上海市成年人中心性肥胖者糖尿病的患病风险

Association of central obesity with risk of diabetes mellitus among adults in Shanghai Municipality

目的采用腰围(waist circumference,WC)、体质指数(body mass index,BMI)综合评价上海35岁及以上成年人中心性肥胖者糖尿病患病风险。方法利用2013年上海慢性病及其危险因素监测样本人数,采用多级抽样方法抽取35岁及以上成年人20 991人,采用问卷调查、身体测量和实验室检测方法收集数据,比较各BMI组别中心性肥胖者糖尿病患病的OR值。结果体质指数正常、超重和肥胖组中,男性中心性肥胖者糖尿病患病率分别为19.68%、21.89%和27.03%;女性中心性肥胖者糖尿病患病率分别为17.78%、19.32%和26.73%;不同体质指数分组中心性肥胖人群糖尿病患病风险情况,男女性正常体重组和女性超重组,调整混杂因素前后,中心性肥胖者糖尿病患病率明显高于同组内的正常腰围人数(P<0.01),OR值分别为男性正常体重组未调整OR值1.62(95%CI:1.16~2.28),调整后OR值1.65(95%CI:1.16~2.33);女性正常体重组未调整OR值2.28(95%CI:1.71~3.04),调整后OR值1.93(95%CI:1.49~2.50);女性超重组未调整OR值2.31(95%CI:1.66~3.22),调整后OR值2.01(95%CI:1.44~2.80)。结论中心性肥胖者与正常腰围者比较具有更高的糖尿病患病风险。

Objective To comprehensively evaluate the risk of developing diabetes mellitus （ DM ） in subjects with central obesity among adults aged 35 years and above in Shanghai by using waist circumference （WC） and body mass index （ BMI ）. Methods Multistage sampling method was adopted to select 20,991 adults aged 35 years and above from the monitored subjects in Shanghai Chronic Disease and Risk Factors Surveillance in 2013. Questionnaire surveys, body measurement and laboratory tests were used to collect the data. Odds ratio for DM was compared among subjects with central obesity from different BMI groups. Results The prevanlenee rates of DM in central obesity males and females from the groups of normal BMI, overweight and obesity were 19.68% and 17.78%, 21.89% and 19.32%, 27.03% and 26.73% respectively. Comparative analysis of different BMI groups showed that among the male and female groups of normal weight and the female overweight group, the prevanlence rate of DM was significantly higher in subjects with central obesity than in ones with normal WC in the same group before and after adjusting for the mixed factors （ all P〈0.01 ）. The unadjusted and adjusted odds ratios in the male and female groups of normal weight and the female overweight group were as follows： 1.62 （ 95%CI： 1.16-2.28） and 1.65 （ 95%CI： 1.16-2.33） , 2.28 （95%CI： 1.71 -3.04）and 1.93 （95%CI：1.49-2.50） , 2.31（95%CI：1.66-3.22） and 2.01 （95%CI：1.44-2.80）. Conclusion Compared with subjects with normal WC, those with central obesity have a higher risk of developing DM.