2型糖尿病影响因素的巢式病例对照研究
|
摘要
目的研究影响2型糖尿病发病的因素,探讨糖尿病家族史分别与总体性肥胖、高血压、高脂血症、腰臀比异常的交互作用对2型糖尿病的影响。
方法采用1：2匹配巢式病例对照研究,以青岛地区2006年调查时的1426位社区居民作为队列人群。2010年对该队列人群仅进行了血糖的检测,以2010年的血糖检测结果作为病例组的入选依据,病例组106例。按照居住地相同、性别相同、年龄相差(±3)岁的原则,以1：2的比例从该队列中为每例病例匹配两位对照,对照组共212人。用Cox回归拟合配对Logistic回归模型,分析影响2型糖尿病发病的因素,运用相加模型分析糖尿病家族史分别与总体性肥胖、高血压、高脂血症、腰臀比异常的交互作用对2型糖尿病的影响。
结果12型糖尿病发病的影响因素
单因素分析显示,糖尿病家族史(χ2=6.90,P=0.009,OR=2.03,95%CI:1.19～3.46)、06年调查时处于肥胖状态(06肥胖)(χ2=17.4,P<0.001,OR=2.82,95%CI: 1.72～4.62)、40岁时肥胖(肥胖40)(χ2=9.18,P=0.002,OR=3.18,95%CI:1.46～6.94)、最高体重时处于肥胖状态(肥胖max)(χ2=10.9,P=0.001,OR=2.24, 95%CI:1.38～3.63)、腰臀比(WHR)异常(χ2=6.51,P=0.011,OR=1.86,95%CI:1.15～3.02)、高脂饮食(χ2=8.87,P=0.003,OR=2.38,95%CI:1.33～4.24)、高血压(χ2= 6.75,P=0.009,OR=1.93,95%CI:1.17～3.17)、高脂血症(χ2=6.05,P=0.014,OR=1.81, 95%CI:1.12～2.91)等因素与2型糖尿病的发病呈正相关关系；体力活动与2型糖尿病的发病呈负相关关系(χ2=6.14,P=0.046,OR=0.59,95%CI:0.39～0.90)、
多因素模型1的结果显示：糖尿病家族史(OR=1.81,P=0.026)、06肥胖(OR=2.58,P=0.005)、高血压(OR=1.35,P=0.012)、高脂血症(OR=1.52,P=0.022)、高脂饮食(OR=3.53,P=0.002)、WHR异常(OR=2.44,P=0.038)等因素与2型糖尿病的发病呈正相关关系,体力活动则与2型糖尿病的发病呈负相关关系(OR=0.57,P=0.031)。
多因素模型2的结果显示：糖尿病家族史(OR=1.89,P=0.046)、高血压(OR=1.64,P=0.018)、高脂血症(OR=1.55,P=0.032)、高脂饮食(OR=3.53,P=0.004)、WHR异常(OR=2.69,P=0.017)等因素与2型糖尿病的发病呈正相关关系,体力活动与2型糖尿病的发病呈负相关关系(OR=0.63,P=0.022)。
多因素模型3的结果显示：糖尿病家族史(OR=1.93,P=0.036)、肥胖40(OR=2.47,P=0.011)、高血压(OR=1.47,P=0.038)、高脂血症(OR=1.57,P=0.022)、高脂饮食(OR=3.52, P=0.002)、WHR异常(OR=2.67,P=0.02)等因素与2型糖尿病的发病呈正相关关系,体力活动与2型糖尿病的发病呈负相关关系(OR=0.59,P=0.042)。
多因素模型4的结果显示：糖尿病家族史(OR=1.84,P=0.025)、肥胖max(OR= 1.56,P=0.039).高血压(OR=1.51,P=0.028)、高脂血症(OR=1.55,P=0.012)、高脂饮食(OR=3.37,P=0.003).WHR异常(OR=2.51,P=0.03)等因素与2型糖尿病的发病呈正相关关系。22型糖尿病发病影响因素间的交互作用
调整混杂因素前,糖尿病家族史与06年调查时处于肥胖状态的协同效应指数(s)为1.81,归因交互效应(I(AB))为2.10,归因交互效应百分比(AP%)为36.8%,纯因子归因交互效应百分比(AP*(AB)%)为44.6%；控制混杂因素后,糖尿病家族史与06年调查时处于肥胖状态的协同效应指数(s)为2.11,归因交互效应(I(AB))为2.42,归因交互效应百分比(AP%)为43.2%,纯因子归因交互效应百分比(AP*(AB)%)为52.6%。
调整混杂因素前,糖尿病家族史与高血压的协同效应指数(s)为2.61,归因交互效应(I(AB))为1.97,归因交互效应百分比(AP%)为47.0%,纯因子归因交互效应百分比(AP*(AB)%)61.5%；控制混杂因素后,糖尿病家族史与高血压的协同效应指数(s)为2.17,归因交互效应(I(AB))为1.17,归因交互效应百分比(AP%)为36.9%,纯因子归因交互效应百分比(AP*(AB)%)为53.9%。
调整混杂因素前,糖尿病家族史与高脂血症的协同效应指数(s)为2.06,归因交互效应(I(AB))为1.46,归因交互效应百分比(AP%)为38.0%,纯因子归因交互效应百分比(AP*(AB)%)51.4%;控制混杂因素后,糖尿病家族史与高脂血症的协同效应指数(s)为2.53,归因交互效应(I(AB))为1.59,归因交互效应百分比(AP%)为43.9%,纯因子归因交互效应百分比(AP*(AB)%)为60.4%。
调整混杂因素前,糖尿病家族史与WHR异常的协同效应指数(s)为3.34,归因交互效应(I(AB))为2.48,归因交互效应百分比(AP%)为54.6%,纯因子归因交互效应百分比(AP*(AB)%)为70.1%；控制混杂因素后,糖尿病家族史与WHR异常的协同效应指数(s)为4.98,归因交互效应(I(AB))为2.70,归因交互效应百分比(AP%)为61.6%,纯因子归因交互效应百分比(AP*(AB)%)为79.9%。结论总体性肥胖、高血压、糖尿病家族史、高脂血症、高脂饮食、腰臀比异常等因素能增加2型糖尿病发病的危险性；增加体力活动可以降低2型糖尿病的发病率；糖尿病家族史与总体性肥胖、腰臀比异常、高血压、高脂血症同时存在时能增加2型糖尿病的发病风险,故应采取综合性措施降低2型糖尿病的发病率。
Objectives:To study the factors influencing type 2 diabetes and discuss the interaction between diabetes family history and overall obesity,hypertension, hyperlipaemia and abnormal waist-to-hip ratio respectively.
Methods:Using matched nested case-control study by matching each patient with two controls,the cohort study population came from 1426 community residents surveyd in 2006,then their blood glucose was examined again in 2010.The subjects were divided into a case group and a control group according to their blood glucose result in 2010. There were 106 cases and 212 controls in this study.A Cox model was used by fitting matching a Logistic model.An additive model was used to analyse the interaction between diabetes family history and overall obesity,hypertension, hyperlipaemia and waist-to-hip ratio respectively.
Results:1 The factors influencing type 2 diabetes
Unifactor model showed:diabetes family history(χ2=6.90,P=0.009,OR=2.03,95%CI: 1.19～3.46),obesity in 2006(χ2=17.4,P<0.001,OR=2.82,95%CI:1.72～4.62), obesity at 40(χ2=9.18,P=0.002,OR=3.18,95%CI:1.46～6.94),obesity when fattest (χ2=10.9,P= 0.001,OR=2.24,95%CI:1.38～3.63),abnormal waist-to-hip ratio(χ2=6.51,P=0.011,OR= 1.86,95%CI:1.15～3.02), high fat diet (χ2=8.87, P=0.003, OR=2.38,95%CI:1.33～4.24),hypertension (χ2=6.75, P=0.009, OR=1.93,95%CI:1.17-3.17),hyperlipaemia(χ2= 6.05,P=0.014,OR=1.81,95%CI:1.12～2.91)and so on had a positive relation with the incidence of type 2 diabetes, while physical activity(x2=6.14,P=0.046, OR=0.59,95%CI: 0.39～0.90) had a negative relation with type 2 diabetes.
Multi-factor model 1 showed:diabetes family history(OR=1.81,P=0.026), obesity in 2006(OR=2.58,P=0.005),hypertension(OR=1.35,P=0.012),hyperlipaemia(OR=1.52,P= 0.022), high fat diet(OR=3.53,P=0.002),abnormal waist-to-hip ratio(OR=2.44,P=0.038) and so on had a positive relation with the incidence of type 2 diabetes,while physical activity (OR= 0.57,P=0.031) had a negative relation with type 2 diabetes.
Multi-factor model 2 showed:diabetes family history(OR=1.89,P=0.046),hypertension (OR=1.64,P=0.018),hyperlipaemia(OR=1.55,P=0.032),high fat diet(OR=3.53,P=0.004), abnormal waist-to-hip ratio(OR=2.69,P=0.017)and so on had a positive relation with the incidence of type 2 diabetes,while physical activity(OR=0.63, P=0.022) had a negative relation with type 2 diabetes.
