CAJ | 학술논문

目的分析生活方式与超重肥胖对糖尿病发病的影响.方法江苏省多代谢异常和代谢综合征综合防治研究队列人群的基线调查开展于1999年4月至2004年5月,采用多阶段抽样的方法,共抽取调查对象8685名.于2006年3月至2007年11月对基线调查满5年的4582名对象进行随访,有效随访3847名,其中满足条件的3461名基线非糖尿病对象被纳入研究.以高脂饮食与否、低纤维饮食与否、久坐活动少与否以及职业体力活动分级作为生活方式变量,以随访时是否为糖尿病为结局变量,采用logistic回归模型分析并比较基线超重肥胖和各生活方式变量在糖尿病发病中的单独作用和共同作用.结果 3461名研究对象在6.3年随访时间中共发生糖尿病162例,发病率为4.7％.在调整性别、年龄、糖尿病家族史、血压、血脂、空腹血糖后,中及轻职业体力活动(与重相比,中:aRR =2.15,95％CI:1.26 ～ 3.68；轻:aRR =2.39,95％ CI:1.12 ～4.87)、久坐活动少(aRR=2.94,95％ CI:1.90 ～4.54)、低纤维饮食(aRR=1.58,95％CI:1.01～2.53)、超重(aRR=1.33,95％ CI:1.01～1.90)以及肥胖(aRR=1.59,95％CI:1.07 ～3.75)在糖尿病发生过程中具有独立作用.无论在体重正常还是超重肥胖对象中,久坐活动少(体重正常组:aRR =3.42,95％CI:1.99 ～5.86;超重肥胖组:aRR =2.41,95％CI:1.13～5.12)和低纤维饮食(体重正常组:aRR=1.42,95％CI:0.81～2.54；超重肥胖组:aRR=2.63,95％ CI:1.15 ～ 6.03)都会增加糖尿病的发病风险,但是按照是否久坐活动少或是否低纤维饮食将对象分组后,在各组中超重肥胖(非久坐活动少组:aRR =2.04,95％∞:0.87 ～4.71;久坐活动少组:aRR=1.21,95％CI:0.82～1.78；非低纤维饮食组:aRR=1.26,95％ CI:0.87～1.84;低纤维饮食组:aRR=1.88,95％ CI:0.80 ～4.80)与糖尿病无关联.结论不良生活方式和超重肥胖会增加糖尿病的发病风险；增加体力活动量和适量纤维饮食比单纯控制体重能够更加有效地降低糖尿病的发病风险. 目的分析生活方式與超重肥胖對糖尿病髮病的影響.方法江囌省多代謝異常和代謝綜閤徵綜閤防治研究隊列人群的基線調查開展于1999年4月至2004年5月,採用多階段抽樣的方法,共抽取調查對象8685名.于2006年3月至2007年11月對基線調查滿5年的4582名對象進行隨訪,有效隨訪3847名,其中滿足條件的3461名基線非糖尿病對象被納入研究.以高脂飲食與否、低纖維飲食與否、久坐活動少與否以及職業體力活動分級作為生活方式變量,以隨訪時是否為糖尿病為結跼變量,採用logistic迴歸模型分析併比較基線超重肥胖和各生活方式變量在糖尿病髮病中的單獨作用和共同作用.結果 3461名研究對象在6.3年隨訪時間中共髮生糖尿病162例,髮病率為4.7％.在調整性彆、年齡、糖尿病傢族史、血壓、血脂、空腹血糖後,中及輕職業體力活動(與重相比,中:aRR =2.15,95％CI:1.26 ～ 3.68；輕:aRR =2.39,95％ CI:1.12 ～4.87)、久坐活動少(aRR=2.94,95％ CI:1.90 ～4.54)、低纖維飲食(aRR=1.58,95％CI:1.01～2.53)、超重(aRR=1.33,95％ CI:1.01～1.90)以及肥胖(aRR=1.59,95％CI:1.07 ～3.75)在糖尿病髮生過程中具有獨立作用.無論在體重正常還是超重肥胖對象中,久坐活動少(體重正常組:aRR =3.42,95％CI:1.99 ～5.86;超重肥胖組:aRR =2.41,95％CI:1.13～5.12)和低纖維飲食(體重正常組:aRR=1.42,95％CI:0.81～2.54；超重肥胖組:aRR=2.63,95％ CI:1.15 ～ 6.03)都會增加糖尿病的髮病風險,但是按照是否久坐活動少或是否低纖維飲食將對象分組後,在各組中超重肥胖(非久坐活動少組:aRR =2.04,95％∞:0.87 ～4.71;久坐活動少組:aRR=1.21,95％CI:0.82～1.78；非低纖維飲食組:aRR=1.26,95％ CI:0.87～1.84;低纖維飲食組:aRR=1.88,95％ CI:0.80 ～4.80)與糖尿病無關聯.結論不良生活方式和超重肥胖會增加糖尿病的髮病風險；增加體力活動量和適量纖維飲食比單純控製體重能夠更加有效地降低糖尿病的髮病風險.
