影响低龄2型糖尿病发病因素的病例对照研究
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摘要
目的分析低龄2型糖尿病(diabetes mellitus type 2,T2DM)发病的影响因素,为制定有针对性干预策略和措施提供依据。方法选取2016年7月1日至11月30日蚌埠医学院第一附属医院、蚌埠市第三人民医院门诊及住院的T2DM患者177例为病例组,对照组为同期在门诊进行健康体检的177例非糖尿病人群。采用以医院为基础的病例对照研究方法,对病例组和对照组进行问卷调查。对研究因素进行单因素及多因素非条件logistic回归分析。结果糖尿病家族史(OR=1.97,95%CI:1.14～3.40);高血脂(OR=3.99,95%CI:1.96～8.14);心情较差(OR=4.64,95%CI:1.93～11.18);水果摄入量不足(OR=2.56,95%CI:1.44～4.55);嗜甜食(OR=1.94,95%CI:1.02～3.69);睡眠时间不足(OR=3.62,95%CI:1.33～9.84)是低龄2型糖尿病发病的危险因素。结论低龄2型糖尿病是遗传和环境因素共同作用的结果,应采取综合的防治措施,尤其对高危人群要加强糖尿病的早期筛查工作,控制各种危险因素。
Objective To investigate the related factors of type 2 diabetes mellitus in young and to provide targeted evidences for prevention and intervention. Methods The cases(age≤45 years) with type 2 diabetes mellitus were interviewed from the Frist Hospital affiliated of Bengbu Medical College and the Third people′s Hospital of Bengbu on hospital basis and outpatient service at department of endocrinology, from March to December 2016.The control group consisted of 177 non-diabetic patients(age≤45 years) who underwent physical examination in outpatient clinics at the same time.A hospital-based case-control study was conducted to investigate the case group and control group who were asked to fill in a self-programmed questionnaire.The main risk factors were screened out by unconditional univariate and multivariate logistic regression. Results Type 2 diabetes mellitus in young was associated with family history of diabetes mellitus(OR=1.97, 95% CI:1.14～3.40), hyperlipidemia(OR=3.99,95%CI:1.96～8.14), bad mood(OR=4.64,95%CI:1.93～11.18), insufficient fruit intake(OR=2.56,95%CI:1.44～4.55), addicted to sweets(OR=1.94,95%CI:1.02～3.69) and sleep debt(OR=3.62,95%CI:1.33～9.84). Conclusions Type 2 diabetes mellitus in young is caused by the effect of both genetic and environmental factor, and the comprehensive measures should be adopted, especially for the high-risk group to strengthen the early screening of diabetes, and to control all kinds of risk factors.
Objective To investigate the related factors of type 2 diabetes mellitus in young and to provide targeted evidences for prevention and intervention. Methods The cases(age≤45 years) with type 2 diabetes mellitus were interviewed from the Frist Hospital affiliated of Bengbu Medical College and the Third people′s Hospital of Bengbu on hospital basis and outpatient service at department of endocrinology, from March to December 2016.The control group consisted of 177 non-diabetic patients(age≤45 years) who underwent physical examination in outpatient clinics at the same time.A hospital-based case-control study was conducted to investigate the case group and control group who were asked to fill in a self-programmed questionnaire.The main risk factors were screened out by unconditional univariate and multivariate logistic regression. Results Type 2 diabetes mellitus in young was associated with family history of diabetes mellitus(OR=1.97, 95% CI:1.14～3.40), hyperlipidemia(OR=3.99,95%CI:1.96～8.14), bad mood(OR=4.64,95%CI:1.93～11.18), insufficient fruit intake(OR=2.56,95%CI:1.44～4.55), addicted to sweets(OR=1.94,95%CI:1.02～3.69) and sleep debt(OR=3.62,95%CI:1.33～9.84). Conclusions Type 2 diabetes mellitus in young is caused by the effect of both genetic and environmental factor, and the comprehensive measures should be adopted, especially for the high-risk group to strengthen the early screening of diabetes, and to control all kinds of risk factors.
引文
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[13] 饶友婷,丽扎·江阿别克,张帆,等.2型糖尿病患者与高危和健康人群日常行为及心理因素的比较[J].中国慢性病预防与控制,2017,25(3):161-164.