Multi-factor model 3 showed:diabetes family history(OR=1.93, P=0.036), obesity at 40 (OR=2.47, P=0.011),hypertension(OR=1.47, P=0.038),hyperlipaemia(OR=1.57, P= 0.022), high fat diet(OR=3.52,P=0.002),abnormal waist-to-hip ratio(OR=2.67, P=0.02) and so on had a positive relation with the incidence of type 2 diabetes,while physical activity (OR=0.59,P=0.042) had a negative relation with type 2 diabetes.
Multi-factor model 4 showed:diabetes family history(OR=1.84,P=0.025),obesity when fattest(OR=1.56,P=0.039),hypertension(OR=1.51,P=0.028),hyperlipaemia(OR=1.55,P= 0.012),high fat diet(OR=3.37,P=0.003),abnormal waist-to-hip ratio(OR= 2.51,P=0.03)and so on had a positive relation with the incidence of type 2 diabetes.
Before adjusting confounding factors,the synergy index between diabetes family history and obesity in 2006 was 1.81 attributable interaction was 2.10;attributable proportion due to interaction was 36.8%;pure attributable proportion due to interaction was 44.6%.After adjusting confounding factors,their synergy index was 2.11;attributable interaction was 2.42;attributable proportion due to interaction was 43.2%;pure attributable proportion due to interaction was 52.6%.
Before adjusting confounding factors,the synergy index between diabetes family history and hypertension was 2.61;attributable interaction was 1.97;attributable proportion due to interaction was 47.0%;pure attributable proportion due to interaction was 61.5%.After adjusting confounding factors,their synergy index was 2.17;attributable interaction was 1.17;attributable proportion due to interaction was 36.9%;pure attributable proportion due to interaction was 53.9%.
Before adjusting confounding factors,the synergy index between diabetes family history and hyperlipaemia was 2.06;attributable interaction was 1.46;attributable proportion due to interaction was 38.0%;pure attributable proportion due to interaction was 51.4%.After adjusting confounding factors,their synergy index was 2.53;attributable interaction was 1.59;attributable proportion due to interaction was 43.9%;pure attributable proportion due to interaction was 60.4%.
Before adjusting confounding factors,the synergy index between diabetes family history and abnormal waist-to-hip ratio was 3.34;attributable interaction was 2.48;attributable proportion due to interaction was 54.6%;pure attributable proportion due to interaction was 70.1%.After adjusting confounding factors,their synergy index was 4.98;attributable interaction was 2.70;attributable proportion due to interaction was 61.6%;pure attributable proportion due to interaction was 79.9%.
Conclusions:Overall obesity,hypertension,diabetes family history, hyperlipaemia, high fat diet, abnormal waist-to-hip ratio and so on can raise the incidence of type 2 diabetes;while physical activity can reduce the incidence of type 2 diabetes. A person with both diabetes family history and overall obesity or abnormal waist-to-hip ratio or hypertension or hyperlipaemia has a higher probability to suffer type 2 diabetes than those without these risk factors.As a result,a series of measures should be taken to reduce the incidence of type 2 diabetes.
方法采用1：2匹配巢式病例对照研究,以青岛地区2006年调查时的1426位社区居民作为队列人群。2010年对该队列人群仅进行了血糖的检测,以2010年的血糖检测结果作为病例组的入选依据,病例组106例。按照居住地相同、性别相同、年龄相差(±3)岁的原则,以1：2的比例从该队列中为每例病例匹配两位对照,对照组共212人。用Cox回归拟合配对Logistic回归模型,分析影响2型糖尿病发病的因素,运用相加模型分析糖尿病家族史分别与总体性肥胖、高血压、高脂血症、腰臀比异常的交互作用对2型糖尿病的影响。
结果12型糖尿病发病的影响因素
单因素分析显示,糖尿病家族史(χ2=6.90,P=0.009,OR=2.03,95%CI:1.19～3.46)、06年调查时处于肥胖状态(06肥胖)(χ2=17.4,P<0.001,OR=2.82,95%CI: 1.72～4.62)、40岁时肥胖(肥胖40)(χ2=9.18,P=0.002,OR=3.18,95%CI:1.46～6.94)、最高体重时处于肥胖状态(肥胖max)(χ2=10.9,P=0.001,OR=2.24, 95%CI:1.38～3.63)、腰臀比(WHR)异常(χ2=6.51,P=0.011,OR=1.86,95%CI:1.15～3.02)、高脂饮食(χ2=8.87,P=0.003,OR=2.38,95%CI:1.33～4.24)、高血压(χ2= 6.75,P=0.009,OR=1.93,95%CI:1.17～3.17)、高脂血症(χ2=6.05,P=0.014,OR=1.81, 95%CI:1.12～2.91)等因素与2型糖尿病的发病呈正相关关系；体力活动与2型糖尿病的发病呈负相关关系(χ2=6.14,P=0.046,OR=0.59,95%CI:0.39～0.90)、
多因素模型1的结果显示：糖尿病家族史(OR=1.81,P=0.026)、06肥胖(OR=2.58,P=0.005)、高血压(OR=1.35,P=0.012)、高脂血症(OR=1.52,P=0.022)、高脂饮食(OR=3.53,P=0.002)、WHR异常(OR=2.44,P=0.038)等因素与2型糖尿病的发病呈正相关关系,体力活动则与2型糖尿病的发病呈负相关关系(OR=0.57,P=0.031)。
多因素模型2的结果显示：糖尿病家族史(OR=1.89,P=0.046)、高血压(OR=1.64,P=0.018)、高脂血症(OR=1.55,P=0.032)、高脂饮食(OR=3.53,P=0.004)、WHR异常(OR=2.69,P=0.017)等因素与2型糖尿病的发病呈正相关关系,体力活动与2型糖尿病的发病呈负相关关系(OR=0.63,P=0.022)。
多因素模型3的结果显示：糖尿病家族史(OR=1.93,P=0.036)、肥胖40(OR=2.47,P=0.011)、高血压(OR=1.47,P=0.038)、高脂血症(OR=1.57,P=0.022)、高脂饮食(OR=3.52, P=0.002)、WHR异常(OR=2.67,P=0.02)等因素与2型糖尿病的发病呈正相关关系,体力活动与2型糖尿病的发病呈负相关关系(OR=0.59,P=0.042)。
多因素模型4的结果显示：糖尿病家族史(OR=1.84,P=0.025)、肥胖max(OR= 1.56,P=0.039).高血压(OR=1.51,P=0.028)、高脂血症(OR=1.55,P=0.012)、高脂饮食(OR=3.37,P=0.003).WHR异常(OR=2.51,P=0.03)等因素与2型糖尿病的发病呈正相关关系。22型糖尿病发病影响因素间的交互作用
调整混杂因素前,糖尿病家族史与06年调查时处于肥胖状态的协同效应指数(s)为1.81,归因交互效应(I(AB))为2.10,归因交互效应百分比(AP%)为36.8%,纯因子归因交互效应百分比(AP*(AB)%)为44.6%；控制混杂因素后,糖尿病家族史与06年调查时处于肥胖状态的协同效应指数(s)为2.11,归因交互效应(I(AB))为2.42,归因交互效应百分比(AP%)为43.2%,纯因子归因交互效应百分比(AP*(AB)%)为52.6%。
调整混杂因素前,糖尿病家族史与高血压的协同效应指数(s)为2.61,归因交互效应(I(AB))为1.97,归因交互效应百分比(AP%)为47.0%,纯因子归因交互效应百分比(AP*(AB)%)61.5%；控制混杂因素后,糖尿病家族史与高血压的协同效应指数(s)为2.17,归因交互效应(I(AB))为1.17,归因交互效应百分比(AP%)为36.9%,纯因子归因交互效应百分比(AP*(AB)%)为53.9%。
调整混杂因素前,糖尿病家族史与高脂血症的协同效应指数(s)为2.06,归因交互效应(I(AB))为1.46,归因交互效应百分比(AP%)为38.0%,纯因子归因交互效应百分比(AP*(AB)%)51.4%;控制混杂因素后,糖尿病家族史与高脂血症的协同效应指数(s)为2.53,归因交互效应(I(AB))为1.59,归因交互效应百分比(AP%)为43.9%,纯因子归因交互效应百分比(AP*(AB)%)为60.4%。
调整混杂因素前,糖尿病家族史与WHR异常的协同效应指数(s)为3.34,归因交互效应(I(AB))为2.48,归因交互效应百分比(AP%)为54.6%,纯因子归因交互效应百分比(AP*(AB)%)为70.1%；控制混杂因素后,糖尿病家族史与WHR异常的协同效应指数(s)为4.98,归因交互效应(I(AB))为2.70,归因交互效应百分比(AP%)为61.6%,纯因子归因交互效应百分比(AP*(AB)%)为79.9%。结论总体性肥胖、高血压、糖尿病家族史、高脂血症、高脂饮食、腰臀比异常等因素能增加2型糖尿病发病的危险性；增加体力活动可以降低2型糖尿病的发病率；糖尿病家族史与总体性肥胖、腰臀比异常、高血压、高脂血症同时存在时能增加2型糖尿病的发病风险,故应采取综合性措施降低2型糖尿病的发病率。
Objectives:To study the factors influencing type 2 diabetes and discuss the interaction between diabetes family history and overall obesity,hypertension, hyperlipaemia and abnormal waist-to-hip ratio respectively.
