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目的了解文化程度与体质指数(BMI)和腰围身高比(WHt R)对糖尿病前期影响及交互作用,为糖尿病前期干预提供依据。方法于2012年采用与人口规模成比例的整群抽样方法对江苏省昆山市18岁及以上居民进行抽样调查,现场调查采取面对面问卷调查、身体测量和实验室检测,采集血样检测空腹血糖、餐后2 h血糖。采用SAS 9.3进行分析,样本数据经过复杂加权,糖尿病前期的影响因素及其交互作用采用多因素logistic回归模型进行分析。结果 2012年昆山市加权后糖尿病前期患病率(95%CI)为17.16%(16.73%~17.59%),男、女性分别为17.67%(17.03%~18.30%)和16.69%(16.10%~17.27%)。调整年龄、性别、吸烟、饮酒及日常体力活动分级等混杂因素后,BMI(OR=1.18,95%CI:1.13~1.24)和WHt R(OR=1.19,95%CI:1.11~1.28)与糖尿病前期存在统计学关联(P<0.01)。文化程度与肥胖指标(BMI和WHt R)呈现交互作用(P<0.01)。不同文化程度分层中,较高的BMI水平和较高的WHt R水平与糖尿病前期患病存在正相关(P<0.05,P<0.01)。结论糖尿病前期患病率在较低文化程度与肥胖人群中较高,应加大对此类人群的健康教育与生活方式指导,避免其进展为糖尿病。
Objective To understand the influence of pre-diabetes and interaction between education level and body mass index (BMI) and waist circumference ratio (WHt R), and to provide basis for pre-diabetes intervention. Methods A cluster sampling method proportional to population size was adopted in 2012 to sample residents aged 18 years and over in Kunshan City, Jiangsu Province. The questionnaire survey, body measurements and laboratory tests were conducted on the spot to collect blood samples for fasting plasma glucose After 2 h blood sugar. Using SAS 9.3 for analysis, the sample data were subjected to complex weighting, predictor of pre-diabetes and their interaction using multivariate logistic regression analysis. Results The prevalence of weighted pre-diabetes in Kunshan City in 2012 was 17.16% (16.73% -17.59%) with 17.67% (17.03% ~ 18.30%) and 16.69% (16.10% ~ 17.27% %). BMI (OR = 1.18, 95% CI: 1.13-1.24) and WHt R (OR = 1.19, 95% CI: 1.11-1.28) were significantly associated with diabetes mellitus after adjustment for age, sex, smoking, alcohol intake and daily physical activity classification. Pre-existence statistical correlation (P <0.01). There was interaction between educational level and obesity index (BMI and WHt R) (P <0.01). In stratification of different education levels, the higher BMI level and the higher WHt R level had a positive correlation with the pre-diabetes (P <0.05, P <0.01). Conclusions The pre-diabetes prevalence rate is higher in lower education level and obese people. Health education and lifestyle guidance should be strengthened for these people to avoid their progression to diabetes.