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目的探索我国社区居民糖调节受损和2型糖尿病的相关因素,为2型糖尿病的防治提供依据。方法在2013年浙江省玉环县健康队列基线调查基础上,选取269例新诊断2型糖尿病(T2DM)患者,按与其性别相同、年龄差小于3岁且无血缘关系的条件随机选取糖调节受损(IGR)和正常糖耐量(NGT)各269例。采用配对logistic回归分析相关危险因素,估计调整比值比(a OR)和95%可信区间(95%CI)。结果从NGT到IGR到T2DM,腹型肥胖比例(χ_(趋势)~2=20.834,P<0.001)、血脂异常比例(χ_(趋势)~2=16.299,P<0.001)和高血压比例(χ_(趋势)~2=10.670,P=0.005)呈增高趋势。在校正年龄、性别及其他因素后,与NGT相比,饮酒(a OR=2.06,95%CI:1.18-3.60)是IGR的独立危险因素;与IGR相比,腹型肥胖(a OR=1.63,95%CI:1.14-2.35)是T2DM的独立危险因素;与NGT相比,高血压(a OR=1.69,95%CI:1.14-2.50)、血脂异常(a OR=1.80,95%CI:1.24-3.63)和腹型肥胖(a OR=2.12,95%CI:1.46-3.08)是T2DM的独立危险因素。结论我国社区居民糖调节受损的患病风险主要与饮酒有关,而高血压、血脂异常和腹型肥胖会增加2型糖尿病的患病风险,应在社区糖尿病防治工作中加以关注。
Objective To explore the related factors of impaired glucose regulation and type 2 diabetes in Chinese community residents and provide evidence for the prevention and treatment of type 2 diabetes mellitus. Methods Based on the baseline survey of healthy cohorts of Yuhuan County in Zhejiang Province in 2013, 269 newly diagnosed type 2 diabetic patients (T2DM) were selected randomly and their glucose regulation was impaired according to the same gender, age less than 3 years old and no blood relationship (IGR) and normal glucose tolerance (NGT) in 269 cases. Correlated risk factors were analyzed using paired logistic regression and adjusted odds ratio (a OR) and 95% confidence interval (95% CI). Results From NGT to IGR to T2DM, the ratio of abdominal obesity (χ_ (trend) ~ 2 = 20.834, P <0.001), the proportion of dyslipidemia (χ_ (trend) ~ 2 = 16.299, P <0.001) (Trend) ~ 2 = 10.670, P = 0.005) showed an increasing trend. Alcohol consumption (a OR = 2.06, 95% CI: 1.18-3.60) was an independent risk factor for IGR compared with NGT after adjusting for age, gender, and other factors; abdominal obesity was significantly higher than IGR (a OR = 1.63 , 95% CI: 1.14-2.35) were independent risk factors for T2DM. Hypertension (a OR = 1.69, 95% CI: 1.14-2.50), dyslipidemia (a OR = 1.80, 95% CI: 1.24-3.63) and abdominal obesity (a OR = 2.12, 95% CI: 1.46-3.08) were independent risk factors for T2DM. Conclusions The prevalence of impaired glucose regulation in community residents in China is mainly related to alcohol consumption. Hypertension, dyslipidemia and abdominal obesity may increase the risk of type 2 diabetes and should pay more attention to the prevention and treatment of community diabetes.