Methods:Using matched nested case-control study by matching each patient with two controls,the cohort study population came from 1426 community residents surveyd in 2006,then their blood glucose was examined again in 2010.The subjects were divided into a case group and a control group according to their blood glucose result in 2010. There were 106 cases and 212 controls in this study.A Cox model was used by fitting matching a Logistic model.An additive model was used to analyse the interaction between diabetes family history and overall obesity,hypertension, hyperlipaemia and waist-to-hip ratio respectively.
Results:1 The factors influencing type 2 diabetes
Unifactor model showed:diabetes family history(χ2=6.90,P=0.009,OR=2.03,95%CI: 1.19～3.46),obesity in 2006(χ2=17.4,P<0.001,OR=2.82,95%CI:1.72～4.62), obesity at 40(χ2=9.18,P=0.002,OR=3.18,95%CI:1.46～6.94),obesity when fattest (χ2=10.9,P= 0.001,OR=2.24,95%CI:1.38～3.63),abnormal waist-to-hip ratio(χ2=6.51,P=0.011,OR= 1.86,95%CI:1.15～3.02), high fat diet (χ2=8.87, P=0.003, OR=2.38,95%CI:1.33～4.24),hypertension (χ2=6.75, P=0.009, OR=1.93,95%CI:1.17-3.17),hyperlipaemia(χ2= 6.05,P=0.014,OR=1.81,95%CI:1.12～2.91)and so on had a positive relation with the incidence of type 2 diabetes, while physical activity(x2=6.14,P=0.046, OR=0.59,95%CI: 0.39～0.90) had a negative relation with type 2 diabetes.
Multi-factor model 1 showed:diabetes family history(OR=1.81,P=0.026), obesity in 2006(OR=2.58,P=0.005),hypertension(OR=1.35,P=0.012),hyperlipaemia(OR=1.52,P= 0.022), high fat diet(OR=3.53,P=0.002),abnormal waist-to-hip ratio(OR=2.44,P=0.038) and so on had a positive relation with the incidence of type 2 diabetes,while physical activity (OR= 0.57,P=0.031) had a negative relation with type 2 diabetes.
Multi-factor model 2 showed:diabetes family history(OR=1.89,P=0.046),hypertension (OR=1.64,P=0.018),hyperlipaemia(OR=1.55,P=0.032),high fat diet(OR=3.53,P=0.004), abnormal waist-to-hip ratio(OR=2.69,P=0.017)and so on had a positive relation with the incidence of type 2 diabetes,while physical activity(OR=0.63, P=0.022) had a negative relation with type 2 diabetes.
Multi-factor model 3 showed:diabetes family history(OR=1.93, P=0.036), obesity at 40 (OR=2.47, P=0.011),hypertension(OR=1.47, P=0.038),hyperlipaemia(OR=1.57, P= 0.022), high fat diet(OR=3.52,P=0.002),abnormal waist-to-hip ratio(OR=2.67, P=0.02) and so on had a positive relation with the incidence of type 2 diabetes,while physical activity (OR=0.59,P=0.042) had a negative relation with type 2 diabetes.
Multi-factor model 4 showed:diabetes family history(OR=1.84,P=0.025),obesity when fattest(OR=1.56,P=0.039),hypertension(OR=1.51,P=0.028),hyperlipaemia(OR=1.55,P= 0.012),high fat diet(OR=3.37,P=0.003),abnormal waist-to-hip ratio(OR= 2.51,P=0.03)and so on had a positive relation with the incidence of type 2 diabetes.
Before adjusting confounding factors,the synergy index between diabetes family history and obesity in 2006 was 1.81 attributable interaction was 2.10;attributable proportion due to interaction was 36.8%;pure attributable proportion due to interaction was 44.6%.After adjusting confounding factors,their synergy index was 2.11;attributable interaction was 2.42;attributable proportion due to interaction was 43.2%;pure attributable proportion due to interaction was 52.6%.
Before adjusting confounding factors,the synergy index between diabetes family history and hypertension was 2.61;attributable interaction was 1.97;attributable proportion due to interaction was 47.0%;pure attributable proportion due to interaction was 61.5%.After adjusting confounding factors,their synergy index was 2.17;attributable interaction was 1.17;attributable proportion due to interaction was 36.9%;pure attributable proportion due to interaction was 53.9%.
Before adjusting confounding factors,the synergy index between diabetes family history and hyperlipaemia was 2.06;attributable interaction was 1.46;attributable proportion due to interaction was 38.0%;pure attributable proportion due to interaction was 51.4%.After adjusting confounding factors,their synergy index was 2.53;attributable interaction was 1.59;attributable proportion due to interaction was 43.9%;pure attributable proportion due to interaction was 60.4%.
Before adjusting confounding factors,the synergy index between diabetes family history and abnormal waist-to-hip ratio was 3.34;attributable interaction was 2.48;attributable proportion due to interaction was 54.6%;pure attributable proportion due to interaction was 70.1%.After adjusting confounding factors,their synergy index was 4.98;attributable interaction was 2.70;attributable proportion due to interaction was 61.6%;pure attributable proportion due to interaction was 79.9%.
Conclusions:Overall obesity,hypertension,diabetes family history, hyperlipaemia, high fat diet, abnormal waist-to-hip ratio and so on can raise the incidence of type 2 diabetes;while physical activity can reduce the incidence of type 2 diabetes. A person with both diabetes family history and overall obesity or abnormal waist-to-hip ratio or hypertension or hyperlipaemia has a higher probability to suffer type 2 diabetes than those without these risk factors.As a result,a series of measures should be taken to reduce the incidence of type 2 diabetes.
引文
[1]Wild S, Roglic G, Green A, et al. Global prevalence of diabetes:estimates for the year 2000 and projections for 2030. Diabetes care,2004,27(5):1047-1053.
[2]全国糖尿病研究协作组调查研究组.全国14省市30万人口中糖尿病调查报告.中华内科杂志,1981,20(11)：678-683.
[3]全国糖尿病防制协作组.1994年中国糖尿病患病率及其危险因素.中华内科杂志,1997,36(6)：384-389.
[4]向红丁,刘纬,刘灿群,等.1996年全国糖尿病流行病学特点基线调查报告[J].中国糖尿病杂志,1998,6(3)：131-133.
[5]李立明,饶克勤,孔灵芝等.中国居民2002年营养与健康状况调查[J].中华流行病学杂志,2005,26(7)：478-484.
[6]Wenying Yang, Juming Lu, Jianping Weng, et al. Prevalence of Diabetes among men and women in China[J].The New England Journal of Medicine,2010,362 (12):1090-1101.
[7]B.Isomaa,B.Forsen, K. Lahti, et al. A family history of diabetes is associated with reduced physical fitness in the Prevalence, Predication and Prevention of Diabetes(PPP)-Botnia study[J]. Diabetetologia,2010,53:1709-1713.
[8]Hemang Parikh and Leif Groop. Candidate Genes for Type 2 Diabetes[J]. Reviews in Endocrine & Metabolic Disorders.2004,5 (2):151-176.
[9]Perry IJ, Wannamethee SG,Walker MK, et al. Prospective study of risk factors for development of non-insulin dependent diabetes in middle aged British men[J].BMJ,1995, 310(6979):560-564.
[10]Sargeant LA, Wareham NJ, Khaw KT, et al. Family history of diabetes identifies a group at increased risk for the metabolic consequences of obesity and physical inactivity in EPICNorfolk:a population-based study[J].International Journal of Obesity,2000,24:1333-1339.
[11]Li Qin, Mirjam J, Knol, et al.Does physical activity modify the risk of obesity for type 2 diabetes;a review of epidemiological data[J].Eur J Epidemiology,2010,25:5-12.
[12]杨平,李忠民,王春华,等.中老年农民人群BMI及WHR与其血压、血糖和脂代谢关系的研究[J].中国老年学杂志,2007,27(12)：1198-1199.
[13]WHO. Department of Chronic Diseases and Health Promotion. Global Activity Questionnaire[J].WHO,2001.
[14]Ainsworth BE, Haskell WL, Leon AS,et al. Compendium of physical activities:classification of energy costs of human physical activities[J].Med Sci Sports Exerc,1993,25(1):71-80.
[15]张文彤.SPSS11统计分析教程(高级篇).[M]北京：北京希望电子出版社,2002.313-315.
[16]赵仲堂,主编。流行病研究方法与应用[M].北京：科学出版社,2000.3-542.
[17]Klupa T, Malecki MT, Pezzolesi M, et al. Further evidence for a susceptibility locus for type 2 diabetes on chromosome 20q13[J]. Diabetes,2000,49:2212-2216.
[18]Grant SF, Thorleifsson G, Reynisdottir I,et al. Variant of transcription factor 7-like 2(TCF7L2) gene confers risk of type 2 diabetes[J]. Nat Genet,2006,38:320-323.
