饮酒量与糖尿病前期3年转归关系的前瞻性研究

A prospective study of the relationship between alcohol consumption and outcome of three-year pre-diabetes

目的探讨饮酒量与糖尿病前期3年转归的关系。方法研究对象来自泸州地区2型糖尿病患者肿瘤发生风险的流行病学研究,从基线调查中筛选出糖尿病前期人群1125例。按饮酒量分为不饮、少量、中量和大量饮酒4组,按体质指数(BMI)是否大于24 kg/m^2分2组。对所调查对象进行3年随访。比较不同饮酒量和BMI水平糖尿病发生情况。结果完成随访1116例,失访9例。不饮、少量、中量和大量饮酒组糖尿病发病率分别为18.81%、8.80%、16.51%、26.53%。Cox比例风险回归分析显示,调整性别、年龄、BMI、热量、基线血糖因素后,少、中、大量饮酒组与不饮酒组糖尿病发病相对风险比RR及95%CI分别为0.49(0.31~0.79)、1.15(0.69~1.92)、1.95(1.25~3.04)。按BMl分组比较:BMI<24 kg/m^2人群少、中、大量饮酒组与不饮酒组糖尿病发病风险比RR及95%CI分别为:0.40(0.20~0.80)、0.77(0.30~1.97)、1.10(0.46~2.64);BMI≥24 kg/m^2人群少、中、大量饮酒组与不饮酒组糖尿病发病风险比RR及95%CI分别为:0.62(0.33~1.66)、1.49(0.80~2.80)、2.64(1.55~4.47)。结论少量饮酒可以降低BMI<24 kg/m^2糖尿病前期人群的糖尿病发病风险,对于BMI≥24 kg/m^2人群大量饮酒则增加糖尿病发病风险。

Objective To investigate the associations of alcohol consumption with the outcome of three-year pre-diabetes. Methods The objects of this study were selected from the epidemiological study of cancer risk of Chinese patients with type 2 diabetes mellitus （T2DM） in Luzhou area. A total of 1 125 cases with pre-diabetes were selected from the baseline survey. Patients divided into four groups including non-alcohol drinking group, small alcohol drinking group, moderate alcohol drinking group, and large alcohol drinking group. Patients also were divided into two groups according to body mass index （BMI, more than 24 kg/m2）. The patients were followed up for three years. The incidence rates of diabetes mellitus were compared between different drinking groups and different BMI groups. Results A total of 1 116 cases were completed the follow-up , 9 cases were lost to follow-up. The incidence rates of DM were 18.81%, 8.80%, 16.51%and 26.53%for non-alcohol drinking group, small alcohol drinking group, moderate alcohol drinking group, and large alcohol drinking group. Cox proportional hazard regression analysis showed that the relative risk ratios and 95%CI of the gender, age, BMI, calorie, baseline blood glucose were 0.49 （0.31-0.79）, 1.15 （0.69-1.92） and 1.95 （1.25-3.04） for small alcohol drinking group, moderate alcohol drinking group, and large alcohol drinking group. In the group of BMI＆lt;24 kg/m2,the relative risks and 95%CI were 0.40 （0.20-0.80）,0.77 （0.30-1.97） and 1.10 （0.46-2.64） for small alcohol drinking group, moderate alcohol drinking group, and large alcohol drinking group. In the group of BMI≥24 kg/m2, the relative risks and 95%CI were 0.62 （0.33-1.66）,1.49 （0.80-2.80） and 2.64 （1.55-4.47）. Conclusion Small amount of alcohol drinking can reduce the incidence of DM in prediabetes people with BMI＆lt;24 kg/m2. Large amount of alcohol drinking is the risk factor of incidence of DM in people with BMI≥24 kg/m2.