文章摘要
邓晓庆,张梅,张笑,赵振平,李纯,黄正京,宋子伟,姜博,郭晓慧,于宁,王丽敏.中国成年人血糖水平现状及其与体质指数和腰围的关系[J].中华流行病学杂志,2022,43(8):1178-1188
中国成年人血糖水平现状及其与体质指数和腰围的关系
Blood glucose levels and the relationship of body mass index and circumference with blood glucose in China
收稿日期:2021-10-11  出版日期:2022-08-13
DOI:10.3760/cma.j.cn112338-20211011-00782
中文关键词: 体质指数  血糖水平  腰围
英文关键词: Body mass index  Blood glucose level  Waist circumference
基金项目:国家重点研发计划(2018YFC1311702,2018YFC1311706);国家重大公共卫生服务项目
作者单位E-mail
邓晓庆 中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室, 北京 100050
中国医科大学公共卫生学院卫生统计学教研室, 沈阳 110122 
 
张梅 中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室, 北京 100050  
张笑 中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室, 北京 100050  
赵振平 中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室, 北京 100050  
李纯 中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室, 北京 100050  
黄正京 中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室, 北京 100050  
宋子伟 中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室, 北京 100050  
姜博 中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室, 北京 100050  
郭晓慧 中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室, 北京 100050  
于宁 中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室, 北京 100050  
王丽敏 中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室, 北京 100050
中国医科大学公共卫生学院卫生统计学教研室, 沈阳 110122 
wanglimin@ncncd.chinacdc.cn 
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中文摘要:
      目的 描述我国成年人血糖水平现状,探讨BMI、腰围与血糖水平的关系。方法 数据源于2018年中国慢性病及危险因素监测,采用多阶段分层整群随机抽样方法在全国31个省(自治区、直辖市)的298个监测区(县)选取≥18岁常住居民,以面对面问卷调查、身体测量和实验室检查方法收集人口学基本信息、慢性病危险因素信息、BMI、腰围和血糖水平等。对数据进行复杂加权后,分组描述不同特征人群的血糖水平,并利用多重线性回归分析不同特征人群的BMI及腰围与FPG及糖化血红蛋白的关系。结果 共纳入177 816名研究对象,我国成年人FPG和糖化血红蛋白分别为(5.73±1.46)mmol/L、(5.37±0.83)%,其中,均以≥60岁年龄组最高,男性均高于女性(P<0.001),城市的平均糖化血红蛋白略高于农村(P<0.001);平均FPG和平均糖化血红蛋白均随BMI和腰围的增长而增高(P<0.001)。多重线性回归校正混杂因素后,BMI每增加1 kg/m2,未诊断为糖尿病、新诊断为糖尿病和自报已诊断为糖尿病的FPG分别增加0.019 mmol/L(P<0.001)、0.021 mmol/L(P=0.163)和0.028 mmol/L(P=0.088);糖化血红蛋白分别增加0.015%、0.050%和0.033%(均P<0.001)。腰围每增加1 cm,亚人群的FPG分别增加0.008 mmol/L(P<0.001)、0.014 mmol/L(P=0.004)、0.023 mmol/L(P<0.001);糖化血红蛋白分别增加0.006%、0.019%、0.019%(均P<0.001)。腰围的标准化β值均高于BMI。结论 未被诊断为糖尿病且BMI或腰围高于正常值的成年人是重点防控人群。腰围预测血糖水平的能力高于BMI,应加大举措提高腰围知晓率,有助于实现各人群维持血糖正常。
英文摘要:
      Objective To describe and compare blood glucose levels in adults aged 18 years old and above in China and explore the relationship between BMI and waist circumference with blood glucose. Methods China Chronic Disease and Risk Factor Surveillance were conducted in 298 counties/districts in China in 2018, covering 31 provinces (autonomous regions, municipalities). A multi-stage stratified cluster random sampling method selected permanent residents aged 18 years and above. Information on demographics, behavior-related risk factors, BMI, waist circumference, and blood glucose were collected through a face-to-face questionnaire, physical measurement, and laboratory examination. After complex weighting of data, they described the blood glucose levels of people with different characteristics and explored the relationship of BMI and waist circumference with blood glucose by multiple linear regression model analysis. Results A total of 177 816 adults were included in the study. The average fasting blood glucose and average glycosylated hemoglobin were (5.73±1.46) mmol/L and (5.37±0.83)%, with people aged 60 years old and above group highest than that of other, with males higher than females (P<0.001); and urban was higher slightly than rural for the average of average glycosylated hemoglobin (P<0.001). The average fasting blood glucose and average glycosylated hemoglobin increased with increased BMI and waist circumference (P<0.001). Results from multiple linear regression model analysis showed that:1) for each increase in BMI unit and waist circumference, the fasting glucose levels increased by 0.019 mmol/L and 0.008 mmol/L (all P<0.001) in those not diagnosed with diabetes, 2) by 0.021 mmol/L (P=0.163) and 0.014 mmol/L (P=0.004) in those newly detected as diabetes, and 3) by 0.028 mmol/L (P=0.088) and 0.023 mmol/L (P<0.001) in those self-reported as having been diagnosed as diabetes, respectively. However, glycosylated hemoglobin levels increased:1) by 0.015% and 0.006% in those not diagnosed as diabetes (all P<0.001), 2) by 0.050% and 0.019% in those newly detected as diabetes (all P<0.001), and 3) by 0.033% and 0.019% in those self-reported as having been diagnosed as diabetes (all P<0.001), respectively. These associations with waist circumference were more robust than with BMI. Conclusions Adults not diagnosed with diabetes with abnormal BMI or waist circumference are the key population for prevention and control. Measures improving the awareness rate of waist circumference should be taken to maintain average blood glucose in various groups.
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