[19]Steinthorsdottir V, Thorleifsson G, Reynisdottir I,et al.A variant in CDKALI influences insulin response and risk of type 2 diabetes [J]. Nat Genet,2007,39:770-775.
[20]Edwards KL, Newman B, Mayer E, et al. Heretability of factors of the insulin resistance syndrome in women twins[J]. Genetic Epidemiology,1997,14(3):241-253.
[21]成金罗,沈默宇,周玲,等.125个家族高发性2型糖尿病的危险因素研究[J].中华流行病学杂志,2004,25(2)：162-164.
[22]Bjomholt JV, Erikssen G, Liestol K, et al. Type 2 diabetes and maternl family history:an impact beyond slow glucose removal rate and fasting hyperglycemia in low-risk individuals?Results from 22.5 years of follow-up of healthy nondiabetic men [J]. Diabetes care,2000,23(9):1255.
[23]Poulsen P., Kyvik, K.0., Vaag, A, et al. Heritability of Type II (non-insulin-dependent) diabetes mellitus and abnormal glucose tolerance a population-based twin study[J]. Diabetetologia,1999,42(2):139-145.
[24]Aristofanis Gikas, Alexios Sotiropoulas, Demosthenes Panagiotakos, et al. Prevalence and associated risk factors of self-reported diabetes mellitus in a sample of adult urban population in Greece:MEDICAL. Exit Poll Research in Salamis (MEDICAL EXPRESS 2002) [J]. BMC Public Health,2004,4:1-9.
[25]Maarit, et al. The relative importance of modifiable potential risk factors of type 2 diabetes:a meta-analysis of two cohorts [J]. Eur J Epidemiol,2010,25:115-124.
[26]Volkan D. Yumuk, et al. High prevalence of obesity and diabetes mellitus in Konya, a central Anatolian city in Turkey[J]. Diabetes Research and Clinical Practice 70, 2005,151-158.
[27]AD ROSENTHAL, F JIN, X-0 SHU. Body fat distribution and risk of diabetes among Chinese women[J].International Journal of Obesit,2004,28:594-599.
[28]STEVENS J, COUPER D, PANKOW, J, et al. Sensitivity and specificity of anthropometries for the predicition of diabetes in a biracial cohort[J].Obes Res 2001;9:696-705.
[29]Levitt NS. The prevalence and identification of risk facors for NIDDM in Urban Africans in Cap Town, South African[J]. Diabetes Care,1993,16:601-607.
[30]马骏,王建华,王正伦,等.2型糖尿病危险因素的病例对照研究[J].中华流行病学杂志,2001,22(5)：365.
[31]Manson JE, Nathan DM, Krolewski AS, et al. A prosective study of exercise and incidence of diabetes among US physicians [J]. JAMA,1992,268(1):63-67.
[32]Hu G.,Qiao Q., Silventoinen, K., et al. Occupational, commuting, and leisure-time physical activity in relation to risk for Type 2 diabetes in middle-aged Finnish men and women[J]. Diabetetologia,2003,46(3):322-329.
[33]刘茂玲,吕郁豪,邹宇华,等.2型糖尿病危险因素的交互作用[J].中国慢性病预防与控制,2008,16(2)：136-138.
[34]0hlson LO, Larsson B, Bjorntorp P, et al.Risk factors for type 2 diabetes mellitus. Thirteen and one-half years of follow-up of the participants in a study of Swedish men born in 1913[J]. Diabetetologia (1998),31:798-805.
[35]马士学,黄孝全.2型糖尿病危险因素的病例对照研究[J].中华全科医师杂志,2006,5(3)：974.
[36]高晓虹,宋桂荣,辛萍等.大连地区2型糖尿病危险因素的非条件logstic回归[J].疾病控制杂志,2002,6(1)：54-56.
[37]赵明瑶,孙海燕,雷立健,等.社区老年糖尿病患病率及危险因素调查[J].上海预防医学杂志,2008,20(6)：295-298.
[38]王宇,施榕.2型糖尿病危险因素流行病学研究进展[J].上海预防医学杂志,2004,16(2)：53-55.
[39]周玲,胡旭,徐天亮,等.2型糖尿病高危人群的早期预测及评价[J].中国公共卫生,2004,20(3)：293-294.
[40]刘尊永,程锦泉,彭吉.深圳市居民糖尿病危险因子与2型糖尿病发病关系的分析[J].中华预防医学杂志,2000,34(4)：232-234.
[41]JA Marshall, S Hoag, S Shetterly, et al. Dietary fat predicts conversion from impaired glucose tolerance to NIDDM[J].The San Luis Valley Diabetes Study:Diabetes Care,17,1994:50-56.
[42]张毓洪,陈启众,贺宝福,等.银川市社区2型糖尿病危险因素病例对照研究[J].宁夏医学杂志,2006,28(2)：95-97.
[43]蒙黄.饮食习惯、体育锻炼及其交互作用对糖尿病发病的影响[J].当代医学,2009,15(13)：66-67.
[44]吴先萍,杨晓妍,张宁梅,等.我国人群2型糖尿病流行病学研究现状[J].预防医学情报杂志,2002,18(5)：413-416.
[45]Koppes LI, Dekker JM, Hendriks HF, et al. Moderate alcohol consumption lowers the risk of type 2 diabetes:a meta-analysis of prospective observational studies. Diabetes Care,2005,28:719-725.
[46]Lapidus L,Bengtsson C,Bergfors E, et al. Alcohol intake among women and its relationship to diabetes incidence and all-cause mortality:the 32 year follow-up of a population study of women in Gothenburg, Sweden[J]. Diabetes Care,2005,28: 2230-2235.
[47]Hosmer DW, Lemeshow S. Confidence interval estimation ofinteraction[J]. Epidemiology,1992(3):452-456.
[48]Andersson T, Alfredsson L,Kallberg H,et al. Calculating meassures of biological interaction[J].Eur J Epidemiol,2007,36:1111-1118.
[49]Rothman KJ. Epidemiology:An introduction[J]. NewYork:Oxford University Press, 2002:168-180.
[50]Morris RD, Limm DL, Hartz J, Kalkhoff RK, Rimm AA. Obesity and heredity in the etiology of non-insulin-dependent diabetes in mellitus 32,662 adult white women[J]. Am J Epidemiol.1989,130:112-121.
[51]Hilding, et al. The impact of family history of diabetes and lifestyle factors on abnormal glucose regulation in middle-aged Swedish men and women. Diabetologia,2006, 49:2589-2598.
[52]陈玉,周玲,徐耀初.2型糖尿病与遗传和环境因素相互关系的研究[J].中华预防医学杂志,2002,36(3)：191-194.
[1]唐晓君,张素华,李革,等.老年人群糖尿病和IGT患病率及其影响因素[J].现代预防医学,2005,32：1614-1616.
[2]徐春生,余灿清,李立明.老年糖尿病[J].中国全科医学,2007,10(12)：1036—1038
[3]许樟荣.我国糖尿病流行病学研究概况[J].总装备部医学学报,2007,9(1)：46-49.
[4]王陇德.中国居民营养与健康状况调查报告之一2002综合报告[M].北京：人民卫生出版社,2005：59
[5]Wenying Yang, Juming Lu, Jianping Weng, et al, Prevalence of diabetes among men and women in China. The new england journal of medicine,2010,362 (12):1090-1101.
[6]王克安,李天麟,向红丁,等.中国糖尿病流行特点研究-糖尿病和糖耐量减低患病率调查[J].中华流行病学杂志,1998,19(5)：282-285.
[7]全国糖尿病研究写作组调查研究组.全国14省市30万人口中糖尿病调查报告.中华内科杂志.1981,20(10)：678-683.
[8]第二次全国糖尿病五年协作防治研讨会纪要.中华内分泌代谢杂志,1995,11(3)：187-188.
[9]王克安,李天麟,李新华,等.中国儿童1型糖尿病的发病率研究.中华内分泌代谢杂志,1999,15(1)：3-7.
[10]章庆红.我国各地糖尿病发病趋势[J].河北医药,2005,27：624-625.
[11]杨泽,郑宏,佟之复,等.1997年北京城乡老年人糖尿病患病率调查[J].中华老年医学杂志,2001,20：290-293.
[12]王守俊,魏承兰,李金法,等.郑州市社区老年人群糖尿病流行特点的研究[J].河南预防医学杂志,2000,11：204-205.[13]刘幼硕.老年人糖尿病的流行病学病因和临床特点[J].中华老年医学杂志,2005,24：718-719.
[14]徐耀初.老年糖尿病流行病学[J].实用老年医学,1999,13：172-173.
[15]杨泽.中国中老年人糖尿病和糖耐量异常的流行病学研究[J].中华流行病学杂志,2003,24：410-412.
[16]Berkowitz GS, Lap inski RH, Wein R, et al. Race/ethnicity and other risk factors for gestational diabetes [J]. Am J Epidemiol,1992,135:965-973.
[17]Green J R, Pawson IG, Schumacher LB, et al. Glucose tolerance in pregnancy:ethnic variation and influence of body habitus [J]. Am J Obstet Gynecol,1990,163:86-92.
