北京市朝阳区中老年女性高甘油三酯腰围与2型糖尿病的关系
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摘要
目的探讨北京市朝阳区中老年女性居民高甘油三酯腰围(hypertriglyceridemia-waist,HTGW)与2型糖尿病(T2DM)的关系,为T2DM的防治提供科学依据。方法于2014年采用多阶段分层抽样方法,抽取北京市朝阳区40～79岁13 684名女性居民作为研究对象。问卷调查一般人口学特征、行为和生活方式以及慢性病史,进行体格检查和实验室测定。采用SPSS 22.0统计软件进行单因素logistic回归分析和多因素logistic回归分析。结果纳入的13 684名研究对象中,T2DM患者2 247例,患病率为16.42%,HTGW代谢类型患者3 594例,患病率为26.26%。单因素logistic回归分析显示,高血压(OR=2.96,95%CI:2.70～3.26)、高腰围(OR=2.61,95%CI:2.31～2.94)、高龄(OR=2.38,95%CI:2.17～2.61)、肥胖(OR=2.39,95%CI:2.12～2.70)和超重(OR=1.60,95%CI:1.44～1.79)是T2DM的危险因素,均有统计学意义(P<0.05);HTGW与T2DM的关联有统计学意义(OR=3.94,95%CI:3.39～4.58)。多因素logistic回归校正混杂因素后,HTGW与T2DM依然存在关联(OR=2.51,95%CI:2.10～2.99,P<0.05)。结论 HTGW是北京市朝阳区中老年女性居民T2DM的重要危险因素,应警惕中老年女性HTGW代谢类型,及早实施干预。
Objective To explore the association of hypertriglyceridemia-waist(HTGW) and type 2 diabetes mellitus(T2 DM) in middle-aged and elderly female residents in Chaoyang district of Beijing,and to provide the scientific basis for the prevention and treatment of T2 DM. Methods In 2014,13 684 female residents(40-79 years old) in Chaoyang district of Beijing were selected by multi-stage stratified sampling method as the subjects. The investigation was performed with questionnaire including the demographic characteristics,behavior and lifestyle data and chronic diseases. Physical examinations and laboratory biochemical tests were conducted. The used software was SPSS 22.0,the univariate logistic regression analysis and multivariate logistic regression model were used to analyze the data. Results Among the 13 684 subjects, the morbidity of T2 DM was 16.42%(2 247 cases);the morbidity of HTGW was 26.26%(3 594 cases). Univariate logistic regression analysis showed that hypertension(OR=2.96,95%CI:2.70-3.26),high waist circumference(OR=2.61,95%CI:2.31-2.94),age(OR=2.38,95%CI:2.17-2.61),obesity(OR=2.39,95%CI:2.12-2.70) and overweight(OR=1.60,95%CI:1.44-1.79) were risk factors for T2 DM(P<0.05).HTGW was strongly correlated with T2 DM(OR=3.94,95%CI:3.39-4.58).The multivariate logistic regression analysis showed that after adjusting confounding factors, HTGW was still correlated with T2 DM( OR =2.51, 95% CI : 2.10-2.99, P <0.05).Conclusion HTGW was an important risk factor for T2 DM among middle-aged and elderly female residents in Chaoyang district of Beijing. More attention should be paid to the metabolic types of HTGW among middle-aged and elderly females and the intervention measures should be taken as soon as possible.
Objective To explore the association of hypertriglyceridemia-waist(HTGW) and type 2 diabetes mellitus(T2 DM) in middle-aged and elderly female residents in Chaoyang district of Beijing,and to provide the scientific basis for the prevention and treatment of T2 DM. Methods In 2014,13 684 female residents(40-79 years old) in Chaoyang district of Beijing were selected by multi-stage stratified sampling method as the subjects. The investigation was performed with questionnaire including the demographic characteristics,behavior and lifestyle data and chronic diseases. Physical examinations and laboratory biochemical tests were conducted. The used software was SPSS 22.0,the univariate logistic regression analysis and multivariate logistic regression model were used to analyze the data. Results Among the 13 684 subjects, the morbidity of T2 DM was 16.42%(2 247 cases);the morbidity of HTGW was 26.26%(3 594 cases). Univariate logistic regression analysis showed that hypertension(OR=2.96,95%CI:2.70-3.26),high waist circumference(OR=2.61,95%CI:2.31-2.94),age(OR=2.38,95%CI:2.17-2.61),obesity(OR=2.39,95%CI:2.12-2.70) and overweight(OR=1.60,95%CI:1.44-1.79) were risk factors for T2 DM(P<0.05).HTGW was strongly correlated with T2 DM(OR=3.94,95%CI:3.39-4.58).The multivariate logistic regression analysis showed that after adjusting confounding factors, HTGW was still correlated with T2 DM( OR =2.51, 95% CI : 2.10-2.99, P <0.05).Conclusion HTGW was an important risk factor for T2 DM among middle-aged and elderly female residents in Chaoyang district of Beijing. More attention should be paid to the metabolic types of HTGW among middle-aged and elderly females and the intervention measures should be taken as soon as possible.
