| 张思婷,张继国,贾小芳,姜红如,王柳森,张兵,王惠君,王志宏,丁钢强.2018年中国15省份18~65岁居民肥胖与2型糖尿病患病的关联研究[J].中华流行病学杂志,2022,43(10):1596-1602 |
| 2018年中国15省份18~65岁居民肥胖与2型糖尿病患病的关联研究 |
| Association between obesity and the prevalence of type 2 diabetes mellitus among Chinese adults aged 18-65 years in 15 provinces in 2018 |
| 收稿日期:2021-11-15 出版日期:2022-10-18 |
| DOI：10.3760/cma.j.cn112338-20211115-00884 |
| 中文关键词: 肥胖 体质指数 腰围 糖尿病 2型 成年人 |
| 英文关键词: Obesity Body mass index Waist circumference Diabetes type 2 Adult |
| 基金项目:国家重点研发计划（2020YFC2006300） |
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| 中文摘要: |
| 目的 分析不同肥胖类型、不同BMI和腰围水平与成年人糖尿病患病风险的关联。方法 利用2018年中国健康与营养调查数据，依据《成人体重判定》（WS/T 428-2013）重新划分肥胖定义，包括非肥胖、单纯一般性肥胖、单纯中心性肥胖和复合型肥胖。应用两水平logistic回归模型及限制性立方样条模型分析不同肥胖类型、不同BMI和腰围水平与糖尿病患病风险的关联。结果 共纳入7 030名18~65岁居民，其中一般性肥胖率、中心性肥胖率分别为男性16.29%（502/3 082）和42.28%（1 303/3 082）；女性14.41%（569/3 948）和37.87%（1 495/3 948）；其中复合型肥胖率男、女性分别为14.70%和12.97%。糖尿病患病率为11.28%，其中男、女性复合型肥胖人群糖尿病患病率分别为18.98%和22.07%，高于单纯中心性肥胖人群（16.24%，15.26%）和非肥胖人群（9.65%，5.18%）。男性单纯中心性肥胖、复合型肥胖患糖尿病的可能性分别是非肥胖人群的1.61（95%CI：1.24~2.08）和2.11（95%CI：1.56~2.86）倍；女性单纯一般性肥胖、单纯中心性肥胖和复合型肥胖患糖尿病的可能性分别是非肥胖人群的2.70（95%CI：1.16~6.28）、2.62（95%CI：2.01~3.40）和4.47（95%CI：3.35~5.98）倍。限制性立方样条模型显示：BMI水平与糖尿病患病风险间呈近乎线性正关联；腰围水平与糖尿病患病风险呈显著正关联，其中女性呈非线性升高（非线性P=0.024）。男性BMI≥22.5 kg/m2、女性BMI≥23.0 kg/m2；男性腰围≥85.0 cm、女性腰围≥80.0 cm时，糖尿病患病风险显著上升。结论 复合型肥胖人群患糖尿病的风险更高。BMI处于正常高值、腰围水平处于中心性肥胖前期时，糖尿病患病风险明显上升。 |
| 英文摘要: |
| Objective To analyze the association between different types of obesity, BMI, and waist circumference (WC) and the risk of type 2 diabetes mellitus (T2DM) in Chinese adults.Methods Based on the China Health and Nutrition Survey data in 2018, different types of obesity were defined across different BMI and WC combinations based on Criteria of weight for adults (WS/T 428-2013), including non-obesity, simple general obesity, simple central obesity, and complex obesity. The associations of different types of obesity, BMI, and WC with T2DM risk were explored using two-level mixed-effects logistic regression and restricted cubic spline models.Results A total of 7 030 subjects aged 18-65 were included in this study. The prevalence of general obesity and central obesity were 16.29% (502/3 082), 42.28% (1 303/3 082) in males, and 14.41% (569/3 948), 37.87% (1 495/3 948) in females. The prevalence of complex obesity was 14.70% and 12.97% in males and females, respectively. The prevalence of T2DM was 11.28% in participants, and the prevalence in complex obesity (18.98%, 22.07%) was higher than in simple central obesity (16.24%, 15.26%) and non-obesity (9.65%, 5.18%) in males and females, respectively. Multilevel regressions showed that males with simple central obesity and complex obesity had 1.61 (95%CI:1.24-2.08) and 2.11 (95%CI:1.56-2.86) times the odds of T2DM, respectively, as compared with the non-obesity; and the odds of T2DM in females were 2.70 (95%CI:1.16-6.28) times for simple general obesity, 2.62 (95%CI:2.01-3.40) times for simple central obesity, and 4.47 (95%CI:3.35-5.98) times for complex obesity. A nearly linear positive association was observed between BMI and T2DM risk. WC was also positively associated with T2DM risk and a non-linearly increased risk in females (P for non-linear=0.024). The risk of T2DM increased when BMI ≥ 22.5 kg/m2 and 23.0 kg/m2, WC ≥ 85.0 cm and 80.0 cm in males and females, respectively.Conclusions Complex obesity adults are more likely to suffer from T2DM. The risk of T2DM increases significantly when BMI is at the normal high values and waist circumference at the stage of pre-central obesity. |
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