[18]Yue DK, Molyneaux LM, Ross GP, et al. Why does ethnicity affect prevalence of gestational diabetes? The underwater volcano theory [J]. DiabetMed,1996,13:748-752.
[19]徐先明,江明礼,董玉英.低危孕妇行妊娠期糖尿病筛选可行性研究[J].现代妇产科进展,2001,1：34-36.
[20]杨慧霞,赵怿,段晓华,等.妊娠期糖代谢异常对母儿结局影响的前瞻性对照研究[J].中国全科医学,2004,14：1044—1046.
[21]Yang XL, Hsu2Hage B, Zhang H, et al. Gestational diabetes mellitus in women of single gravidity in Tianjin City, China[J]. Diabetes Care,2005,25:847-851.
[22]Ko GT, TamWH, Chan JC, et al. Prevalence of gestational diabetes mellitus in Hong Kong based on the 1998 WHO criteria [J]. DiabetMed,2002,19 (1):80.
[23]马润玫,杜明钰,王丹丹,张燕.妊娠合并糖尿病的流行病学现状[J].中国实用妇科与产科杂志,2007,6(23)：455-458
[24]巩纯秀,朱逞,颜纯,等.1997-2000年与1988-1996年北京地区儿童1型糖尿病发病率比较[J].中华儿科杂志,2004,42(2)：113-115.
[25]Wang SS, Lan L, Ling L, et al. The incidence of insulin-dependent diabetes mellitus in children of the different ethic groups in Nanning during 1989-1999 [J]. Chin J Clin Rehabil,2004,8 (6): 1186-1187.
[26]张毓洪,杨建军,张波,等.宁夏地区儿童1型糖尿病的发病情况调查[J].宁夏医学院学报,2005,27(5)：347-349.
[27]张听,沈水仙,罗飞宏,等.上海市卢湾区青少年2型糖尿病患病率调查[J].中国循证儿科杂志,2006,1(3)：204-209.
[28]叶军,韩连书,邱文娟,等.儿童、青少年肥胖者2型糖尿病和高危者筛查[J].中华内分泌代谢杂志,2004,20(2)：131-135.
[29]秀敏,梁黎,董关萍,等.浙江省1999～2004年新诊断儿童1型糖尿病流行病学特征及血脂水平[J].实用儿科临床杂志,2006,21(8)：471-472.
[30]Todd JA. From genome to an etiology in a multifactorial disease, type 1 diabetes [J]. Bioessays, 1999,21 (2):164-174.
[31]Reece EA, Hagay Z, Hobbins JC. Insulin-dependent diabetes mellitus and immunogenetics: meaternal and fetal considerations [J]. Obstet Gynecal Surg,1991,46 (5):255-263.
[32]Owertach D. [J]. Diabeto logia,1998,90:31.
[33]Khalil L. [J]. Proc N atl A cad SciU SA,1990,87:1094.
[34]Bao M Z, Wang JX, Dorman TS, et al. HLA-DQ 13 mon-A sp57 allele and incidence of diabetes in China and USA [J]. Lancet,1998,2:497.
[35]Nakayama M, A biru N, Moriyama H, et al. P rime role for an insulin epitope in the development of type 1 diabetes in NOD mice [J]. Nature,2005,435 (7039):220-223.
[36]任宏,欧阳凤秀,罗飞宏,沈水仙,姜庆五.儿童1型糖尿病环境危险因素病例对照研究[J].中国公共卫生.2005；21(2)：129-130.
[37]张慧颖,王滨有,赵雪妮,梁子君,孙俭宏,张冬梅,段稳铭,路波.哈尔滨市儿童1型糖尿病危险因素研究.中国初级卫生保健,2000,08.10；14(8)：31-32.
[38]王爱华,朱逞,洪宝瑟,张纪水.情绪障碍对1型糖尿病儿童代谢控制机治疗依从性的影响[J].实用儿科临床杂志,2007；22(14)：1081-1082.
[39]Ravussin E, Valencia ME, Esparza J, et al. Effects of a traditional lifestyle on obesity in Pima Indians[J]. Diabetes Care,1994,17:1067-1074.
[40]Robert DM, David LR, Arthur JH, et al. Obesity and heredity in the etiology of non-insulin-dependent diabetes mellitus in 32 662 adult white women[J]. AM J Epidemiol, 1989,130(1):112-114.
[41]陈思东,俞守义,许雅,等.2型糖尿病发病危险因素的研究[J].中国公共卫生,2002,18(7)：18.
[42]郝新生,魏枫,房忠女.非胰岛素依赖型糖尿病危险因素的研究[J].中国慢性病预防与控制杂志,1999,7(4)：150.
[43]陈思东,俞守义,许雅,等.Ⅱ型糖尿病发病危险因素的研究[J].中国公共卫生,2002,18(7)：814.
[44]王红霞,梁秀芬,张玉梅,我国2型糖尿病的流行病学及危险因素研究[J],内蒙古医学杂志,2006,38：156-159.
[45]曾平,李淑葵,杨宏云,等,老年人2型糖尿病的危险因素分析[J],中华老年医学杂志,2003,22(1)：37-39.
[46]赵路静,宋青春.肥胖与2型糖尿病的关系,河北北方学院学报(医学版),2005,22(1)：51-53.
[47]Steppan CM, Bailey ST, Bhat S, et al. The hormone resistin links obesity to diabetes [J]. Nature,2001;409:307.
[48]王文娟,王克安,李天麟.体重指数、腰围和腰臀比预测高血压、高血糖及其二者聚集性的实用价值及其探讨[J].中华流行病学杂志,2002,23(1)：16.
[49]刘国红.Ⅱ型糖尿病的流行病学特征[J].湖北预防医学杂志,2003,14(1)：4.
[50]马林茂,富振英,王克安,等.2型糖尿病危险因素的Logistic回归分析[J].中国糖尿病杂志,1999,7(5)：262.
[51]史晓红,杨泽,高芳堃,等,北京市2型糖尿病高危险年龄人群危险因素特征[J].中国临床康复,2006,10(1)：4-6.
[52]陈黎亚,李志远.糖尿病与膳食因素及其他相关因素的研究[J].河南预防医学杂志,2004,15(3)：140.
[53]陈金钰.糖尿病患者的健康行为和自我功效[J].现代护理,2002,8：801-802
[54]杨兆军,杨文英,李光伟,等.中国成人不同糖代谢异常的分布[J].中华医学杂志,2003,83(24)：2128-2131.
[55]程志强.2型糖尿病遗传研究新进展[J].国外医学内分泌学分册,1997,17(4)：185.
[56]张维忠.肥胖、2型糖尿病与高血压[J].中华内科杂志,2002,41(4)：284.
[57]潘柏中.糖尿病诊断和治疗的检验项目评价[J].中华医学杂志,2003,83(3)：169-171.
[58]张毓洪,陈启众,贺宝福,等.银川市社区二型糖尿病危险因素病例对照研究[J].宁夏医学杂志,2006,28(2)：95-97.
[59]唐晓君,张素华,李革,等.重庆地区社区人群二型糖尿病现况调查[J].中国临床康复,2006,10(12)：10-12.
[60]中国肥胖问题工作组数据汇总分析协作组.我国成人体重指数和腰围对相关疾病危险因素异常的预测价值：适宜体重指数和腰围切点的研究[J].中华流行病学,2002,23(1)：5-10.
[61]孙莉敏.运动锻炼对2型糖尿病患者血脂与体质指标的影响[J].中国运动医学,2002,21(1)：51-54.
[62]胡传峰,李立明,陆美琪,等.2型糖尿病危险因素的非条件Logistic回归分析[J].中国慢性病预防与控制,2000,8(4)：162-164.
[63]深圳市卫生局.深圳市慢性非传染性疾病流行病学研究[M].湖南：湖南科学技术出版社,1999：32-35.
[64]吴赤蓬,王声涌,荆春霞,等.戒烟与糖尿病的关系[J].中国公共卫生,2004,20(1)：33.
[65]Targher G, Bertolini L, Zenari L, et al. Cigarette smoking and plasma total homocysteine levels in young adults with type 1 diabetes [J]. Diabetes Care,2000,23 (4):524-528.
[66]Wei M, Gibbons LW, Mithell TL, et al. Alcohol intake and incidence of type 2 diabetes in men [J]. Diabetes Care,2000,23 (1):18-22.
[67]宋煜炜,李英娥.膳食营养、生活方式与糖尿病[J].中国行为医学科学.2003,12(5)：596-598.
[68]富振英,马林茂,王克安,等.我国Ⅱ型糖尿病的流行特征[J].中国慢性病预防与控制,1999,7(3)：125.
[69]张亚非.生命早期的营养不良与成年期糖尿病[J].国外医学卫生学分册,2000,27(6)：321-323,372.
[70]李艳艳,胡东生,李春阳,等.农村居民糖尿病患病率及危险因素分析.中国公共卫生,2008：24：1273-1275.
[71]孙毓蔓.社区2型糖尿病流行现状及相关危险因素分析.现代预防医学,2010；37：4411-4417.
[72]王玉春.青岛市城阳区2型糖尿病患病率及相关危险因素分析.山东医药,2010；50：58-60.
