超重肥胖和空腹血糖关系的民族间差异研究

Relationship between Overweight/Obesity and Fasting Blood Glucose among Different Ethnicities of Uygur,Kazak,Mongolian,Han Ethnical Populations in Xinjiang Boertala Region

目的了解新疆博尔塔拉蒙古自治州维吾尔族、哈萨克族、蒙古族、汉族人群超重肥胖与空腹血糖(FBG)水平关系的民族间差异。方法从2004年9—10月新疆博尔塔拉蒙古自治州维吾尔族、哈萨克族、蒙古族、汉族代谢综合征的流行病学调查资料中选取FBG、体质指数(BMI)及腰围数据完整的3 888例受检者,其中维吾尔族986例,哈萨克族985例,蒙古族794例,汉族1 123例。BMI分级:18.5～23.9 kg/m2为正常体质量;24.0～27.9kg/m2为超重;BMI≥28.0 kg/m2为肥胖。腰围分级:男<85 cm或女<80 cm为正常腰围;男85～94 cm或女80～89cm为腰围增加;男≥95 cm或女≥90 cm为腹型肥胖。比较4个民族不同BMI或腰围分级间FBG水平及高FBG患病率,然后通过线性回归分析及Logistic回归分析探讨4个民族BMI、腰围与FBG的关系。结果 (1)维吾尔族、哈萨克族、蒙古族、汉族中FBG水平分别为(6.1±2.2)、(5.5±1.2)、(5.5±1.4)、(6.0±2.1)mmol/L,差异有统计学意义(F=29.962,P<0.001);其中维吾尔族、汉族的FBG水平高于哈萨克族、蒙古族,差异有统计学意义(P<0.05)。4个民族不同BMI分级的性别构成(除外汉族)、FBG水平、高FBG患病率(除外哈萨克族)比较,不同腰围分级的性别构成(除外哈萨克族)、FBG水平、高FBG患病率比较,差异均有统计学意义(P<0.05)。维吾尔族人随着BMI(正常体质量、超重、肥胖)或腰围(正常腰围、腰围增加、腹型肥胖)的增加,FBG水平及高FBG患病率均增加,不同分级间两两比较差异均有统计学意义(P<0.05);蒙古族人超重和肥胖时FBG水平及高FBG患病率较正常体质量时增加(P<0.05),腹型肥胖时FBG水平及高FBG患病率均高于正常腰围、腰围增加时(P<0.05);哈萨克族和汉族人肥胖或腹型肥胖时FBG水平分别较正常体质量、超重时或正常腰围、腰围增加时升高(P<0.05);汉族人随着腰围的增加,高FBG患病率增加,不同腰围分级间比较差异有统计学意义(P<0.05)。(2)线性回归分析显示,BMI(正常体质量、超重、肥胖)或腰围(正常腰围、腰围增加、腹型肥胖)每增加1级,4个民族的FBG水平均增加(P<0.05),其中维吾尔族人增加最显著(回归系数分别为0.367和0.418,P均<0.001),其次是汉族、蒙古族和哈萨克组。Logistic回归分析显示,与正常体质量或正常腰围者比,超重、肥胖或腰围增加、腹型肥胖时高FBG患病风险以维吾尔族人最高,其次是汉族人;哈萨克族人BMI及腰围对高FBG患病风险无影响;蒙古族人仅腹型肥胖时高FBG患病风险增加。结论在新疆博尔塔拉蒙古自治州维吾尔族、哈萨克族、蒙古族、汉族中,BMI或腰围增加对FBG的影响存在民族间差异,对维吾尔族人影响最大,哈萨克族人相对较小。

Objective To investigate the relationship between overweight/obesity and fasting blood glucose （FBG） a- mong Uygur, Kazak, Mongolian and Han ethnical populations in Xinjiang Boertala region. Methods 3 888 subjects （ Uygur 986, Kazak 985, Mongolian 794, Han 1 123 ） were selected from the cross - sectional study data of metabolism syndrome in Xinjiang Boertala region. Body mass index （BMI） was classified as normal （ BMI = 18. 5 to 23.9 kg/m2 ）, overweight （ BMI = 24. 0 to 27. 9 kg/m2 ） and obesity （ BMI ≥28.0 kg/m2 ）, and waist circumference （WC） as normal （ WC 〈 male 85cm/female 80 cm）, overweight （WC =male 85 to 94 cm/female 80 to 89 cm）, abdominal obesity （WC≥male 95 cm/female 90 cm）. The FBG levels and the incidence of high FBG among people with different BMI and WC levels were compared, and the relation- ship between FBG, BMI and WC was analyzed by linear - regression analysis and logistic regression analyses. Results （ 1 ） Mean FBG level was （6. 1 ±2. 2） mmol/L in Uygur, （5.5 ± 1.2） mmol/L in Kazak, （5.5 ± 1.4） mmol/L in Mongolian,（6.0 ± 2. 1 ） mmol/L in Han, and the difference was statistically significant （ F = 29. 962, P 〈 0. 001 ） . The average level of FBG and the prevalence rate of high FBG （ I〉6. 1 mmol/L） in Uygur population were significantly increased with the increasing of BMI and WC levels （all P 〈0. 05 ） . Mongolian who were overweight or obese had higher FBG levels than the subjects of nor- mal weight （all P 〈 0.05） . Kazak and Han who were obese or abdominal obese had higher FBG levels than the subjects of nor- mal weight or WC （ all P 〈 0. 05 ） . The prevalence rate of high FBG was not significantly increased with the increasing BMI in Kazak population （P =0. 213） . （2） After correction confound factors by multiple linear regression, with BMI （from 18.5 to 23.9, 24. 0 to 27.9 to ≥28 kg/m2 ） and WC increasing （from WC 〈 male 85 cm/female 80 cm, male 85 ~ 94 cm/female 80 - 89 cm to≥male 95 cm/female 90 cm） , the level of FBG all increased among the four ethnical populations, and most significant- ly increased FBG level was Uygur population （ respectively B = 0. 367, 0. 418, all P 〈 0. 001 ）, second Mogolian and Han, the last Kazak （respectively 13 =0. 113, 0. 152, all P 〈0. 05） . Compared with normal weight or WC level, Uygur population who were overweight （ BMI 24. 0 to 27.9 kg/m2, WC = male 85 to 94 em/female 80 to 89 cm） /obesity （ BMI≥28 kg/m2, WC ≥ male 95cm/female 90cm） had the highest risk of high FBG development, but it had no significant influence on Kazak （all P 〉 0.05 ） . Compared with normal BMI or WC level, the risk of high FBG development increased among Han who were obesity or abdominal obesity and among Mongolian who were abdominal obesity. Conclusion Among Uygur, Kazak, Mongolian, Han eth- nical populations in Xinjiang Boertala region, the influence of increased of BMI or WC on the FBG level and the risk of high FBG development were highest in Uygur, and were lowest in Kazak.