设计划（15GWZK0801） |
| 作者 | 单位 | E-mail | | 陈晓英 | 200032 上海, 复旦大学公共卫生学院流行病学教研室, 公共卫生安全教育部重点实验室 | | | 吴照帆 | 200032 上海, 复旦大学公共卫生学院流行病学教研室, 公共卫生安全教育部重点实验室 | | | 王学才 | 313200 浙江省湖州市德清县疾病预防控制中心 | | | 董晓莲 | 313200 浙江省湖州市德清县疾病预防控制中心 | | | 朱建福 | 313200 浙江省湖州市德清县疾病预防控制中心 | | | Chen Yue | K1N6N5 加拿大渥太华大学医学院 | | | 肖甜 | 200032 上海, 复旦大学公共卫生学院流行病学教研室, 公共卫生安全教育部重点实验室 | | | 姜庆五 | 200032 上海, 复旦大学公共卫生学院流行病学教研室, 公共卫生安全教育部重点实验室 | | | 付朝伟 | 200032 上海, 复旦大学公共卫生学院流行病学教研室, 公共卫生安全教育部重点实验室 | fcw@fudan.edu.cn |
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| 中文摘要: |
| 目的 探讨BMI动态变化对队列人群2型糖尿病（T2DM）发病的影响。方法 以2006年开展的浙江省德清县农村社区成年人群健康队列为基础，随机抽取3 043名基线未患T2DM对象构建亚队列，于2015年7-11月进行随访，共1 867名调查对象纳入研究，进行问卷调查、体格检查和实验室检测。以中国标准对基线BMI（kg/m2）分类：<24.0为正常，24.0～27.9为超重，≥28.0为肥胖；BMI每年变化<0.05 kg/m2表示基本无变化。用Cox回归模型分析基线BMI及其变化与T2DM发生的关系。结果 随访人时为（8.68±1.25）年，新发T2DM为213例，其中女性125例，发病密度为13.14/1 000人年。Cox回归模型分析显示，在调整其他可能影响因素后，与基线BMI<24.0 kg/m2人群相比，基线BMI≥28.0 kg/m2的人群发生T2DM的风险较高（aHR=2.12，95% CI：1.22～3.68）；在基线BMI<24.0 kg/m2的人群中，与BMI基本无变化的人群相比，BMI增加的人群发生T2DM的风险较高（aHR=2.21，95% CI：1.17～4.17）。结论 基线BMI和BMI改变均可增加T2DM的发病风险，尤其是基线BMI正常的人群，其BMI改变对T2DM的发生影响较大。 |
| 英文摘要: |
| Objective To investigate the influence of body mass index (BMI) and its change on the incidence of type 2 diabetes mellitus (T2DM) in an adult cohort. Methods A total of 3 043 subjects randomly selected among those without T2DM at baseline survey from the Rural Deqing Health Cohort Study were included into this study and follow up was conducted for 1 867 of them from July to November 2015. The subjects were divided into 3 groups according to their baseline BMI, normal group (BMI<24.0), overweight group (BMI:24.0-27.9) and obese group (BMI ≥28.0) and the subjects with stable weight (BMI change of -0.05 to +0.05 per year) were used as the referent category. Cox proportional model was used to estimate associations between BMI, its changes and T2DM. Results With an average of (8.68±1.25) person years, 213 new T2DM cases, including 125 females were detected, and incidence density was 13.14 per 1 000 person years. After adjusted for other covariates, the risk for incidence of T2DM was significantly higher in subjects with baseline BMI ≥28.0 kg/m2 than those with baseline BMI<24.0 kg/m2 (aHR=2.12, 95%CI:1.22-3.68), and weight gains were strongly associated with the incidence of T2DM in those with baseline BMI<24.0 kg/m2 (aHR=2.21, 95%CI:1.17-4.17). Conclusion Both BMI and its change were significantly associated with incidence of T2DM, especially in the population with BMI<24.0 kg/m2 at baseline. |
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