[73]强兆艳,王建华,齐秀英.妊娠糖尿病危险因素病例对照研究[J].中国公共卫生,2006,22(7)：795-796.
[74]张红,杨西林,张翠萍,等.妊娠糖尿病筛查与筛查阳性的危险因素分析[J].中国全科医学,2004,7(2)：86-87.
[75]刁文丽,李志勤,于丽娅,等.辽宁省农村孕妇妊娠糖尿病筛查阳性率及危险因素分析[J].中国全科医学,2010,13(10B)：3309-3310.
[76]张眉花,杨慧霞,孙伟杰.糖尿病家族史与妊娠期糖代谢异常发病相关性的前瞻性对照研究[J].中华糖尿病杂志,2005,13：163-166.
[77]Lao TT, HoLF, Chan BCP et al. Maternal age and prevalence of gestational diabetes mellitus Diabetes Care,2006,29(4):948.
[78]任香梅,黄水平,邵继红,等.妊娠糖尿病发病率及危险因素分析[J].中国妇幼保健,2008,23：2954-2956.
[79]杨慧霞,赵怿,段晓华,吴北生.妊娠期糖代谢异常对母儿结局影响的前瞻性对照研 究[J].中国全科医学,2004,7(14)：1044-1047.
[80]王娜,周建博,董砚虎.妊娠糖尿病的研究现状.国外医学内分泌学分册,2004,24(2)：132.
[81]王正英,邓振宇,徐庆十.老年冠心病患者社区综合敢于前瞻性对照研究[J].中国热带医学,2008,8(4)：627-629.
[82]美国糖尿病学会(ADA).糖尿病诊疗标准(一)[J].国外医学内分泌学分册,2005,25：436-437.
[83]IDF Clinical Guidelines Task Force. Global Guideline for Type 2 Diabetes:recommendations for standard, comp rehensive, and minimal care [J]. Diabetic Medicine,2006,23:579-593.
[84]王惠贤.健康教育是建立新型护患关系的重要环节[J].实用护理杂志,2001,17(3)：54.
[85]金香今.乳腺癌术后的整体护理[J].中国现代医生,2007,45(19)：114-115.
[86]Eriksson KF, Lindgrde F. Prevention of type 2 (non-insulin-dependent) diabetes mellitus by diet and physical exercise:the 5-year Malmo feasibility study [J]. Diabetologal,1998,34:891.
[87]张安玉.糖尿病的流行形式及其防治的有关问题[J].中国慢性病预防与控制,2005,13：257-259.
[88]Knowler WC, Barrett-Connor E,Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifes-tyle intervention or metformin [J]. N Eng J Med,2002,346:393-403.
[89]常向云.糖尿病流行现状及防治对策[J].全科医学临床与教育,2004,2(1)：49-50.
[90]樊学翠,张培芳,侯元华,等.健康体检人群糖尿病相关知识的调查[J].护理学杂志,2007,22(19)：15
[91]熊建菁,卢伟.糖尿病患者非药物干预研究[J].中国慢性病预防与控制,2006,14：382-384.
[2]全国糖尿病研究协作组调查研究组.全国14省市30万人口中糖尿病调查报告.中华内科杂志,1981,20(11)：678-683.
[3]全国糖尿病防制协作组.1994年中国糖尿病患病率及其危险因素.中华内科杂志,1997,36(6)：384-389.
[4]向红丁,刘纬,刘灿群,等.1996年全国糖尿病流行病学特点基线调查报告[J].中国糖尿病杂志,1998,6(3)：131-133.
[5]李立明,饶克勤,孔灵芝等.中国居民2002年营养与健康状况调查[J].中华流行病学杂志,2005,26(7)：478-484.
[6]Wenying Yang, Juming Lu, Jianping Weng, et al. Prevalence of Diabetes among men and women in China[J].The New England Journal of Medicine,2010,362 (12):1090-1101.
[7]B.Isomaa,B.Forsen, K. Lahti, et al. A family history of diabetes is associated with reduced physical fitness in the Prevalence, Predication and Prevention of Diabetes(PPP)-Botnia study[J]. Diabetetologia,2010,53:1709-1713.
[8]Hemang Parikh and Leif Groop. Candidate Genes for Type 2 Diabetes[J]. Reviews in Endocrine & Metabolic Disorders.2004,5 (2):151-176.
[9]Perry IJ, Wannamethee SG,Walker MK, et al. Prospective study of risk factors for development of non-insulin dependent diabetes in middle aged British men[J].BMJ,1995, 310(6979):560-564.
[10]Sargeant LA, Wareham NJ, Khaw KT, et al. Family history of diabetes identifies a group at increased risk for the metabolic consequences of obesity and physical inactivity in EPICNorfolk:a population-based study[J].International Journal of Obesity,2000,24:1333-1339.
[11]Li Qin, Mirjam J, Knol, et al.Does physical activity modify the risk of obesity for type 2 diabetes;a review of epidemiological data[J].Eur J Epidemiology,2010,25:5-12.
[12]杨平,李忠民,王春华,等.中老年农民人群BMI及WHR与其血压、血糖和脂代谢关系的研究[J].中国老年学杂志,2007,27(12)：1198-1199.
[13]WHO. Department of Chronic Diseases and Health Promotion. Global Activity Questionnaire[J].WHO,2001.
[14]Ainsworth BE, Haskell WL, Leon AS,et al. Compendium of physical activities:classification of energy costs of human physical activities[J].Med Sci Sports Exerc,1993,25(1):71-80.
[15]张文彤.SPSS11统计分析教程(高级篇).[M]北京：北京希望电子出版社,2002.313-315.
[16]赵仲堂,主编。流行病研究方法与应用[M].北京：科学出版社,2000.3-542.
[17]Klupa T, Malecki MT, Pezzolesi M, et al. Further evidence for a susceptibility locus for type 2 diabetes on chromosome 20q13[J]. Diabetes,2000,49:2212-2216.
[18]Grant SF, Thorleifsson G, Reynisdottir I,et al. Variant of transcription factor 7-like 2(TCF7L2) gene confers risk of type 2 diabetes[J]. Nat Genet,2006,38:320-323.
[19]Steinthorsdottir V, Thorleifsson G, Reynisdottir I,et al.A variant in CDKALI influences insulin response and risk of type 2 diabetes [J]. Nat Genet,2007,39:770-775.
[20]Edwards KL, Newman B, Mayer E, et al. Heretability of factors of the insulin resistance syndrome in women twins[J]. Genetic Epidemiology,1997,14(3):241-253.
[21]成金罗,沈默宇,周玲,等.125个家族高发性2型糖尿病的危险因素研究[J].中华流行病学杂志,2004,25(2)：162-164.
[22]Bjomholt JV, Erikssen G, Liestol K, et al. Type 2 diabetes and maternl family history:an impact beyond slow glucose removal rate and fasting hyperglycemia in low-risk individuals?Results from 22.5 years of follow-up of healthy nondiabetic men [J]. Diabetes care,2000,23(9):1255.
[23]Poulsen P., Kyvik, K.0., Vaag, A, et al. Heritability of Type II (non-insulin-dependent) diabetes mellitus and abnormal glucose tolerance a population-based twin study[J]. Diabetetologia,1999,42(2):139-145.
[24]Aristofanis Gikas, Alexios Sotiropoulas, Demosthenes Panagiotakos, et al. Prevalence and associated risk factors of self-reported diabetes mellitus in a sample of adult urban population in Greece:MEDICAL. Exit Poll Research in Salamis (MEDICAL EXPRESS 2002) [J]. BMC Public Health,2004,4:1-9.
[25]Maarit, et al. The relative importance of modifiable potential risk factors of type 2 diabetes:a meta-analysis of two cohorts [J]. Eur J Epidemiol,2010,25:115-124.
[26]Volkan D. Yumuk, et al. High prevalence of obesity and diabetes mellitus in Konya, a central Anatolian city in Turkey[J]. Diabetes Research and Clinical Practice 70, 2005,151-158.
[27]AD ROSENTHAL, F JIN, X-0 SHU. Body fat distribution and risk of diabetes among Chinese women[J].International Journal of Obesit,2004,28:594-599.
[28]STEVENS J, COUPER D, PANKOW, J, et al. Sensitivity and specificity of anthropometries for the predicition of diabetes in a biracial cohort[J].Obes Res 2001;9:696-705.
[29]Levitt NS. The prevalence and identification of risk facors for NIDDM in Urban Africans in Cap Town, South African[J]. Diabetes Care,1993,16:601-607.
[30]马骏,王建华,王正伦,等.2型糖尿病危险因素的病例对照研究[J].中华流行病学杂志,2001,22(5)：365.
[31]Manson JE, Nathan DM, Krolewski AS, et al. A prosective study of exercise and incidence of diabetes among US physicians [J]. JAMA,1992,268(1):63-67.
[32]Hu G.,Qiao Q., Silventoinen, K., et al. Occupational, commuting, and leisure-time physical activity in relation to risk for Type 2 diabetes in middle-aged Finnish men and women[J]. Diabetetologia,2003,46(3):322-329.