목적 분석생활방식여초중비반대당뇨병발병적영향.방법 강소성다대사이상화대사종합정종합방치연구대렬인군적기선조사개전우1999년4월지2004년5월,채용다계단추양적방법,공추취조사대상8685명.우2006년3월지2007년11월대기선조사만5년적4582명대상진행수방,유효수방3847명,기중만족조건적3461명기선비당뇨병대상피납입연구.이고지음식여부、저섬유음식여부、구좌활동소여부이급직업체력활동분급작위생활방식변량,이수방시시부위당뇨병위결국변량,채용logistic회귀모형분석병비교기선초중비반화각생활방식변량재당뇨병발병중적단독작용화공동작용.결과 3461명연구대상재6.3년수방시간중공발생당뇨병162례,발병솔위4.7％.재조정성별、년령、당뇨병가족사、혈압、혈지、공복혈당후,중급경직업체력활동(여중상비,중:aRR =2.15,95％CI:1.26 ～ 3.68；경:aRR =2.39,95％ CI:1.12 ～4.87)、구좌활동소(aRR=2.94,95％ CI:1.90 ～4.54)、저섬유음식(aRR=1.58,95％CI:1.01～2.53)、초중(aRR=1.33,95％ CI:1.01～1.90)이급비반(aRR=1.59,95％CI:1.07 ～3.75)재당뇨병발생과정중구유독립작용.무론재체중정상환시초중비반대상중,구좌활동소(체중정상조:aRR =3.42,95％CI:1.99 ～5.86;초중비반조:aRR =2.41,95％CI:1.13～5.12)화저섬유음식(체중정상조:aRR=1.42,95％CI:0.81～2.54；초중비반조:aRR=2.63,95％ CI:1.15 ～ 6.03)도회증가당뇨병적발병풍험,단시안조시부구좌활동소혹시부저섬유음식장대상분조후,재각조중초중비반(비구좌활동소조:aRR =2.04,95％∞:0.87 ～4.71;구좌활동소조:aRR=1.21,95％CI:0.82～1.78；비저섬유음식조:aRR=1.26,95％ CI:0.87～1.84;저섬유음식조:aRR=1.88,95％ CI:0.80 ～4.80)여당뇨병무관련.결론 불량생활방식화초중비반회증가당뇨병적발병풍험；증가체력활동량화괄량섬유음식비단순공제체중능구경가유효지강저당뇨병적발병풍험.
Objective To investigate the relative contribution of lifestyle and obesity to the risk of developing type 2 diabetes.Methods All baseline survey data were based on the program Prevention of Multiple Metabolic Disorders and Metabolic Syndrome in Jiangsu Province (PMMJS) which was conducted during April 1999 to May 2004.In the baseline survey,8685 participants were selected using multi-stage sampling method.From March 2006 to November 2007,4582 participants who bad been in the study for at least 5 years were included in the follow-up survey.A total of 3847 participants were followed and of them 3461 non-diabetic subjects were included in this analysis.High fat diet or not,low fiber diet or not,sedentary or not and occupational physical activity classification were defined as lifestyle variables and the incidence of type 2 diabetes at follow-up survey was defined as outcome variable.It was prospectively examined that the separate and joint association of lifestyle and obesity with the development of type 2diabetes in subjects recruited fiom PMMJS,using logistic regression model.Results A total of 162 incident cases of type 2 diabetes during 6.3 years of follow-up in total 3461 participants were documented.The incidence rate was 4.7％.After adjusted for sex,age,family history of diabetes,blood pressure,lipids and fast plasma glucose,risk of type 2 diabetes increased with lighter occupational physical activity ( compared with vigorous group,moderate group aRR =2.15,95％ CI:1.26 - 3.68 ; light groop aRR =2.39,95％ CI:1.12 -4.87),sedentary lifestyle ( aRR =2.94,95％ CI:1.90 -4.54),low fiber diet ( aRR =1.58,95％CI:1.01 -2.53),overweight (aRR=1.33,95％CI:1.01 -1.90) and obesity (aRR =1.59,95％CI:1.07- 3.75 ).In joint analysis of lifestyle and obesity,the impact of sedentary lifestyle ( in BMI ＜ 25 group,aRR =3.42,95％CI:1.99 -5.86; in BMI≥25 group,aRR =2.41, 95％CI:1.13 -5.12) and low fiber diet ( in BMl ＜ 25 group,aRR =1.42,95％ CI:0.81 - 2.54 ; in BMI ＞ 25 group,aRR =2.63,95％ CI:1.15 -6.03) on diabetes were independent of overweight and obesity.When stratified by sedentary lifestyle or low fiber diet,there was no association between overweight/obesity and diabetes risk ( sedentary aRR =2.04,95％CI 0.87-4.71,non sedentary aRR=1.21,95％CI:0.82-1.78; non low fiber diet aRR=1.26,95％ CI:0.87 - 1.84,low fiber diet aRR =1.88,95％ CI:0.80-4.80).Conclusion Unhealthy lifestyle,overweight and obesity independently increase the risk of type 2 diabetes.The magnitude of risk contributed by sedentary lifestyle and low fiber diet arc much greater than that imparted by overweight and obesity.