膳食、生活方式等环境因素对T2DM的影响

Diet,lifestyle and other environmental factors on the influence of T2DM

目的：分析膳食、生活方式因素对T2DM的影响,为制定T2DM群体预防和控制措施提供科学依据。方法：采用多阶段分层随机抽样方法,对赣州市章贡区、黄金区、南康市（县级市）、兴国县、于都县、上犹县、龙南县、大余县、赣县等35-64岁的常住居民共9801人进行T2DM基线调查;调查内容包括人口学和膳食状况、体格检查及实验室检测;应用单因素非条件logistic回归分析、多因素非条件logistic回归模型拟合,筛选T2DM可疑危险因素。结果：共获得有效资料8 906份,T2DM患病率为7.7%;单因素分析表明,年龄（OR=3.633,95%CI：1.805-6.471）、文化程度（OR=8.081,95%CI：2.689-13.378）、家族糖尿病史（OR=2.669,95%CI：1.048-4.332）、高血压史（OR=3.167,95%CI：1.119-5.672）、腰臀比（OR=2.322,95%CI：1.291-3.855）、高密度脂蛋白胆固醇（OR=0.336,95%CI：0.219-0.738）、粗粮的摄入（OR=0.553,95%CI：0.121-0.833）、甜食的摄入（OR=2.284,95%CI：1.776-3.068）及体力活动（OR=0.765,95%CI：0.309-0.977）等9个因素与T2DM患病有统计学意义（P〈0.05）的关联;多因素回归模型拟合发现,年龄（OR=2.412,95%CI：1.409-4.127）和腰臀比（OR=2.673,95%CI：1.461-4.889）是T2DM发生的独立危险因素,而高密度脂蛋白胆固醇（OR=0.499,95%CI：0.295-0.846）和粗粮的摄入（OR=0.385,95%CI：0.185-0.803）是T2DM发生的保护因素。结论：T2DM与膳食、生活方式等环境因素有关,且环境因素间相互作用;针对T2DM高危人群和全人群采取适当运动、合理膳食、控制体重等综合干预措施是预防T2DM的重要手段。

Objective： To analyze the effect of dietary and lifestyle factors on T2 DM. Then to provide the scientific reference for the further study of prevention and regulation of T2 DM. Methods： Using multi-stage stratified random sampling method,9 801 permanent residents（ aged 35 - 64） be selected from Zhang Gong county,Huangjin county,nankang county（ county-level cities）,Xing Guo county,Yu Du county and Shang You county,Longnan county,Dayu county,Gan county among Gan Zhou City. Then baseline investigation to be carried out. The contents of investigation be involved by demography,diet,physical examination and laboratory detection. Application of single factor unconditioned logistic regression analysis and multiple factors unconditioned logistic regression model fitting,screening of T2 DM suspicious risk factors. Results： 8 906 valid data was obtained,the prevalence rate of T2 DM was 7. 7%. Single-factor analysis showed that nine factors,including age（ OR = 3. 633,95% CI： 1. 805- 6. 471） 、level of education（ OR = 8. 081,95% CI： 2. 689 - 13. 378） 、family history of diabetes（ OR = 2. 669,95% CI： 1. 048 - 4. 332） 、history of high blood pressure（ OR = 3. 167,95% CI：1. 119 - 5. 672） 、waist / hip ratio（ WHR）（ OR = 2. 322,95% CI： 1. 291 - 3. 855） 、high density lipoprotein cholesferol（ HDL-C）（ OR = 0. 336,95% CI： 0. 219 - 0. 738） 、intake of whole grains（ OR = 0. 553,95% CI： 0. 121 - 0. 833） 、intake of sweets（ OR = 2. 284,95% CI： 1. 776 - 3. 068） and physical activity（ OR = 0. 765,95% CI： 0. 309 - 0. 977）,were statistically significant correlation with T2DM（ P〈0. 05）. Multi-factor regression model fitting indicated that age（ OR =2. 412,95% CI： 1. 409 - 4. 127） and WHR（ OR = 2. 673,95% CI： 1. 461 - 4. 889） were independent risk factors with T2 DM,while HDL-C（ OR = 0. 499,95% CI： 0. 295 - 0. 846） and intake of whole grains（ OR = 0. 385,95% CI： 0. 185 -0. 803） were protective factors with T2 DM. Conclusion： T2 DM is associated with environmental factors such as diet and lifestyle,and between environmental factors interact with each other. In view of T2 DM high-risk groups and all the crowd,appropriate exercise,reasonable diet,weight control,and other important intervention measures are very necessary to prevent the T2 DM.