[33]刘茂玲,吕郁豪,邹宇华,等.2型糖尿病危险因素的交互作用[J].中国慢性病预防与控制,2008,16(2)：136-138.
[34]0hlson LO, Larsson B, Bjorntorp P, et al.Risk factors for type 2 diabetes mellitus. Thirteen and one-half years of follow-up of the participants in a study of Swedish men born in 1913[J]. Diabetetologia (1998),31:798-805.
[35]马士学,黄孝全.2型糖尿病危险因素的病例对照研究[J].中华全科医师杂志,2006,5(3)：974.
[36]高晓虹,宋桂荣,辛萍等.大连地区2型糖尿病危险因素的非条件logstic回归[J].疾病控制杂志,2002,6(1)：54-56.
[37]赵明瑶,孙海燕,雷立健,等.社区老年糖尿病患病率及危险因素调查[J].上海预防医学杂志,2008,20(6)：295-298.
[38]王宇,施榕.2型糖尿病危险因素流行病学研究进展[J].上海预防医学杂志,2004,16(2)：53-55.
[39]周玲,胡旭,徐天亮,等.2型糖尿病高危人群的早期预测及评价[J].中国公共卫生,2004,20(3)：293-294.
[40]刘尊永,程锦泉,彭吉.深圳市居民糖尿病危险因子与2型糖尿病发病关系的分析[J].中华预防医学杂志,2000,34(4)：232-234.
[41]JA Marshall, S Hoag, S Shetterly, et al. Dietary fat predicts conversion from impaired glucose tolerance to NIDDM[J].The San Luis Valley Diabetes Study:Diabetes Care,17,1994:50-56.
[42]张毓洪,陈启众,贺宝福,等.银川市社区2型糖尿病危险因素病例对照研究[J].宁夏医学杂志,2006,28(2)：95-97.
[43]蒙黄.饮食习惯、体育锻炼及其交互作用对糖尿病发病的影响[J].当代医学,2009,15(13)：66-67.
[44]吴先萍,杨晓妍,张宁梅,等.我国人群2型糖尿病流行病学研究现状[J].预防医学情报杂志,2002,18(5)：413-416.
[45]Koppes LI, Dekker JM, Hendriks HF, et al. Moderate alcohol consumption lowers the risk of type 2 diabetes:a meta-analysis of prospective observational studies. Diabetes Care,2005,28:719-725.
[46]Lapidus L,Bengtsson C,Bergfors E, et al. Alcohol intake among women and its relationship to diabetes incidence and all-cause mortality:the 32 year follow-up of a population study of women in Gothenburg, Sweden[J]. Diabetes Care,2005,28: 2230-2235.
[47]Hosmer DW, Lemeshow S. Confidence interval estimation ofinteraction[J]. Epidemiology,1992(3):452-456.
[48]Andersson T, Alfredsson L,Kallberg H,et al. Calculating meassures of biological interaction[J].Eur J Epidemiol,2007,36:1111-1118.
[49]Rothman KJ. Epidemiology:An introduction[J]. NewYork:Oxford University Press, 2002:168-180.
[50]Morris RD, Limm DL, Hartz J, Kalkhoff RK, Rimm AA. Obesity and heredity in the etiology of non-insulin-dependent diabetes in mellitus 32,662 adult white women[J]. Am J Epidemiol.1989,130:112-121.
[51]Hilding, et al. The impact of family history of diabetes and lifestyle factors on abnormal glucose regulation in middle-aged Swedish men and women. Diabetologia,2006, 49:2589-2598.
[52]陈玉,周玲,徐耀初.2型糖尿病与遗传和环境因素相互关系的研究[J].中华预防医学杂志,2002,36(3)：191-194.
[1]唐晓君,张素华,李革,等.老年人群糖尿病和IGT患病率及其影响因素[J].现代预防医学,2005,32：1614-1616.
[2]徐春生,余灿清,李立明.老年糖尿病[J].中国全科医学,2007,10(12)：1036—1038
[3]许樟荣.我国糖尿病流行病学研究概况[J].总装备部医学学报,2007,9(1)：46-49.
[4]王陇德.中国居民营养与健康状况调查报告之一2002综合报告[M].北京：人民卫生出版社,2005：59
[5]Wenying Yang, Juming Lu, Jianping Weng, et al, Prevalence of diabetes among men and women in China. The new england journal of medicine,2010,362 (12):1090-1101.
[6]王克安,李天麟,向红丁,等.中国糖尿病流行特点研究-糖尿病和糖耐量减低患病率调查[J].中华流行病学杂志,1998,19(5)：282-285.
[7]全国糖尿病研究写作组调查研究组.全国14省市30万人口中糖尿病调查报告.中华内科杂志.1981,20(10)：678-683.
[8]第二次全国糖尿病五年协作防治研讨会纪要.中华内分泌代谢杂志,1995,11(3)：187-188.
[9]王克安,李天麟,李新华,等.中国儿童1型糖尿病的发病率研究.中华内分泌代谢杂志,1999,15(1)：3-7.
[10]章庆红.我国各地糖尿病发病趋势[J].河北医药,2005,27：624-625.
[11]杨泽,郑宏,佟之复,等.1997年北京城乡老年人糖尿病患病率调查[J].中华老年医学杂志,2001,20：290-293.
[12]王守俊,魏承兰,李金法,等.郑州市社区老年人群糖尿病流行特点的研究[J].河南预防医学杂志,2000,11：204-205.[13]刘幼硕.老年人糖尿病的流行病学病因和临床特点[J].中华老年医学杂志,2005,24：718-719.
[14]徐耀初.老年糖尿病流行病学[J].实用老年医学,1999,13：172-173.
[15]杨泽.中国中老年人糖尿病和糖耐量异常的流行病学研究[J].中华流行病学杂志,2003,24：410-412.
[16]Berkowitz GS, Lap inski RH, Wein R, et al. Race/ethnicity and other risk factors for gestational diabetes [J]. Am J Epidemiol,1992,135:965-973.
[17]Green J R, Pawson IG, Schumacher LB, et al. Glucose tolerance in pregnancy:ethnic variation and influence of body habitus [J]. Am J Obstet Gynecol,1990,163:86-92.
[18]Yue DK, Molyneaux LM, Ross GP, et al. Why does ethnicity affect prevalence of gestational diabetes? The underwater volcano theory [J]. DiabetMed,1996,13:748-752.
[19]徐先明,江明礼,董玉英.低危孕妇行妊娠期糖尿病筛选可行性研究[J].现代妇产科进展,2001,1：34-36.
[20]杨慧霞,赵怿,段晓华,等.妊娠期糖代谢异常对母儿结局影响的前瞻性对照研究[J].中国全科医学,2004,14：1044—1046.
[21]Yang XL, Hsu2Hage B, Zhang H, et al. Gestational diabetes mellitus in women of single gravidity in Tianjin City, China[J]. Diabetes Care,2005,25:847-851.
[22]Ko GT, TamWH, Chan JC, et al. Prevalence of gestational diabetes mellitus in Hong Kong based on the 1998 WHO criteria [J]. DiabetMed,2002,19 (1):80.
[23]马润玫,杜明钰,王丹丹,张燕.妊娠合并糖尿病的流行病学现状[J].中国实用妇科与产科杂志,2007,6(23)：455-458
[24]巩纯秀,朱逞,颜纯,等.1997-2000年与1988-1996年北京地区儿童1型糖尿病发病率比较[J].中华儿科杂志,2004,42(2)：113-115.
[25]Wang SS, Lan L, Ling L, et al. The incidence of insulin-dependent diabetes mellitus in children of the different ethic groups in Nanning during 1989-1999 [J]. Chin J Clin Rehabil,2004,8 (6): 1186-1187.
[26]张毓洪,杨建军,张波,等.宁夏地区儿童1型糖尿病的发病情况调查[J].宁夏医学院学报,2005,27(5)：347-349.
[27]张听,沈水仙,罗飞宏,等.上海市卢湾区青少年2型糖尿病患病率调查[J].中国循证儿科杂志,2006,1(3)：204-209.
[28]叶军,韩连书,邱文娟,等.儿童、青少年肥胖者2型糖尿病和高危者筛查[J].中华内分泌代谢杂志,2004,20(2)：131-135.
[29]秀敏,梁黎,董关萍,等.浙江省1999～2004年新诊断儿童1型糖尿病流行病学特征及血脂水平[J].实用儿科临床杂志,2006,21(8)：471-472.
[30]Todd JA. From genome to an etiology in a multifactorial disease, type 1 diabetes [J]. Bioessays, 1999,21 (2):164-174.
[31]Reece EA, Hagay Z, Hobbins JC. Insulin-dependent diabetes mellitus and immunogenetics: meaternal and fetal considerations [J]. Obstet Gynecal Surg,1991,46 (5):255-263.
[32]Owertach D. [J]. Diabeto logia,1998,90:31.
[33]Khalil L. [J]. Proc N atl A cad SciU SA,1990,87:1094.
[34]Bao M Z, Wang JX, Dorman TS, et al. HLA-DQ 13 mon-A sp57 allele and incidence of diabetes in China and USA [J]. Lancet,1998,2:497.
