中国成年人静坐时间与2型糖尿病发病关系的前瞻性队列研究

从祥丰; 刘少博; 徐婷玲; 王文绢; 马吉祥; 陈波; 李剑虹

Abstract

从祥丰,刘少博,徐婷玲,王文绢,马吉祥,陈波,李剑虹.中国成年人静坐时间与2型糖尿病发病关系的前瞻性队列研究[J].Chinese journal of Epidemiology,2020,41(9):1465-1470

中国成年人静坐时间与2型糖尿病发病关系的前瞻性队列研究

Relationship between sedentary time and incidence of type 2 diabetes in adults in China: a prospective cohort study

Received:September 26, 2019

DOI：10.3760/cma.j.cn112338-20190926-00705

KeyWord: 静坐时间糖尿病,2型前瞻性研究

English Key Word: Sedentary time Type 2 diabetes Prospective study

FundProject:国家重点研发计划（2018YFC1313904）

Author Name	Affiliation	E-mail
Cong Xiangfeng	National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Liu Shaobo	National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Xu Tingling	National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Wang Wenjuan	National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Ma Jixiang	Office of Non-communicable Diseases and Ageing Health Management, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Chen Bo	National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Li Jianhong	National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China	lijianhong@ncncd.chinacdc.cn

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Abstract:

目的探讨我国成年人静坐时间与2型糖尿病发病的关系。方法将2010年中国慢性病及其危险因素监测数据作为基线数据。从2010年监测点中选取8个省，每个省选择2个监测点（城市和农村各1个）作为随访点，排除基线2型糖尿病患者，共8 625人进入随访队列，2016－2017年进行随访调查，共随访到5 991人。采用Cox比例风险回归模型分析静坐时间与2型糖尿病发病的关系，并按性别、地区、城乡等不同特征进行亚组分析。结果根据入选标准共纳入5 782名研究对象，平均随访6.4年（36 927.0人年），随访期间共观察到2型糖尿病发病事件592例，2型糖尿病发病密度为16.0/千人年。多因素Cox回归分析结果显示，在调整了相关混杂因素之后，与静坐时间0.0~h/d者相比，静坐时间>6.0 h/d者糖尿病发病风险增加33%（HR=1.33，95% CI：1.05~1.68）。亚组分析显示结果和全人群结果略有不同，只在男性、吸烟、中心性肥胖、超重/肥胖、有糖尿病家族史、农村、东部和中部地区人群中发现，静坐时间过长与糖尿病发病风险有统计学关联。结论静坐时间过长可增加2型糖尿病发病风险。应加强生活方式干预，减少成年人静坐时间，尤其是每日静坐时间>6.0 h的人群。

English Abstract:

Objective To explore the relationship between sedentary time and the incidence of type 2 diabetes in adults in China. Methods Data collected from the Chinese Chronic Disease and Risk Factor Surveillance (CCDRFS) in 2010 were used as baseline data. Eight provinces where CCDRFS were conducted in 2010 were selected, and two surveillance spots (one in urban area and another one in rural area) of each provinces were further selected for the follow-up studies. After excluding diagnosed diabetes patients according to baseline data, a total of 8 625 of subjects were recruited as participants. In the follow up carried out from 2016 to 2017, a total of 5 991 people received complete follow up. Cox proportional hazards models were used to analyze the relationship between sedentary time and the incidence of type 2 diabetes, and subgroup analysis was conducted based on variables such as gender, geographic area, and urban area or rural areas. Results A total of 5 782 subjects were included in final analysis. During an average 6.4 years of follow up (36 927.0 person-years), 592 participants developed type 2 diabetes, the incidence rate was 16.0 per 1 000 person years. Multivariate Cox regression analysis showed that after adjustment for possible confounders, compared with the 0.0- h/d group, the risk of diabetes incidence increased by 33% (HR=1.33, 95% CI: 1.05-1.68) for those who had sedentary time for more than 6.0 h every day. The subgroup analysis showed that the significant association was only observed in those who were men, current smokers, central obese, had family history of diabetes, had rural residency, and lived in eastern and central areas of China. Conclusions Longer sedentary time can increase the risk of type 2 diabetes. Lifestyle intervention should be strengthened to reduce sedentary time, especially for people who had sedentary time for more than 6.0 h every day.

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