[14] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,30(8):447-498.
[15] 符健,韩耀风,王萌,等.中国居民2型糖尿病危险因素Meta分析[J].中国老年学杂志,2018,38(6):1303-1307.
[16] 邵永强,樊丽辉,李江峰,等.温州市居民糖尿病患病率及危险因素调查研究[J].中国预防医学杂志,2015,16(12):966-971.
[17] 章樱,陈国庆,张勤.超重或肥胖青少年膳食摄入与睡眠规律关系的研究[J].中国预防医学杂志,2016,17(12):943-946.
[18] Shan Z,Ma H,Xie M,et al.Sleep duration and risk of type 2 diabetes:a meta-analysis of prospective studies[J].Diabetes Care,2015,38(3):529-537.
[19] 谢平,黄坚.2型糖尿病危险因素的研究进展[J].应用预防医学,2016,22(1):88-91.
[20] 武言广.中国居民营养膳食指南大全集[M].南昌:江西科学技术出版社,2012.
[2] Wang L,Gao P,Zhang M,et al.Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013[J].JAMA,2017,317(24):2515-2523.
[3] 国家卫生计生委疾病预防控制局.中国居民营养与慢性病状况报告(2015)[R].北京:人民卫生出版社,2016.
[4] Bo A,Thomsen RW,Nielsen JS,et al.Early onset type 2 diabetes:Age gradient in clinical and behavioural risk factors in 5115 persons with newly diagnosed type 2 diabetes-results from the DD2 study.[J].Diabetes Metab Res Rev,2018,34(3):e2968.
[5] 吴善玉,全贞玉.腹型肥胖与高血压和高血脂及高血糖的相关性[J].中国慢性病预防与控制,2013,21(1):50-52.
[6] 中国营养学会.中国居民膳食指南2016[M].北京:人民卫生出版社,2016.
[7] 栗新燕,邹晨辰,周思宁,等.大连市社区居民2型糖尿病发病影响因素病例对照研究[J].中国公共卫生,2016,32(11):1459-1462.
[8] National Lung and Blood Institute.How Much Sleep Is Enough[EB/OL].[2018-05-01].https://www.nhlbi.nih.gov/health/healthtopics/topics/sdd/howmuch.
[9] 王超.中国成人超重和肥胖及主要危险因素对糖尿病发病的影响[D].北京:北京协和医学院,2014.
[10] 胡丹丹,李江,傅华.亚洲人群2型糖尿病非侵入性筛查方法研究进展[J].中国预防医学杂志,2016,17(2):148-151.
[11] 杨光,吴云涛,阮晓兰,等.糖尿病、高血压人群心脑血管事件的发生情况及影响因素[J].中华高血压杂志,2014,22(12):1132-1138.
[12] 周婷,刘祥,李晓松,等.中国人群2型糖尿病影响因素的Meta分析[J].中华流行病学杂志,2016,37(5):730-736.
[13] 饶友婷,丽扎·江阿别克,张帆,等.2型糖尿病患者与高危和健康人群日常行为及心理因素的比较[J].中国慢性病预防与控制,2017,25(3):161-164.
[14] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,30(8):447-498.
[15] 符健,韩耀风,王萌,等.中国居民2型糖尿病危险因素Meta分析[J].中国老年学杂志,2018,38(6):1303-1307.
[16] 邵永强,樊丽辉,李江峰,等.温州市居民糖尿病患病率及危险因素调查研究[J].中国预防医学杂志,2015,16(12):966-971.
[17] 章樱,陈国庆,张勤.超重或肥胖青少年膳食摄入与睡眠规律关系的研究[J].中国预防医学杂志,2016,17(12):943-946.
[18] Shan Z,Ma H,Xie M,et al.Sleep duration and risk of type 2 diabetes:a meta-analysis of prospective studies[J].Diabetes Care,2015,38(3):529-537.
[19] 谢平,黄坚.2型糖尿病危险因素的研究进展[J].应用预防医学,2016,22(1):88-91.
[20] 武言广.中国居民营养膳食指南大全集[M].南昌:江西科学技术出版社,2012.