衰老和肥胖与糖尿病的关系

Relationship of aging and obesity with type 2 diabetes

目的 探索随年龄增长、肥胖程度与糖尿病患病率的关系。方法 对“九五”攻关糖尿病研究数据库中25 896名40～99岁研究对象的年龄、肥胖、糖尿病(DM)和糖耐量低减(IGT)等相应数据进行了相关分析。按WHO(1999)标准对数据库中IGT和DM患者进行分类,按中国标准(2002)对数据库中全身性超重[体重指数(BMI)≥24]、肥胖(BMI≥28)、腹部肥胖(男,WC≥85cm;女,WC≥80cm)及腰臀肥胖(WHR≥0.93)患者进行分类。结果(1)DM患病率与年龄增长(男:R^2=0.99,女:R^2=0.91)和IGT(男:R^2=0.96,女:R^2=0.96)呈正相关。(2)DM患病率与超重(男:R^2=0.23,女:R^2=0.88)、肥胖(男:R^2=0.96,女:R^2=0.99)和腹部肥胖(男:R^2=O.82,女:R^2=O.74)呈正相关;IGT患病率与腹部肥胖(男;R^2=0.98,女:R^2=0.98)呈正相关。BMI、WC、WHR三项指标组合与DM/IGT患病率呈正相关。(3)BMI随年龄增长而下降,WC、WHR随年龄增长而上升。(4)随年龄增长肥胖程度增加可明显增加DM/IGT患病率。结论 衰老、BMI、腹部肥胖与DM和IGT患病率增长有明显的相关关系。衰老同时伴全身和腹部肥胖可加大DM和IGT的患病风险。

Objective To explore the relationship of overweight and obesity with type 2 diabetes (DM) and impaired glucose tolerance (IGT) prevalent rates in the middle and old aged Chinese population. Methods All data were from the database of the 9th 5 years national project of medical research on diabetes epidemiology. We correlated the DM and IGT prevalent rates in 25 896 adult individuals aged 40-99 years with overweight or obesity from 22 populations in 12 areas, China, in 1998. Individuals with overweight (BMI≥24), obesity (BMI≥28), abdominal obese [male: waist circumference (WC)≥85 cm; female: WC?80 cm] and waist to hip circumference ratio (WHR≥ 0. 93) were classified according to China criteria. T2 DM and IGT were diagnosed based on WHO criteria respectively. Results (1) Diabetes (DM, male: R2 = 0. 99,female : R2 = 0. 91) and impaired glucose tolerance (IGT, male ; R2 = 0. 96,female: R2 = 0. 96) prevalence correlated positively with aging. (2) Depending on aging, the relationships between DM and overweight (male: J?2 = 0. 23,female: R2 = 0. 88); and obesity (male: K2 = 0. 96,female: R2 = 0. 99) :and WC(male: R2 = 0. 82, female : R2 = 0. 74) ( and between IGT and WC (male: R2 = 0. 98,female: R2 = 0. 98) were markedly positive. The combination of BMI, WC and WHR, as a specific obesity index to classify the target populations with different grades of obesity status, was positively correlated with DM and IGT prevalent rates separately. 3) Following aging, body mass index (BMI) decreased, but WC and WHR increased with age increment. (4) The relationship between obesity and DM/IGT prevalence following aging were showed positively, but we could not show the positive relationship between DM/IGT and WHR and between IGT and BMI. Conclusion The results show that there are markedly positive relationships of overweight and obesity with DM prevalence.