用危险因素评分法分析超重及肥胖对糖尿病的影响

Contribution of overweight and obesity to the prevalence rate of diabetes and its other risk factors

目的用危险因素评分法评价可干预的危险因素超重及肥胖对糖尿病发病及其他相关危险因素的影响。方法采用危险因素评分法在对糖尿病危险因素进行流行病学问卷调查的基础上,根据体质量指数(BMI)将人群分为A(超重肥胖)、B(正常)两组,A组2580人,B组2768人。分别对两组人群的糖尿病和糖耐量异常(IGT)的患病率进行统计,并采用非条件logistic回归分析筛选糖尿病的危险因素,根据危险因素的回归系数β值确定不同变量的积分值,以累计积分值的大小判断个体患病的危险性。结果 A组糖尿病的患病率为6.7%,IGT的患病率为17.5%;年龄、糖尿病家族史、腰臀比、收缩压、脉搏、高血糖史等6个因素经筛选成为危险因素变量。B组糖尿病的患病率为1.1%,IGT的患病率为7.0%,年龄、舒张压、糖尿病家族史、高血糖史等4个因素经筛选成为危险因素变量。趋势性χ2检验显示,差异有统计学意义(P<0.001)。结论超重肥胖人群糖尿病患病率明显高于普通人群。年龄、血压、糖尿病家族史、既往高血糖史是糖尿病发病的独立危险因素。通过测身高、体质量及回答问卷的无创方法,能发现潜在的、易忽略的危险因素,对体质量进行早期干预能够显著减少糖尿病及IGT的发病率。

Objective To investigate the contributions of overweight and obesity to the prevalence rate of diabetes and its other risk factors on the basis of a questionnaire of the diabetes epidemic survey model.Methods Based on a questionnaire of epidemiological survey,obese and non-obese target populations were enrolled.According to the body mass index （BMI） ,the participants were divided into 2 groups：group A （BMI≥24 kg/m2） and group B （BMI24 kg/m2） .The prevalence rate of diabetes and impaired glucose tolerance（IGT） were calculated.Logistic regression analysis was carried out to screen the primary risk factors of diabetes.The score of the variables was determined by β-coefficients,and used to predict the risk of correlation factors.Results The prevalence rate of diabetes and IGT were 6.7% and 17.5% in group A,and 1.1% and 7.0% in group B,respectively.Age,family history of diabetes,waist-hip ratio （WHR） ,systolic pressure,pulse,and history of high glucose were singled out as risk factors in group A.Age,diastolicpressure,family history of diabetes,and history of high glucose were risk factors in group B.A trend χ2 test yielded a sta-tistical significance （P0.001） .Conclusion The prevalence rate of diabetes and IGT were much higher in the over-weight and obese population than in the non-obese population.Lifestyle modification can control this factor,it is promising to prevent or delay the development of diabetes mellitus and IGT.Age,blood pressure,family history of diabetes,and history of high blood sugar are all independent risk factors for diabetes.