自然人群中被动吸烟与糖尿病及糖尿病前期关系的横断面研究

Cross-sectional study on the relationship between passive smoking and diabetes,pre-diabetes in natural population

目的探讨自然人群中被动吸烟与糖尿病、糖尿病前期的关系。方法运用多阶段抽样的方法抽取2013年5月~2015年12月江西省慢病监测点的6000例居民,采用中国疾病预防控制中心设计的《中国慢性病及其危险因素监测问卷》进行问卷调查和实验室检查。依据空腹血糖检测结果,将研究对象分为糖尿病组(426例,空腹血糖≥7.0 mmol/L)、糖尿病前期组(848例,6.1 mmol/L<空腹血糖<7.0 mmol/L)、健康组(4562例,空腹血糖≤6.1 mmol/L)三组。评价糖尿病、糖尿病前期与被动吸烟的关系。结果筛选出符合条件的样本5836例,样本回收率为97.27%。研究对象中,主动报告吸烟史的有5335例,其中仅被动吸烟者占40.67%,仅主动吸烟者占3.62%,既主动又被动吸烟者占18.33%,不吸任何烟者占37.38%。糖尿病组在性别、年龄、文化程度、婚姻状况、职业、体重指数(BMI)、饮酒、血压、血脂方面的分布与健康组比较,差异有统计学意义(P<0.05);糖尿病前期组在年龄、文化程度、婚姻状况、职业、BMI、饮酒、血压、血脂方面的分布与健康组比较,差异有统计学意义(P<0.05)。健康组、糖尿病组及糖尿病前期组的吸烟情况比较,差异有统计学意义(P<0.05)。广义Logit回归分析结果显示,年龄≥60岁、肥胖、饮酒、高血压、血脂异常是糖尿病或糖尿病前期的危险因素(P<0.05);同时研究结果显示,在控制了性别、年龄、文化程度、婚姻状况、职业、BMI、饮酒、高血压、血脂异常等因素后,仅被动吸烟或者主动+被动吸烟均与糖尿病或糖尿病前期无统计学关联(P>0.05)。结论横断面研究表明被动吸烟与糖尿病及糖尿病前期无关,但仍需多中心的大样本研究进行进一步验证。

Objective To explore the relationship between passive smoking and diabetes,pre-diabetes in natural population.Methods A total of 6000 residents from chronic disease surveillance in Jiangxi province were selected by multi-stage sampling from May 2013 to December 2015,and the Surveillance Questionnaire for Chronic Diseases and Their Risk Factors in China designed by Chinese Center for Disease Control and Prevention was used for questionnaire survey and laboratory examination.According to the results of fasting blood glucose,the subjects were divided into three groups:diabetic group(426 cases,fasting blood glucose≥7.0 mmol/L),pre-diabetic group(848 cases,6.1 mmol/L<fasting blood glucose<7.0 mmol/L),and healthy group(4562 cases,fasting blood glucose≤6.1 mmol/L).The relationship between prediabetes mellitus and passive smoking was evaluated.Results A total of 5836 qualified samples were screened,and the sample recovery rate was 97.27%.Among the subjects,5335 cases reported smoking history actively,among which only passive smokers accounted for 40.67%,only active smokers accounted for 3.62%,both active and passive smokers accounted for 18.33%,and those who did not smoke any cigarettes accounted for 37.38%.There were significant differences in gender,age,education level,marital status,occupation,body mass index(BMI),alcohol consumption,blood pressure,blood lipid distribution between diabetic group and healthy group(P<0.05).Compared with the healthy group,there were statistically significant differences in the distribution of age,educational level,marital status,occupation,BMI,alcohol consumption,blood pressure and blood lipid in the pre-diabetic group(P<0.05).There was statistical significance in smoking among healthy group,diabetic group and pre-diabetic group(P<0.05).Generalized Logit regression analysis showed that age≥60 years old,obesity,alcohol consumption,hypertension,dyslipidemia were risk factors for diabetes or pre-diabetes(P<0.05).At the same time,after controlling for gender,age,education level,marital status,occupation,BMI,alcohol consumption,hypertension,dyslipidemia and other factors,there was no statistical correlation between only passive smoking or active+passive smoking and diabetes or pre-diabetes(P>0.05).Conclusion The cross-sectional study shows that passive smoking is not associated with diabetes and pre-diabetes,but large multi-center studies are needed for further validation.