2017年广州地区新诊断2型糖尿病、糖耐量异常危险因素病例对照研究
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摘要
目的探索2017年新诊断2型糖尿病(type 2 diabetes mellitus,T2DM)、糖耐量异常(impaired glucose tolerance,IGR)危险因素,为T2DM的防治措施提供依据。方法选择新诊断T2DM456名,按性别相同、年龄差小于5岁随机选择IGR和正常糖耐量(normal glucose tolerance,NGT)各456名,用多类结果logistic回归和有序多分类logistic回归分析T2DM和IGR的影响因素。结果有序多分类logistic回归显示消瘦(OR=2.060,95%CI:1.020～4.162)、超重(OR=1.478,95%CI:1.181～1.849)、肥胖(OR=2.151,95%CI:1.561～2.965)、饮酒(OR=1.521,95%CI:1.093～2.117)、体力劳动者(OR=1.892,95%CI:1.317～2.718)是糖尿病疾病程度的危险因素,已婚(β=-0.591,OR=0.554,95%CI:0.385～0.795),运动(β=-0.336,OR=0.715,95%CI:0.579～0.883)是糖尿病疾病程度的保护因素;结合T2DM-NGT对照、T2DM-IGR对照、IGR-NGT对照3组比较,体力劳动者是糖尿病的危险人群,运动、饮酒、已婚的影响在IGR到T2DM阶段,在NGT转为IGR过程中作用较弱,而BMI影响NGT-IGR-T2DM整个过程。结论超重与肥胖是糖尿病整个病程的危险因素,体力劳动者是糖尿病的危险人群,已婚、运动是糖尿病的保护因素,饮酒是糖尿病的危险因素。
Objective To explore the factors affecting the newly diagnosed type 2 diabetes mellitus(T2 DM)and impaired glucose tolerance(IGR)in 2017,and to provide a basis for the prevention and treatment of T2 DM.Methods 456 new diagnosed type 2 diabetes mellitus were selected,and 456 patients with the same gender and age difference of fewer than 5 years were randomly selected for IGR and normal glucose tolerance(NGT).The multivariate logistic regression and ordered multi-class logistic regression were used to analyze the influencing factors of T2 DM and IGR.Results Ordered multi-class logistic regression showed that thin(OR=2.060,95%CI:1.020～4.162),overweight(OR=1.478,95%CI:1.181～1.849),obesity(OR=2.151,95%CI:1.561～2.965),drink(OR=1.521,95%CI:1.093～2.117)and manual workers(OR=1.892,95%CI:1.317～2.718)were risk factors for diabetes disease.Married(β=-0.591,OR=0.554,95%CI:0.385～0.795)and exercise(β=-0.336,OR=0.715,95%CI:0.579～0.883)were the degree of diabetes protective factors.Compared with the T2 DM-NGT control,T2 DM-IGR control,and IGR-NGT control group,manual workers were at risk for diabetes.The effects of exercise,drinking,and marriage was in the IGR to T2 DM stage.They were weaker in the process of converting NGT to IGR,and BMI affected the whole process of NGT-IGR-T2 DM.Conclusion Overweight and obesity are risk factors for diabetes.The manual workers are at risk for diabetes.Married and exercise are protective factors for diabetes.Drinking is a risk factor for diabetes.
