CAJ | 학술논문

目的评估青岛地区糖尿病发病率,以及体重变化等危险因素对糖尿病发病的影响.方法研究对象源自2006年建立的青岛地区35 ～ 74岁成年人糖尿病前瞻性队列.共有1 294名基线未诊断糖尿病者参加2009-2011年的随访调查.糖尿病诊断依据WHO/国际糖尿病联盟2006年标准.运用多因素logistic backward回归分析,评估危险因素对糖尿病发病率的影响.结果经过4年随访调查,有120名新发糖尿病病例,累积糖尿病患病率为11.8％.与正常人群相比,新确诊糖尿病患者年龄较大,年龄校正的BMI、WC、SBP和TC明显增加(P＜0.05).年龄、居住农村、基线体重和体重变化是糖尿病发病的独立危险因素.多因素logistic回归调整的糖尿病发病风险比(RR值)分别为1.45(95％CI:1.13 ～ 1.87)、1.93(95％CI:1.12～3.34)、1.46(95％CI:1.05 ～ 2.03)和1.49(95％CI:1.18～ 1.88).与体重稳定的者相比,体重减少＞5％和BMI＜28 kg/m2的人群,糖尿病发病降低67％(RR=0.33,95％CI:0.11 ～ 0.97);但BMI＞28 kg/m2者中增加了糖尿病发病危险,并随体重变化而不同(P＜0.01).基线调查时WC和体重增加者也表现出相同的变化趋势.结论进一步证实肥胖在糖尿病发展中的作用,基线时的BMI和体重增加是预测糖尿病发病的独立危险因素.
목적 평고청도지구당뇨병발병솔,이급체중변화등위험인소대당뇨병발병적영향.방법 연구대상원자2006년건립적청도지구35 ～ 74세성년인당뇨병전첨성대렬.공유1 294명기선미진단당뇨병자삼가2009-2011년적수방조사.당뇨병진단의거WHO/국제당뇨병련맹2006년표준.운용다인소logistic backward회귀분석,평고위험인소대당뇨병발병솔적영향.결과 경과4년수방조사,유120명신발당뇨병병례,루적당뇨병환병솔위11.8％.여정상인군상비,신학진당뇨병환자년령교대,년령교정적BMI、WC、SBP화TC명현증가(P＜0.05).년령、거주농촌、기선체중화체중변화시당뇨병발병적독립위험인소.다인소logistic회귀조정적당뇨병발병풍험비(RR치)분별위1.45(95％CI:1.13 ～ 1.87)、1.93(95％CI:1.12～3.34)、1.46(95％CI:1.05 ～ 2.03)화1.49(95％CI:1.18～ 1.88).여체중은정적자상비,체중감소＞5％화BMI＜28 kg/m2적인군,당뇨병발병강저67％(RR=0.33,95％CI:0.11 ～ 0.97);단BMI＞28 kg/m2자중증가료당뇨병발병위험,병수체중변화이불동(P＜0.01).기선조사시WC화체중증가자야표현출상동적변화추세.결론 진일보증실비반재당뇨병발전중적작용,기선시적BMI화체중증가시예측당뇨병발병적독립위험인소.
Objective Since the incidence rates and risk factor for type 2 diabetes in Chinese populations had not been well known,the aim of this study was to evaluate the impact of weight change and other risk factors on incident type 2 diabetes in Qingdao,China.Methods A prospective population-based cohort study was carried out,based on subjects aged 35-74 years who participated in the ‘Qingdao Diabetes Survey’ in 2006.Subjects were free of diabetes at baseline.A total of 1 294 subjects attended the follow up survey between 2009 and 2011.The diagnostic criteria for Diabetes was classified according to both the World Health Organization and the International Diabetes Federation 2006.A logistic regression was built using the backward stepwise selection to assess the effects of risk factors on the incident type 2 diabetes.Results During a 4-year follow up period,120 cases with incident type 2 diabetes were identified,with cumulative incidence of diabetes as 11.8％.Participants who developed type 2 diabetes were significantly older,having significantly higher age-adjusted BMI/waist circumference/systolic blood pressure and total cholesterol,than those subjects who remained non-diabetic both in urban and rural areas.Among individuals with no diabetes at the baseline,factors as age,living in the rural areas,baseline BMI and weight change had all independently contributed to the development of diabetes.The multivariate adjusted relative risks (95％ CIs) related to the incidence of diabetes were 1.45 (1.13-1.87),1.93 (1.12-3.34),1.46 (1.05-2.03) and 1.49 (1.18-1.88),respectively,for a one standard deviation increase in continuous variables.Compared with the reference group of non-obese and with stable weight,factor as weight loss ＞5％ and BMI ＜28 kg/m2 were independently associated with a 67％ (RR=0.33,95％ CI:0.11-0.97) reduction in the risk of type 2 diabetes,while BMI ＞28 kg/m2 could increase the risk across the levels of weight change.Similar trends were observed in higher waist and weight gain at baseline.Conclusion This study confirmed the critical importance of obesity in the development of type 2 diabetes.Baseline BMI and weight gain appeared independent predictors on type 2 diabetes.