文章摘要
胡强,江朝强,张维森,郑家强,徐琳,靳雅丽,沈振敏,朱峰,林大庆.成年早中期体重变化与中老年糖尿病的相关性研究[J].中华流行病学杂志,2017,38(12):1699-1702
成年早中期体重变化与中老年糖尿病的相关性研究
Association between body weight change during early and middle adulthood and the risk of type 2 diabetes in middle aged and elderly population
收稿日期:2017-05-04  出版日期:2017-12-26
DOI:10.3760/cma.j.issn.0254-6450.2017.12.023
中文关键词: 体质指数  糖尿病,2型  生物库队列
英文关键词: Body mass index  Type 2 diabetes mellitus  Biobank Cohort
基金项目:国家重点研发计划(2017YFC0907100);广东省自然科学基金(2015A030313891)
作者单位E-mail
胡强 510620 广州市第十二人民医院分子流行病学研究室  
江朝强 510620 广州市第十二人民医院分子流行病学研究室  
张维森 510620 广州市第十二人民医院分子流行病学研究室 zwsgzcn@163.com 
郑家强 英国伯明翰大学公共卫生与流行病学系  
徐琳 510080 广州, 中山大学公共卫生学院  
靳雅丽 510620 广州市第十二人民医院分子流行病学研究室  
沈振敏 510620 广州市第十二人民医院分子流行病学研究室  
朱峰 510620 广州市第十二人民医院分子流行病学研究室  
林大庆 999077 中国香港大学公共卫生学院  
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中文摘要:
      目的 探讨成年早、中期体重变化与中老年糖尿病的相关性。方法 基于"广州生物库队列研究"(GBCS)平台,选取其中28 736例≥ 50岁广州市中老年人为研究对象,采用多因素logistic回归模型,分析调整年龄、吸烟、饮酒、体力活动、教育程度、职业、居住地、BMI后成年早中期体重变化、达到最重体重时的年龄等与糖尿病的关系。结果 研究对象年龄男性(64.3±6.7)岁,女性(61.0±7.0)岁,糖尿病患病率男、女性(13.1%和13.7%)基本一致。与体重基本不变组相比,男女性糖尿病患病风险均随其成年早、中期体重增加而增加(趋势检验P<0.01),以体重增加>20 kg组患糖尿病风险最高,男女性OR值分别为2.83(95% CI:1.99~4.02)和3.13(2.47~3.96)。与在20岁时已达到最高体重者相比,以40~49岁达到最重体重组糖尿病患病风险最高,男性OR=5.32(95% CI:1.92~14.8),女性OR=3.41(95% CI:2.49~4.67)。男女性成年后体重减少仅与中老年自报糖尿病有关,与新诊断糖尿病无关。结论 成年早、中期体重增加可增加中老年糖尿病患病风险,体重明显增重到发生糖尿病相隔时间可能为10~20年。
英文摘要:
      Objective To examine the association between weight changes during early and middle adulthood and the risk of type 2 diabetes mellitus in middle aged and elderly population.Methods Based on the Guangzhou Biobank Cohort Study (GBCS), 28 736 residents aged ≥ 50 years were included in Guangzhou. Multivariate logistic regression was used to analyze the association between body weight changes during early or middle adulthood and age when the heaviest weight reaching the threshold on the risk of type 2 diabetes mellitus in middle age or elderly population. Adjustments on age, smoking, alcohol consumption, physical activity, education level, occupation, district of residence and body mass index etc., were made.Results The mean age was 64.3 (standard deviation=6.7) years in men and 61.0 (standard deviation=7.0) years in women, with the prevalence rates of diabetes as 13.1% and 13.7% in men and women, respectively. Compared to those with stable body weight, the risk of diabetes increased with weight gain during early and middle adulthood in both men and women (both P values for trend <0.01). Participants who gained more than 20 kg during early and middle adulthood were associated with the highest risk of diabetes in men (OR=2.83, 95% CI:1.99-4.02) and women (OR=3.13, 95% CI:2.47-3.96). Compared to those who reached the highest weight at age 20, those who reaching the highest weight at 40 to 49 years were associated with the highest risk of diabetes, with OR being 5.32 (95% CI:1.92-14.8) in men and 3.41 (95% CI:2.49-4.67) in women, respectively. Weight loss in adulthood was associated with self-reported but not newly diagnosed diabetic cases in both middle and older aged men and women.Conclusion Weight gain during early and middle adulthood may increase the risk of diabetes in middle and older aged population. The detrimental effect of obesity on diabetes might become significantly visible in the next decades.
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