成都地区中老年人群体质量指数及腹型肥胖对糖尿病患病率及空腹血糖水平的影响

Effects of Body Mass Index and Abdominal Obesity on Prevalence of Diabetes Mellitus and Fasting Blood-glucose in Elderly People in Chengdu

目的研究成都地区中老年人群体质量指数(BMI)及腹型肥胖对糖尿病患病率及空腹血糖水平的影响。方法 2007年5月,采用随机抽样方法抽取50～80岁中老年人685人进行心血管危险因素调查,其男394人,女291人,年龄(63.3±0.2)岁。结果成都地区中老年人群的超重和肥胖所占的比例较大(约44.3%),按BMI分组(BMI<24 kg/m2;24 kg/m2≤BMI<28 kg/m2;BMI≥28 kg/m2)的糖尿病患病率分别为14.0%、18.7%及23.3%,组间差异有统计学意义(P=0.031)。男女分别按腹型肥胖标准分组(男性切点=85 cm,女性切点=80 cm),男性糖尿病患病率在非腹型肥胖及腹型肥胖组分别为17.9%及18.7%组间差异无统计学意义(P=0.849),女性糖尿病患病率分别为9.7%及18.4%,组间差异有统计学意义(P=0.034)。整个人群中,空腹血糖无随BMI增加而升高的趋势(P=0.071);女性人群中,空腹血糖随腰围的增加而升高(P=0.001);而在男性人群中无此趋势。在调整相关指标后,logistic回归分析提示BMI对糖尿病患病率独立影响,以BMI正常为参照,超重及肥胖的OR值分别为:1.412[95%CI(0.818,2.437),P=0.215]及2.200[95%CI(1.034,5.178),P=0.046]。在调整相关指标后,腹型肥胖在女性人群中对糖尿病患病率独立影响,以非腹型肥胖为参考,腹型肥胖的OR值为:1.394[95%CI(1.080,3.205),P=0.041],而在男性人群中无此关系。结论成都地区中老年人群超重及肥胖所占的比重较大,BMI可影响糖尿病患病率及空腹血糖水平;腹型肥胖能够影响女性人群糖尿病患病率及空腹血糖水平,但在男性人群中无此关系。

Objective To evaluate the effects of body mass index（BMI） and abdominal obesity on prevalence of diabetes mellitus（DM） and fasting blood-glucose（FBG） in the elderly in Chengdu.Methods In May 2007,685 subjects with an average age of（63.28 ± 0.24） years old were recruited by random sampling method for the study.Among them,57.5% were male.A survey on the risk factors of cardiovascular diseases was carried out.Results The proportion of overweight and obesity in the elderly of Chengdu was about 44.3%.We divided the subjects into three groups according to BMI（BMI24 kg/m2;24 kg/m2≤BMI28 kg/m2;and BMI≥28 kg/m2）,and DM prevalence rate was respectively 14.0%,18.7% and 23.3% for those three groups（P=0.031）.Then we divided the men and the women respectively according to the standard of abdominal obesity（male： 85 cm;female： 80 cm）,and the DM prevalence rate of normal men and men with abdominal obesity was respectively 17.9% and 18.7%（P=0.849）,but in the women,the DM prevalence rate was respectively 9.7% and 18.4% which were statistically different（P=0.034）.In all the subjects,FBG increased along with the increasing of BMI（P=0.071）.FBG had a trend to increase along with the increasing of waist circumference（WC） in the women（P=0.001）.After the adjustment of relevant indices,logistic regression analysis indicated that BMI was an independent risk factor for DM.With the reference to the normal BMI group,the OR values of overweight and obesity were respectively 1.412 [95%CI（0.818,2.437）,P=0.215] and 2.200 [95%CI（1.034,5.178）,P=0.046].The abdominal obesity was a risk factor for DM in women but not in men.In women,the OR of abdominal obesity referring to normal WC was 1.394（95%CI： 1.080-3.205,P=0.041）.Conclusions The proportion of overweight and obesity is high among the elderly people in Chengdu area.BMI can affect the prevalence of DM and the level of FBG.Abdominal obesity can affect the prevalence of DM and the level of FBG in women but not in men.