[35]Nakayama M, A biru N, Moriyama H, et al. P rime role for an insulin epitope in the development of type 1 diabetes in NOD mice [J]. Nature,2005,435 (7039):220-223.
[36]任宏,欧阳凤秀,罗飞宏,沈水仙,姜庆五.儿童1型糖尿病环境危险因素病例对照研究[J].中国公共卫生.2005；21(2)：129-130.
[37]张慧颖,王滨有,赵雪妮,梁子君,孙俭宏,张冬梅,段稳铭,路波.哈尔滨市儿童1型糖尿病危险因素研究.中国初级卫生保健,2000,08.10；14(8)：31-32.
[38]王爱华,朱逞,洪宝瑟,张纪水.情绪障碍对1型糖尿病儿童代谢控制机治疗依从性的影响[J].实用儿科临床杂志,2007；22(14)：1081-1082.
[39]Ravussin E, Valencia ME, Esparza J, et al. Effects of a traditional lifestyle on obesity in Pima Indians[J]. Diabetes Care,1994,17:1067-1074.
[40]Robert DM, David LR, Arthur JH, et al. Obesity and heredity in the etiology of non-insulin-dependent diabetes mellitus in 32 662 adult white women[J]. AM J Epidemiol, 1989,130(1):112-114.
[41]陈思东,俞守义,许雅,等.2型糖尿病发病危险因素的研究[J].中国公共卫生,2002,18(7)：18.
[42]郝新生,魏枫,房忠女.非胰岛素依赖型糖尿病危险因素的研究[J].中国慢性病预防与控制杂志,1999,7(4)：150.
[43]陈思东,俞守义,许雅,等.Ⅱ型糖尿病发病危险因素的研究[J].中国公共卫生,2002,18(7)：814.
[44]王红霞,梁秀芬,张玉梅,我国2型糖尿病的流行病学及危险因素研究[J],内蒙古医学杂志,2006,38：156-159.
[45]曾平,李淑葵,杨宏云,等,老年人2型糖尿病的危险因素分析[J],中华老年医学杂志,2003,22(1)：37-39.
[46]赵路静,宋青春.肥胖与2型糖尿病的关系,河北北方学院学报(医学版),2005,22(1)：51-53.
[47]Steppan CM, Bailey ST, Bhat S, et al. The hormone resistin links obesity to diabetes [J]. Nature,2001;409:307.
[48]王文娟,王克安,李天麟.体重指数、腰围和腰臀比预测高血压、高血糖及其二者聚集性的实用价值及其探讨[J].中华流行病学杂志,2002,23(1)：16.
[49]刘国红.Ⅱ型糖尿病的流行病学特征[J].湖北预防医学杂志,2003,14(1)：4.
[50]马林茂,富振英,王克安,等.2型糖尿病危险因素的Logistic回归分析[J].中国糖尿病杂志,1999,7(5)：262.
[51]史晓红,杨泽,高芳堃,等,北京市2型糖尿病高危险年龄人群危险因素特征[J].中国临床康复,2006,10(1)：4-6.
[52]陈黎亚,李志远.糖尿病与膳食因素及其他相关因素的研究[J].河南预防医学杂志,2004,15(3)：140.
[53]陈金钰.糖尿病患者的健康行为和自我功效[J].现代护理,2002,8：801-802
[54]杨兆军,杨文英,李光伟,等.中国成人不同糖代谢异常的分布[J].中华医学杂志,2003,83(24)：2128-2131.
[55]程志强.2型糖尿病遗传研究新进展[J].国外医学内分泌学分册,1997,17(4)：185.
[56]张维忠.肥胖、2型糖尿病与高血压[J].中华内科杂志,2002,41(4)：284.
[57]潘柏中.糖尿病诊断和治疗的检验项目评价[J].中华医学杂志,2003,83(3)：169-171.
[58]张毓洪,陈启众,贺宝福,等.银川市社区二型糖尿病危险因素病例对照研究[J].宁夏医学杂志,2006,28(2)：95-97.
[59]唐晓君,张素华,李革,等.重庆地区社区人群二型糖尿病现况调查[J].中国临床康复,2006,10(12)：10-12.
[60]中国肥胖问题工作组数据汇总分析协作组.我国成人体重指数和腰围对相关疾病危险因素异常的预测价值：适宜体重指数和腰围切点的研究[J].中华流行病学,2002,23(1)：5-10.
[61]孙莉敏.运动锻炼对2型糖尿病患者血脂与体质指标的影响[J].中国运动医学,2002,21(1)：51-54.
[62]胡传峰,李立明,陆美琪,等.2型糖尿病危险因素的非条件Logistic回归分析[J].中国慢性病预防与控制,2000,8(4)：162-164.
[63]深圳市卫生局.深圳市慢性非传染性疾病流行病学研究[M].湖南：湖南科学技术出版社,1999：32-35.
[64]吴赤蓬,王声涌,荆春霞,等.戒烟与糖尿病的关系[J].中国公共卫生,2004,20(1)：33.
[65]Targher G, Bertolini L, Zenari L, et al. Cigarette smoking and plasma total homocysteine levels in young adults with type 1 diabetes [J]. Diabetes Care,2000,23 (4):524-528.
[66]Wei M, Gibbons LW, Mithell TL, et al. Alcohol intake and incidence of type 2 diabetes in men [J]. Diabetes Care,2000,23 (1):18-22.
[67]宋煜炜,李英娥.膳食营养、生活方式与糖尿病[J].中国行为医学科学.2003,12(5)：596-598.
[68]富振英,马林茂,王克安,等.我国Ⅱ型糖尿病的流行特征[J].中国慢性病预防与控制,1999,7(3)：125.
[69]张亚非.生命早期的营养不良与成年期糖尿病[J].国外医学卫生学分册,2000,27(6)：321-323,372.
[70]李艳艳,胡东生,李春阳,等.农村居民糖尿病患病率及危险因素分析.中国公共卫生,2008：24：1273-1275.
[71]孙毓蔓.社区2型糖尿病流行现状及相关危险因素分析.现代预防医学,2010；37：4411-4417.
[72]王玉春.青岛市城阳区2型糖尿病患病率及相关危险因素分析.山东医药,2010；50：58-60.
[73]强兆艳,王建华,齐秀英.妊娠糖尿病危险因素病例对照研究[J].中国公共卫生,2006,22(7)：795-796.
[74]张红,杨西林,张翠萍,等.妊娠糖尿病筛查与筛查阳性的危险因素分析[J].中国全科医学,2004,7(2)：86-87.
[75]刁文丽,李志勤,于丽娅,等.辽宁省农村孕妇妊娠糖尿病筛查阳性率及危险因素分析[J].中国全科医学,2010,13(10B)：3309-3310.
[76]张眉花,杨慧霞,孙伟杰.糖尿病家族史与妊娠期糖代谢异常发病相关性的前瞻性对照研究[J].中华糖尿病杂志,2005,13：163-166.
[77]Lao TT, HoLF, Chan BCP et al. Maternal age and prevalence of gestational diabetes mellitus Diabetes Care,2006,29(4):948.
[78]任香梅,黄水平,邵继红,等.妊娠糖尿病发病率及危险因素分析[J].中国妇幼保健,2008,23：2954-2956.
[79]杨慧霞,赵怿,段晓华,吴北生.妊娠期糖代谢异常对母儿结局影响的前瞻性对照研 究[J].中国全科医学,2004,7(14)：1044-1047.
[80]王娜,周建博,董砚虎.妊娠糖尿病的研究现状.国外医学内分泌学分册,2004,24(2)：132.
[81]王正英,邓振宇,徐庆十.老年冠心病患者社区综合敢于前瞻性对照研究[J].中国热带医学,2008,8(4)：627-629.
[82]美国糖尿病学会(ADA).糖尿病诊疗标准(一)[J].国外医学内分泌学分册,2005,25：436-437.
[83]IDF Clinical Guidelines Task Force. Global Guideline for Type 2 Diabetes:recommendations for standard, comp rehensive, and minimal care [J]. Diabetic Medicine,2006,23:579-593.
[84]王惠贤.健康教育是建立新型护患关系的重要环节[J].实用护理杂志,2001,17(3)：54.
[85]金香今.乳腺癌术后的整体护理[J].中国现代医生,2007,45(19)：114-115.
[86]Eriksson KF, Lindgrde F. Prevention of type 2 (non-insulin-dependent) diabetes mellitus by diet and physical exercise:the 5-year Malmo feasibility study [J]. Diabetologal,1998,34:891.
[87]张安玉.糖尿病的流行形式及其防治的有关问题[J].中国慢性病预防与控制,2005,13：257-259.
[88]Knowler WC, Barrett-Connor E,Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifes-tyle intervention or metformin [J]. N Eng J Med,2002,346:393-403.
[89]常向云.糖尿病流行现状及防治对策[J].全科医学临床与教育,2004,2(1)：49-50.
[90]樊学翠,张培芳,侯元华,等.健康体检人群糖尿病相关知识的调查[J].护理学杂志,2007,22(19)：15
[91]熊建菁,卢伟.糖尿病患者非药物干预研究[J].中国慢性病预防与控制,2006,14：382-384.