引文
[1] NCD Risk Factor Collaboration(NCD-RisC). Worldwide trends in diabetes since 1980:a pooled analysis of 751 population-based studies with 4.4 million participants[J]. Lancet,2016,387(10027):1513-1530.
[2]纪立农.丰富中国2型糖尿病防治措施的临床证据链,建立基于中国人群证据的糖尿病防治指南———纪念第1版《中国2型糖尿病防治指南》发布10周年[J].中国糖尿病杂志,2014,22(1):1-4.
[3] Xu Y,Wang L,He J,et al. Prevalence and control of diabetes in Chinese adults[J]. JAMA,2013,310(9):948-959.
[4]冷瑶,李燕喃,邓晶.我国中老年糖尿病患者的疾病经济负担分析[J].卫生经济研究,2018,10(12):46-49.
[5] Samadi S,Bozorgmanesh M,Khalili D,et al. Hypertriglyceridemic waist:the point of divergence for prediction of CVD vs. mortality:Tehran Lipid and Glucose Study[J]. Int J Cardiol,2013,165(2):260-265.
[6] Chen S,Guo X,Yu S,et al. Association between the hypertriglyceridemic waist phenotype,prediabetes,and diabetes mellitus in rural Chinese population:a cross-sectional study[J]. Int J Environ Res Public Health,2016,13(4):1-9.
[7] Zhang M,Gao Y,Chang H,et al. Hypertriglyceridemic-waist phenotype predicts diabetes:a cohort study in Chinese urban adults[J].BMC public health,2012,12(1):1471-2458.
[8]北京市朝阳区疾病预防控制中心慢病所.北京市成人慢性病危险因素监测手册[M].北京:北京市朝阳区疾病预防控制中心慢病所,2008:44-67.
[9]李新华,任永成,赵景志,等.河南某农村中老年女性人群高甘油三酯腰围与2型糖尿病的关系[J].郑州大学学报(医学版),2015,50(4):511-514.
[10]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志,2011,7(39):579-616.
[11]中国肥胖问题工作组.中国成人超重和肥胖症预防与控制指南(节录)[J].营养学报,2004,(1):1-4. DOI:10.13325/j.cnki.acta.nutr.sin.2004.01.001
[12] Colman PG,Thomas DW,Zimmet PZ,et al. New classification and criteria for diagnosis of diabetes mellitus. The Australasian working party on diagnostic criteria for diabetes mellitus[J]. N Z Med J,1999,112(1086):139-141.
[13] Alberti KG,Zimmet P,Shaw J. Metabolic syndrome-a new worldwide definition. A consensus statement from the International Diabetes Federation[J]. Diabet Med,2006,23(5):469-480.
[14] Lemieux I,Pascot A,Couillard C,et al. Hypertriglyceridemic waist:a marker of the atherogenic metabolic triad(hyperinsulinemia;hyperapolipoprotein B;small,dense LDL)in men?[J]. Circulation,2000,102(2):179-184.
[15] Kahn HS,Valdez R. Metabolic risks identified by the combination of enlarged waist and elevated triacylglycerol concentration[J]. Am J Clin Nutr,2003,78(5):928-934.
[16] Diaz-Santana MV,Su觃rez Pérez EL,Ortiz Martinez AP,et al. Association between the hypertriglyceridemic waist phenotype,prediabetes,and diabetes mellitus among adults in Puerto Rico[J]. J Immigr Minor Health,2016,18(1):102-109.
