酒精摄入量与糖尿病患病关系的横断面研究

Relationship between alcohol intake and prevalence of diabetes mellitus:a cross-sectional study

目的：探讨酒精摄入量与糖尿病患病的关系。方法：采用分层随机抽样方法 ,先随机抽取泸州市3个社区,每个社区内再随机抽取到个人,共抽取泸州市区40岁及以上常驻居民4 000人,对其进行调查问卷及体格检查,生化检查。结果：调查有效人数共3 970名,其中糖尿病患病率为19.47%。饮酒率为41.2%,其中男性饮酒率为60.9%,女性饮酒率为30.9%,男性明显高于女性。按饮酒量不同分组：男女新诊糖尿病患病率少量饮酒组（男5.09%,女4.26%）均低于不饮酒组（男9.17%,女7.11%）,男性大量饮酒组（男21.76%,女15.19%）均高于其他3组;男女既诊糖尿病患病率均随饮酒量的增加而下降,大量饮酒组最低。总体而言,少量饮酒组新诊患病率最低,并明显低于不饮酒组,大量饮酒组明显高于其他3组。既诊患病率饮酒组均低于不饮酒组。各组生化指标比较：少量和中量饮酒组餐后2 h血糖（2-hour postprandial glucose,2h PG）、糖化血红蛋白（hemoglobin A1C,Hb A1C）均明显低于不饮酒组,大量饮酒组空腹血糖、2h PG及Hb A1C水平明显高于其他3组。大量饮酒组胆固醇明显高于少量和中量饮酒组,高密度脂蛋白明显低于其他3组,低密度脂蛋白明显高于其他3组。logistic回归分析调整混杂因素后,少量饮酒是糖尿病的保护因素（OR=0.641,95%CI=0.508~0.807）。结论：少量饮酒是糖尿病的保护因素,大量饮酒则升高血糖、血脂水平。

Objective ：To investigate the relationship between alcohol intake and prevalence of diabetes mellitus（DM）. Methods ：Stratified sampling was used to select 4 000 permanent residents aged 40 years and above. All participants completed standardized questionnaire,physical examination and biochemical tests. Results：The total effective number was 3 970 and the prevalence of DM was 19.47%. The percentage of drinking was 41.2%,of which the male was 60.9%,the female was 30.9%;the percentage of male was significantly higher than that of female（P 0.05）. The prevalence of newly diagnosed DM in small-amount drinking group（male5.09%,female 4.26%） was lower than that of non-drinking group（male 9.17%,female 7.11%）. The prevalence in large-amount drinking group（male 21.76%,female1 15.19%） was significantly higher than that of other three groups. The prevalence of previously diagnosed DM was decreased with the increase of drinking amount;the prevalence of large-amount drinking group was the lowest. In general,the prevalence of newly diagnosed DM in small-amount drinking group was lower than that of non-drinking group. The prevalence of large-amount drinking group was significantly higher than that of the other three groups. The prevalence of previously diagnosed DM in drinking groups was lower than that of non-drinking group. The levels of 2-hour postprandial glucose（2h PG） and hemoglobin A1C（ Hb A1C） in groups of small- amount and moderate-amount drinking groups were significantly lower than those of non-drinking group. In large-amount drinking group,the levels of fasting plasma glucose,2h PG and Hb A1 C were significantly higher than those of the other three groups;the level of cholesterol was significantly higher than that of small and moderate drinking group. The high-density lipoprotein was significantly lower than that of the other three groups,the low-density lipoprotein was significantly higher than that the other three groups（P0.05）. The multivariate logistic regression analysis revealed that the group of small-amount drinking had a lower odds ratio for diabetes compared with that of non-drinking group（OR=0.641,95%CI=0.508 to 0.807）,and it was a protective factor for diabetes even after the adjustment of gender,age,BMI,smoking,calorie intake,family history of diabetes. Conclusion：Small-amount drinking is a protective factor for DM. Large-amount drinking can increase the levels of blood glucose and blood lipid.