脂质蓄积指数与我国中老年人群2型糖尿病发病关联的纵向研究

Correlation between lipid accumulation product and type 2 diabetes mellitus among middle-aged and elderly people in China

目的了解中国中老年人群脂质蓄积指数(LAP)与2型糖尿病发病风险之间的关联,为2型糖尿病防治提供科学依据。方法数据来源于中国健康与养老追踪调查(CHARLS)2011年和2015年数据,选择其中5317名≥45岁且符合纳入排除标准的中老年人为研究对象,进行问卷调查、体格检查和实验室检测。根据LAP(男性)=[腰围(cm)-65]×甘油三酯(mmol/L),LAP(女性)=[腰围(cm)-58]×甘油三酯(mmol/L)计算研究对象LAP。采用SPSS 20.0软件进行t检验和χ^(2)检验,采用R 4.2.3软件进行限制性立方样条函数(RCS)分析LAP与2型糖尿病发病风险之间的非线性关系,采用多因素logistic回归分析LAP与2型糖尿病发病风险的关联。结果2015年随访调查时,共有492人(9.3%)被诊断为2型糖尿病。RCS分析结果显示,LAP与2型糖尿病发病风险之间呈现非线性关系,全人群LAP>25.553时、男性LAP>19.055或女性LAP>31.127时,2型糖尿病发病风险显著上升。多因素logistic回归分析结果显示,校正混杂因素后,全人群中与LAP较低组(≤25.553)相比,较高组(>25.553)2型糖尿病发病风险上升了145%(OR=2.45,95%CI:1.97~3.05)。男性中与LAP较低组(≤19.055)相比,较高组(>19.055)2型糖尿病发病风险上升了71%(OR=1.71,95%CI:1.25~2.34)。女性中与LAP较低组(≤31.127)相比,较高组(>31.127)2型糖尿病发病风险上升了217%(OR=3.17,95%CI:2.31~4.35)。结论LAP对中国中老年人群2型糖尿病发病风险具有一定的指示作用,可将其纳入中老年人群2型糖尿病早期风险监测指标体系。

Objective To explore the correlation between lipid accumulation product(LAP)and the risk of type 2 diabetes mellitus(T2DM)among middle-aged and elderly people,and provide the scientific basis for prevention and treatment of T2DM.Data were from the China Health and Retirement Longitudinal Study(CHARLS)2011 and 2015,5317 residents(≥45 years old)meeting the inclusion and exclusion criteria were selected as the subjects.The investigation was performed with questionnaire,physical examination and lab test.According to LAP(male)=[WC(cm)-65]×TG(mmol/L)and LAP(female)=[WC(cm)-58]×TG(mmol/L),the LAP of subjects were calculated.The t test andχ^(2) test were used to analyze the data,the used software was SPSS 20.0;R 4.2.3 software was utilized for restrictive cubic spline(RCS)function to analyze the non-linear relationship between LAP and risk of T2DM.Multivariate logistic regression was used to analyze the correlation between LAP and risk of T2DM.Results At the follow-up survey in 2015,492 subjects(9.3%)were diagnosed with T2DM.RCS analysis showed that there was the non-linear correlation between LAP and the risk of T2DM,when all LAP was>25.553,male LAP was>19.055 and male LAP was>31.127,the risk of T2DM increased significantly.Multivariate logistic regression showed that after adjusting for the confounding factors,as compared with the lower LAP group(≤25.553),the T2DM risk of higher LAP group(>25.553)increased by 145%(OR=2.45,95%CI:1.97-3.05)in all people;as compared with male lower LAP group(≤19.055),the T2DM risk of male higher LAP group(>19.055)increased by 71%(OR=1.71,95%CI:1.25-2.34);as compared with female lower LAP group(≤31.127),the T2DM risk of female higher LAP group(>31.127)increased by 217%(OR=3.17,95%CI:2.31-4.35).Conclusion LAP has some indicating role of T2DM risk among middle-aged and elderly people,LAP may be included in monitoring index system for early T2DM risk among middle-aged and elderly people.