不同肥胖指标与老年人糖尿病患病风险的调查研究

Investigation on the relationship between different physical indexes and the risk of diabetes mellitus in the elderly

目的 分析肥胖指标BMI、腰围(WC)、脂质蓄积指数(LAP)、中国人内脏脂肪指数(CVAI)、身体圆度指数(BRI)与老年人糖尿病的关系,探讨各指标对老年人糖尿病的预测效果。方法 采取分层随机整群抽样的方法,覆盖南京市江宁区辖区内10个街道,以社区卫生服务中心为单位,选取2021年参加体检且符合纳入标准的56 410例老年人作为研究对象。收集所有研究对象的体格检查及实验室检查指标,根据是否患有糖尿病分为糖尿病组和非糖尿病组,比较2组间各指标的差异。采用Logistic回归分析探讨各肥胖指标与糖尿病之间的相关性;采用ROC曲线分析各指标对糖尿病的预测价值。结果 与非糖尿病组比较,糖尿病组性别、年龄、文化水平、婚姻状态、吸烟状况、饮酒状况、高血压、血脂异常以及BMI、WC、LAP、CVAI和BRI水平差异均具有统计学意义(P<0.05)。BMI、WC、LAP、CVAI、BRI及5种指标联合应用对老年人糖尿病患病预测的AUC分别为0.593、0.590、0.599、0.618、0.590、0.620。结论 BMI、WC、LAP、CVAI和BRI均是糖尿病的危险因素,5种指标联合应用对糖尿病的预测价值高于单个指标,因此可以利用5种指标联合进行糖尿病的预测。

Objective To analyze the relationship between obesity indexes such as BMI,waist circumference(WC),lipid accumulation product(LAP),Chinese visceral adiposity index(CVAI),body roundness index(BRI),and diabetes in the elderly,and to explore the predictive effects of these indexes for diabetes in the elderly.Methods A stratified random cluster sampling method was employed,covering 10 streets in Jiangning District,Nanjing.A total of 56410 elderly individuals who met the criteria and participated physical examinations in the community health service centers from January to December 2021 were enrolled in this study.The data of physical examination and laboratory indexes were collected.The elderly were divided into the diabetes group and the non-diabetes group based on whether they presented with diabetes,and the differences in the indexes between the two groups were compared.Logistic regression analysis was used to explore the correlation between various obesity indexes and diabetes,and receiver operating characteristic(ROC)curve analysis was used to assess the predictive value of these indexes for diabetes.Results Compared with the non-diabetes group,there were statistically significant differences in gender,age,education level,marital status,smoking status,alcohol consumption,hypertension,dyslipidemia,and the levels of BMI,WC,LAP,CVAI and BRI in the diabetes group(P<0.05).The area under the curve(AUC)of BMI,WC,LAP,CVAI,BRI,and the combination of these five indexes in predicting diabetes in the elderly was 0.593,0.590,0.599,0.618,0.590 and 0.620,respectively.Conclusions BMI,WC,LAP,CVAI and BRI are risk factors for diabetes.The combination of these five indexes shows better predictive value for diabetes than those alone.