Objective To explore the factors affecting the newly diagnosed type 2 diabetes mellitus(T2 DM)and impaired glucose tolerance(IGR)in 2017,and to provide a basis for the prevention and treatment of T2 DM.Methods 456 new diagnosed type 2 diabetes mellitus were selected,and 456 patients with the same gender and age difference of fewer than 5 years were randomly selected for IGR and normal glucose tolerance(NGT).The multivariate logistic regression and ordered multi-class logistic regression were used to analyze the influencing factors of T2 DM and IGR.Results Ordered multi-class logistic regression showed that thin(OR=2.060,95%CI:1.020～4.162),overweight(OR=1.478,95%CI:1.181～1.849),obesity(OR=2.151,95%CI:1.561～2.965),drink(OR=1.521,95%CI:1.093～2.117)and manual workers(OR=1.892,95%CI:1.317～2.718)were risk factors for diabetes disease.Married(β=-0.591,OR=0.554,95%CI:0.385～0.795)and exercise(β=-0.336,OR=0.715,95%CI:0.579～0.883)were the degree of diabetes protective factors.Compared with the T2 DM-NGT control,T2 DM-IGR control,and IGR-NGT control group,manual workers were at risk for diabetes.The effects of exercise,drinking,and marriage was in the IGR to T2 DM stage.They were weaker in the process of converting NGT to IGR,and BMI affected the whole process of NGT-IGR-T2 DM.Conclusion Overweight and obesity are risk factors for diabetes.The manual workers are at risk for diabetes.Married and exercise are protective factors for diabetes.Drinking is a risk factor for diabetes.
引文
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[15] 陈璐,陈适,许可,等.糖尿病患者行为方式与血糖控制关系[J].中国公共卫生,2017,32(10):1501-1503.
[16] 贾克宝,王立.不同步行强度对2型糖尿病患者餐后血糖的影响[J].中国健康教育,2013,29(5):450-452.
[17] 蒲鑫鑫,冯坤,唐贵忠,等.重庆市老年人常见慢性病防控知识、态度及行为现况调查[J].现代预防医学,2018,26(1):85-89,98.
[2] Farag YM,Gaballa MR.Diabesity:an overview of a rising epidemic[J].Nephrology,Dialysis,Transplantation:Official Publication of the European Dialysis and Transplant Association-European Renal Association,2011,26(1):28-35.
[3] 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):2-42.
[4] Xu Y,Wang LM,He J,et al.Prevalence and control of diabetes in Chinese adults[J].Journal of the American Medical Association,2013,310(9):948-958.
[5] Cai L,Li L,Dong J,et al.The economic burden of type 2 diabetes mellitus in rural southwest China[J].International Journal of Cardiology,2013,165(2):273-277.
[6] 中国高血压防治指南修订委员会.中国高血压防治指南(2010年修订版)[M].北京:人民卫生出版社,2012.
[7] 陈春明,孔灵芝,中华人民共和国卫生部疾病控制司.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006.
[8] Tabák AG,Herder C,Rathmann W,et al.Prediabetes:a high-risk state for diabetes development[J].Lancet,2012,379(9833):2279-2290.
[9] 付俊梅.高血压合并糖尿病发生的危险因素分析[J].中华临床医师杂志(电子版),2016,40(14):2203-2206.
[10] Shen X,Vaidya A,Wu S,et al.The diabetes epidemic in China:an integrated review of national surveys[J].Endocrine Practice:Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists,2016,22(9):1119-1129.
[11] 胡文斌,张婷,张小花,等.文化程度和肥胖指标交互作用对糖尿病前期患病影响研究[J].中国慢性病预防与控制,2017,25(9):658-661.
[12] 王瑞琪,杜茂林,梁丹艳,等.内蒙古地区流动人口糖尿病影响因素的研究[J].现代预防医学,2018,45(1):155-159.
[13] 陈利强,骆秀婷,岳文静.广东惠州地区职工糖尿病患病情况调查与研究[J].河北医学,2016,22(2):329-332.
[14] Ouchi N,Ohashi K,Shibata R,et al.Adipocytokines and obesity-linked disorders[J].Nagoya Journal of Medical Science,2012,74(1/2):19-30.
[15] 陈璐,陈适,许可,等.糖尿病患者行为方式与血糖控制关系[J].中国公共卫生,2017,32(10):1501-1503.
[16] 贾克宝,王立.不同步行强度对2型糖尿病患者餐后血糖的影响[J].中国健康教育,2013,29(5):450-452.
[17] 蒲鑫鑫,冯坤,唐贵忠,等.重庆市老年人常见慢性病防控知识、态度及行为现况调查[J].现代预防医学,2018,26(1):85-89,98.