CAJ | 학술논문

目的　了解吸烟、饮酒在糖尿病发病风险中的作用，及其对糖尿病及IGT患者餐后血糖、血压、BMI及WHR的影响。方法　利用广东省1998对全省11 742名抽样人群进行的糖尿病流行病学调查数据，做多元Logistic回归分析和广义线性模型方差分析。结果　调查人群中，糖尿病主要独立预测因素为年龄(OR=2.053，1.568～2.687)、家族史(OR=3.210，2.019～5.104)、职业运动量(OR=1.644，1.217～2.221)、WHR(OR=2.255，1.690～3.008)、BMI(OR=2.538，1.905～3.381)和高血压(OR=3.088，2.246～4.245)。吸烟和饮酒的独立风险作风不显著，调整年龄、运动、家族史、经济水平等其他因素后，每日吸烟＞25支或每周饮酒＞7次的相对危险度(OR)分别为1.037(0.367～1.535)和1.261(0.718～2.214)。但吸烟、饮酒和年龄、职业运动量及家族史有明显的相乘交互作用，每日吸烟＞25支明显增加50岁以上人群和低职业运动量人群的糖尿病患病风险，每周饮酒＞7次除增加职业运动量较低人群患病风险外，使50岁以下人群的患病危险性增加1.42倍，并大幅增加有糖尿病家族史人群的相对危险性(OR=8.61，2.14～34.63)。在糖尿病及IGT患者中，当前吸烟者的BMI低于已戒烟和不吸烟者，WHR则高于不吸烟者，当前饮酒者BMI较已戒酒者低，但WHR差异不明显。结论　大量吸烟、饮酒是糖尿病可变的、非独立的危险因素，与年龄、少运动和家族史等主要危险因素有明显的相乘交互作用。吸烟可能导致糖尿病及IGT患者体脂异常分布。
목적　료해흡연、음주재당뇨병발병풍험중적작용，급기대당뇨병급IGT환자찬후혈당、혈압、BMI급WHR적영향。방법　이용광동성1998대전성11 742명추양인군진행적당뇨병류행병학조사수거，주다원Logistic회귀분석화엄의선성모형방차분석。결과　조사인군중，당뇨병주요독립예측인소위년령(OR=2.053，1.568～2.687)、가족사(OR=3.210，2.019～5.104)、직업운동량(OR=1.644，1.217～2.221)、WHR(OR=2.255，1.690～3.008)、BMI(OR=2.538，1.905～3.381)화고혈압(OR=3.088，2.246～4.245)。흡연화음주적독립풍험작풍불현저，조정년령、운동、가족사、경제수평등기타인소후，매일흡연＞25지혹매주음주＞7차적상대위험도(OR)분별위1.037(0.367～1.535)화1.261(0.718～2.214)。단흡연、음주화년령、직업운동량급가족사유명현적상승교호작용，매일흡연＞25지명현증가50세이상인군화저직업운동량인군적당뇨병환병풍험，매주음주＞7차제증가직업운동량교저인군환병풍험외，사50세이하인군적환병위험성증가1.42배，병대폭증가유당뇨병가족사인군적상대위험성(OR=8.61，2.14～34.63)。재당뇨병급IGT환자중，당전흡연자적BMI저우이계연화불흡연자，WHR칙고우불흡연자，당전음주자BMI교이계주자저，단WHR차이불명현。결론　대량흡연、음주시당뇨병가변적、비독립적위험인소，여년령、소운동화가족사등주요위험인소유명현적상승교호작용。흡연가능도치당뇨병급IGT환자체지이상분포。
Objective　To examine the association between smoking, alcohol consumption and the risk of diabetes and the impacts of smoking and alcohol on postprandial plasma glucose(PG), blood pressure, body mass index(BMI) and waist-to-hip ratio(WHR) in patients with diabetes and IGT.Methods　Data from 1998 Guangdong provincial diabetes interview survey, a population-based cross-sectional study including. 11 767 residents aged 20～74 years［male 5　462, female 6 305,mean age (43.8±13.6) years］, was used for analysis. Standard oral glucose tolerance test(75 g) and physical examination were conducted on all subjects. Questionnaire included questions about physical activity, family history, economic state, average daily consumption of alcohol and cigarette, etc. Multivariate logistic regression and GLM-General factorial analysis were used. Results　In Guangdong population, the main independent predictive factors of diabetes were age (OR=2.053, 1.568～2.687), family history (OR=3.210, 2.019～5.104), exercise (OR=1.644, 1.217～2.221), BMI(OR=2.538, 1.905～3.381), WHR(OR=2.255,1.690～3.008) and hypertension(OR=3.088, 2.246～4.245). Affer adjusted for age, physical activity, family history and economic state, the odds ratio of smoking＞25 cigarettes a day was 1.037(0.367～1.535), drinking＞7 times per week was 1.261(0.718～2.214); but there were significant interaction between smoking or drinking and age, family history or exercise condition, after controlling for confounders, the odds ratios of diabetes were 3.910(1.953～7.826) for smoking＞25 cigarettes a day and age＞50 years, 2.251(1.144～4.431) for smoking＞25 cigarettes a day and lower physical activity, 2.421(1.130～5.185) for drinking＞7 times per week and age＜50 years, 8.608(2.140～34.631) for drinking＞7 times per week with family history. Among the patients with diabetes or IGT, current smoking had higher WHR but lower BMI than never and ever smoker, current drinker only had lower BMI than ever drinker. Conclusion　Either heavy smoking or drinking may be a dependent, modifiable risk factor for diabetes in Guangdong population. It has significant interaction with other independent risk factor for diabetes in Guangdong population. It has significant interaction with other independent risk factors-age, family history and physical activity. Smoking may lead to abnormal body fat distribution in diabetes and IGT.