上海市浦东新区15岁及以上居民体质指数、腰围、腰臀比与糖尿病患病的关系

Relationship of body mass index, waist circumference and waist-to-hip ratio with diabetes mellitus in community residents aged 15 years old and above in Pudong new district, Shanghai

目的:分析浦东新区≥15岁社区居民BMI、腰围、腰臀比与糖尿病患病的关系,为糖尿病防治策略的制定提供依据。方法:采用多阶段分层整群抽样方法,2016年对7194名≥15岁社区居民进行问卷调查、体格检查和实验室检测,采用χ2检验、单因素线性相关、logistic回归分析BMI、腰围、腰臀比与糖尿病患病的相关性。结果:2016年浦东新区糖尿病粗患病率为27.37%,标化后为12.75%,男、女性之间患病率存在差异,男性略高于女性,糖尿病患病率随着年龄的增长呈上升趋势。FPG、餐后2 h血糖、糖化血红蛋白水平与BMI、腰围、腰臀比呈正相关。在调整混杂因素后,多元logistic回归分析结果显示,肥胖(OR=1.351,P<0.01)、腰围过大(OR=1.255,P<0.01)、腰臀比过高(OR=1.291,P<0.01)是糖尿病的危险因素。结论:肥胖、腰围、腰臀比的升高会增加糖尿病的患病风险,保持健康体重,尤其要防止腰围、腰臀比的升高,减少腹部脂肪的堆积,有利于降低糖尿病的患病风险。

Objective To analyze the relationship of body mass index(BMI),waist circumference(WC),waist-to-hip ratio(WHR)with diabetes mellitus in community residents aged≥15 years in Pudong new district of Shanghai,and provide evidence for the prevention and treatment of diabetes mellitus.Methods Using multi-stage stratified cluster sampling method,a total of 7194 community residents aged≥15 years were surveyed by using questionnaire,physical examination and laboratory tests in 2016.The relationship of BMI,waist circumference and waist-hip ratio with diabetes mellitus was analyzed byχ2 test,single factor linear correlation and logistic regression analyses.Results In 2016,the crude prevalence rate of diabetes mellitus in Pudong was 27.37%,which was 12.75%after standardization.The prevalence rate of diabetes mellitus was slightly higher in men than in women and was increased with age.The levels of FPG,2 h plasma glucose and HbA1c were positively correlated with BMI,WC and WHR.After adjusting the confounding factors,multiple logistic regression analysis showed that obesity(OR=1.351,P<0.01),excessive waist circumference(OR=1.255,P<0.01)and high WHR(OR=1.291,P<0.01)were risk factors for diabetes mellitus.Conclusions The increase of obesity,WC and WHR will increase the risk for diabetes mellitus.It is important to maintain healthy weight,especially the control of WC and WHR,reduce the accumulation of abdominal fat to reduce the risk for diabetes mellitus.