青岛地区成年人体重变化和糖尿病发病率相关性研究

宁锋; 汪韶洁; 王玉美; 孙健平; 张磊; 高维国; 南海荣; 任杰; 乔青; 逄增昌

Abstract

宁锋,汪韶洁,王玉美,孙健平,张磊,高维国,南海荣,任杰,乔青,逄增昌.青岛地区成年人体重变化和糖尿病发病率相关性研究[J].Chinese journal of Epidemiology,2014,35(7):764-768

青岛地区成年人体重变化和糖尿病发病率相关性研究

Weight change in association with the incidence of type 2 diabetes in adults from Qingdao, China

Received:December 20, 2013

DOI：10.3760/cma.j.issn.0254-6450.2014.07.002

KeyWord: 糖尿病体重变化危险因素发病率

English Key Word: Diabetes mellitus Weight change Risk factors Incidence

FundProject:世界糖尿病基金会支持项目（WDF05-108, WDF07-308）

Author Name	Affiliation	E-mail
Ning Feng	Qingdao Centers for Disease Control and Prevention, Qingdao 266033, China	ningf1010@126.com
Wang Shaojie	Qingdao Centers for Disease Control and Prevention, Qingdao 266033, China
Wang Yumei	Dongying People’s Hospital
Sun Jianping	Qingdao Centers for Disease Control and Prevention, Qingdao 266033, China
Zhang Lei	Department of Endocrinology, Weifang Medical College Qingdao Endocrinology and Diabetes Hospital
Gao Weiguo	Department of Research and Development, AstraZeneca, Shanghai
Nan Hairong	Faculty of Health and Social Science, HongKong Polytechnic University
Ren Jie	Institution of Chronic Disease, Shandong Centers for Disease Control and Prevention
Qiao Qing	Department of Public Health, University of Helsinki
Pang Zengchang	Qingdao Centers for Disease Control and Prevention, Qingdao 266033, China

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Abstract:

目的评估青岛地区糖尿病发病率, 以及体重变化等危险因素对糖尿病发病的影响。方法研究对象源自2006 年建立的青岛地区35～74 岁成年人糖尿病前瞻性队列。共有1 294 名基线未诊断糖尿病者参加2009－2011 年的随访调查。糖尿病诊断依据WHO/国际糖尿病联盟2006 年标准。运用多因素logistic backward 回归分析, 评估危险因素对糖尿病发病率的影响。结果经过4 年随访调查, 有120 名新发糖尿病病例, 累积糖尿病患病率为11.8%。与正常人群相比, 新确诊糖尿病患者年龄较大, 年龄校正的BMI、WC、SBP和TC明显增加（P＜0.05）。年龄、居住农村、基线体重和体重变化是糖尿病发病的独立危险因素。多因素logistic 回归调整的糖尿病发病风险比（RR值）分别为1.45（95%CI：1.13～1.87）、1.93（95%CI：1.12～3.34）、1.46（95%CI：1.05～2.03）和1.49（95%CI：1.18～1.88）。与体重稳定的者相比, 体重减少＞5%和BMI＜28 kg/m²的人群, 糖尿病发病降低67%（RR＝0.33, 95%CI：0.11～0.97）；但BMI＞28 kg/m² 者中增加了糖尿病发病危险, 并随体重变化而不同（P＜0.01）。基线调查时WC和体重增加者也表现出相同的变化趋势。结论进一步证实肥胖在糖尿病发展中的作用, 基线时的BMI和体重增加是预测糖尿病发病的独立危险因素。

English Abstract:

Objective Since the incidence rates and risk factor for type 2 diabetes in Chinesepopulations had not been well known, the aim of this study was to evaluate the impact of weight change and other risk factors on incident type 2 diabetes in Qingdao, China. Methods A prospective population-based cohort study was carried out, based on subjects aged 35-74 years who participated in the‘Qingdao Diabetes Survey’in 2006. Subjects were free of diabetes at baseline. A total of 1 294 subjects attended the follow up survey between 2009 and 2011. The diagnostic criteria for Diabetes was classified according to both the World Health Organization and the International Diabetes Federation 2006. A logistic regression was built using the backward stepwise selection to assess the effects of risk factors on the incident type 2 diabetes. Results During a 4-year follow up period, 120 cases with incident type 2 diabetes were identified, with cumulative incidence of diabetes as 11.8% .Participants who developed type 2 diabetes were significantly older, having significantly higher age-adjusted BMI/waist circumference/systolic blood pressure and total cholesterol, than those subjects who remained non-diabetic both in urban and rural areas. Among individuals with no diabetes at the baseline, factors as age, living in the rural areas, baseline BMI and weight change had all independently contributed to the development of diabetes. The multivariate adjusted relative risks （95%CIs）related to the incidence of diabetes were 1.45（1.13-1.87）, 1.93（1.12-3.34）, 1.46（1.05-2.03） and 1.49（1.18-1.88）, respectively, for a one standard deviation increase in continuous variables. Compared with the reference group of non-obese and with stable weight, factor as weight loss ＞5% and BMI ＜28 kg/m² were independently associated with a 67%（RR＝0.33, 95% CI：0.11-0.97）reduction in the risk of type 2 diabetes, while BMI ＞28 kg/m² could increase the risk across the levels of weight change. Similar trends were observed in higher waist and weight gain at baseline. Conclusion This study confirmed the critical importance of obesity in the development of type 2 diabetes. Baseline BMI and weight gain appeared independent predictors on type 2 diabetes.

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