[17] Zhao K,Yang SS,Wang HB,et al. Association between the hypertriglyceridemic waist phenotype and prediabetes in Chinese adults aged 40 years and older[J]. J Diabetes Res,2018:1031939. DOI:10.1155/2018/1031939.
[18]邓颖,陈晓芳,胥馨尹,等.四川省中老年人群糖尿病患病率及相关因素分析[J].中国医学前沿杂志(电子版),2016,8(12):18-21.
[19]张文,解为慈,刘文.高甘油三酯腰围表型与糖尿病发病关系的Meta分析[J].海南医学,2016,27(3):490-494.
[2]纪立农.丰富中国2型糖尿病防治措施的临床证据链,建立基于中国人群证据的糖尿病防治指南———纪念第1版《中国2型糖尿病防治指南》发布10周年[J].中国糖尿病杂志,2014,22(1):1-4.
[3] Xu Y,Wang L,He J,et al. Prevalence and control of diabetes in Chinese adults[J]. JAMA,2013,310(9):948-959.
[4]冷瑶,李燕喃,邓晶.我国中老年糖尿病患者的疾病经济负担分析[J].卫生经济研究,2018,10(12):46-49.
[5] Samadi S,Bozorgmanesh M,Khalili D,et al. Hypertriglyceridemic waist:the point of divergence for prediction of CVD vs. mortality:Tehran Lipid and Glucose Study[J]. Int J Cardiol,2013,165(2):260-265.
[6] Chen S,Guo X,Yu S,et al. Association between the hypertriglyceridemic waist phenotype,prediabetes,and diabetes mellitus in rural Chinese population:a cross-sectional study[J]. Int J Environ Res Public Health,2016,13(4):1-9.
[7] Zhang M,Gao Y,Chang H,et al. Hypertriglyceridemic-waist phenotype predicts diabetes:a cohort study in Chinese urban adults[J].BMC public health,2012,12(1):1471-2458.
[8]北京市朝阳区疾病预防控制中心慢病所.北京市成人慢性病危险因素监测手册[M].北京:北京市朝阳区疾病预防控制中心慢病所,2008:44-67.
[9]李新华,任永成,赵景志,等.河南某农村中老年女性人群高甘油三酯腰围与2型糖尿病的关系[J].郑州大学学报(医学版),2015,50(4):511-514.
[10]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志,2011,7(39):579-616.
[11]中国肥胖问题工作组.中国成人超重和肥胖症预防与控制指南(节录)[J].营养学报,2004,(1):1-4. DOI:10.13325/j.cnki.acta.nutr.sin.2004.01.001
[12] Colman PG,Thomas DW,Zimmet PZ,et al. New classification and criteria for diagnosis of diabetes mellitus. The Australasian working party on diagnostic criteria for diabetes mellitus[J]. N Z Med J,1999,112(1086):139-141.
[13] Alberti KG,Zimmet P,Shaw J. Metabolic syndrome-a new worldwide definition. A consensus statement from the International Diabetes Federation[J]. Diabet Med,2006,23(5):469-480.
[14] Lemieux I,Pascot A,Couillard C,et al. Hypertriglyceridemic waist:a marker of the atherogenic metabolic triad(hyperinsulinemia;hyperapolipoprotein B;small,dense LDL)in men?[J]. Circulation,2000,102(2):179-184.
[15] Kahn HS,Valdez R. Metabolic risks identified by the combination of enlarged waist and elevated triacylglycerol concentration[J]. Am J Clin Nutr,2003,78(5):928-934.
[16] Diaz-Santana MV,Su觃rez Pérez EL,Ortiz Martinez AP,et al. Association between the hypertriglyceridemic waist phenotype,prediabetes,and diabetes mellitus among adults in Puerto Rico[J]. J Immigr Minor Health,2016,18(1):102-109.
[17] Zhao K,Yang SS,Wang HB,et al. Association between the hypertriglyceridemic waist phenotype and prediabetes in Chinese adults aged 40 years and older[J]. J Diabetes Res,2018:1031939. DOI:10.1155/2018/1031939.
[18]邓颖,陈晓芳,胥馨尹,等.四川省中老年人群糖尿病患病率及相关因素分析[J].中国医学前沿杂志(电子版),2016,8(12):18-21.
[19]张文,解为慈,刘文.高甘油三酯腰围表型与糖尿病发病关系的Meta分析[J].海南医学,2016,27(3):490-494.
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