| 张瑞,张德生,王若楠,尹春,白朝,黄文雅,杨景丽,黄佩瑶,柳念,陈晓亮,王玉峰,程宁,白亚娜.体质指数、血压与糖尿病发病关系的巢式病例对照研究[J].中华流行病学杂志,2021,42(4):662-667 |
| 体质指数、血压与糖尿病发病关系的巢式病例对照研究 |
| Relationship of body mass index and blood pressure with diabetes: a nested case-control study |
| 收稿日期:2020-04-01 出版日期:2021-04-22 |
| DOI：10.3760/cma.j.cn112338-20200401-00493 |
| 中文关键词: 糖尿病 体质指数 血压 金昌队列 |
| 英文关键词: Diabetes Body mass index Blood pressure Jinchang cohort |
| 基金项目:兰州大学“一带一路”专项（2018ldbrzd008）；美国国立卫生研究院（1R01ES029082） |
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| 中文摘要: |
| 目的 探讨金昌队列人群BMI、血压与新发糖尿病的关系，为该人群防治糖尿病提供参考。方法 采用巢式病例对照研究，以金昌队列第一次随访（2013-2015年）期间新发1 021例糖尿病患者作为病例组，在同期随访期间未新发糖尿病、循环系统及内分泌系统疾病者中，按照性别相同、年龄±2岁进行1：1匹配，选取1 021例对照组，最终共纳入2 042名研究对象。采用多因素条件logistic回归模型、相加及相乘交互模型探讨BMI、血压与新发糖尿病的关系。结果 调整职业、饮酒、糖尿病家族史、高尿酸血症、高TC血症、高TG血症、低HDL-C血症、高LDL-C血症等因素后，多因素条件logistic回归分析结果显示，糖尿病的发生风险随BMI、血压的递增呈上升趋势（趋势检验P<0.05）。高血压与超重/肥胖对糖尿病的发生存在相乘交互作用，男性、女性超重/肥胖的高血压患者糖尿病的发生风险分别是体重及血压正常人群的2.04倍（95%CI：1.54~2.69）、3.88倍（95%CI：2.55~5.91）。肥胖且SBP≥160 mmHg（1 mmHg=0.133 kPa）者糖尿病发生风险是体重及SBP正常者的4.57倍（95%CI：2.50~8.34），肥胖且DBP≥90 mmHg者糖尿病发生风险是体重及DBP正常者的3.40倍（95%CI：2.19~5.28）。结论 超重/肥胖及高血压可增加金昌队列人群糖尿病的发生风险，应加强该人群体重及血压健康教育，降低糖尿病发生风险。 |
| 英文摘要: |
| Objective To explore the relationship of body mass index and blood pressure with the incidence of diabetes in Jinchang cohort. Methods We designed a nested case-control study, a total of 29 572 workers who had no history of diabetes in baseline survey in Jinchang cohort were selected as the study cohort from June 2011 to December 2013. After 2 year follow-up, 1 021 workers with first diagnosed diabetes were selected as the case group, after 1:1 matching according to the same gender and age ±2 years among those without diabetes, circulatory system, or endocrine system diseases during the same follow-up period, 1 021 controls was selected and 2 042 subjects were finally included. We used multivariate conditional logistic regression model, additive interaction model and multiplicative interaction model to explore the relationship of body mass index and blood pressure with the incidence of diabetes. Results After adjusting for factors such as occupation, alcohol use, family history of diabetes, hyperuricemia, hypercholesterolemia, hypertriglyceridemia, low-HDL cholesterolemia and high-LDL cholesterolemia, multivariate conditional logistic regression analysis showed that the risk of diabetes increased with body mass index and blood pressure. Hypertension and overweight/obesity had a multiplicative interaction on the incidence of diabetes. The risks of diabetes in men and women with hypertension and overweight/obese were 2.04 times (95%CI:1.54-2.69) and 3.88 times (95%CI:2.55-5.91) higher than those in men and women with normal body weight and blood pressure, respectively. In the combination of BMI and blood pressure, obese individuals with SBP ≥ 160 mmHg were 4.57 times (95%CI:2.50-8.34) more likely to have diabetes than those with normal BMI and SBP, obese individuals with DBP ≥ 90 mmHg were 3.40 times (95%CI:2.19-5.28) more likely to have diabetes than those with normal BMI and DBP. Conclusions Overweight/obesity and hypertension can increase the risk of diabetes. Health education about body weight and blood pressure controls should be strengthened to reduce the risk of diabetes. |
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