大连市社区居民2型糖尿病发病影响因素病例对照研究

栗新燕; 邹晨辰; 周思宁; 李晓枫; 马莉; 高晓虹; 高政南

doi:10.11847/zgggws2016-32-11-03

大连市社区居民2型糖尿病发病影响因素病例对照研究

Influencing factors of type 2 diabetes mellitus among community residents in Dalian city: a case-control study

摘要

摘要: 目的了解辽宁省大连市社区居民2型糖尿病的发病影响因素，为该地区制定2型糖尿病的防治策略和措施提供参考依据。方法于2011年8-12月在大连市6个社区整群抽取2 396名过去未确诊患2型糖尿病的≥40岁社区居民进行问卷调查、体格检查和实验室检测，根据实验室检测结果将其中1 177例新发2型糖尿病患者和1 219名未患2型糖尿病人群分别作为病例组和对照组，分析大连市社区居民2型糖尿病发病的影响因素。结果病例组患者饮酒、肉类摄入频率≥3次/d、超重、肥胖、中心性肥胖、有糖尿病家族史、高血压、总胆固醇边缘升高、总胆固醇升高、甘油三酯边缘升高、甘油三酯升高、低密度脂蛋白胆固醇边缘升高、低密度脂蛋白胆固醇升高的比例分别为31.78%、25.32%、44.27%、42.23%、73.41%、22.60%、69.67%、38.40%、27.78%、16.65%、26.51%、31.01%、19.12%，均高于对照组人群的24.36%、21.82%、43.40%、21.00%、48.97%、18.79%、42.82%、37.57%、18.95%，10.83%、10.67%、26.17%、12.80%，病例组患者体力活动高度活跃的比例（14.87%）低于对照组人群（18.70%），差异均有统计学意义（均P<0.05）；多因素非条件logistic回归分析结果显示，饮酒、超重或肥胖、中心性肥胖、有糖尿病家族史、高血压、甘油三酯升高（包括边缘升高和升高）和低密度脂蛋白胆固醇升高（包括边缘升高和升高）是大连市社区居民2型糖尿病发病的危险因素，体力活动高度活跃是大连市社区居民2型糖尿病发病的保护因素。结论大连市社区居民2型糖尿病发病的主要影响因素为饮酒、体力活动、体质指数、腰臀比、糖尿病家族史、血压以及甘油三酯和低密度脂蛋白胆固醇水平。

Abstract: Objective To analyze influencing factors of type 2 diabetes mellitus(T2DM)among community residents in Dalian city and to provide references for making preventive strategies and interventions in the city.Methods With cluster sampling method,2 396 residents without T2DM diagnosis and aged ≥40 years were recruited from six communities in Dalian city and surveyed with a questionnaire interview,physical examination,and laboratory tests from August to December 2011.Then the 1 177 participants with T2DM were assigned into a case group and other 1 219 without the disease into a control group based on the results of laboratory tests.Factors associated with T2DM were compared between the cases and the controls.Results The cases showed higher proportions than the controls for alcohol drinking(31.78% vs.24.36%),taking meat ≥3 times per day (25.32% vs.21.82%),overweight (44.27% vs.43.40%),obesity (42.23% vs.21.00%),abdominal obesity (73.41% vs.48.97%),with familial history of diabetes (22.60% vs.18.79%),with familial history of hypertension (69.67% vs.42.82%),with a higher but not abnormal total cholesterol (TC) (38.40% vs.37.57%),with high TC (27.78% vs.18.95%),with a higher but not abnormal triglyceride(TG) (16.65% vs.10.83%),with high TG (26.51% vs.10.67%),with a higher but not abnormal low-density lipoprotein cholesterol (LDL-C) (31.01% vs.26.17%),and with high LDL-C (19.12% vs.12.80%);while the proportion of frequent physical activity was significantly lower in the cases than in the controls (14.87% vs.18.70%,P<0.05).The results of multivariate logistic regression analysis showed that the risk factors of T2DM included alcohol drinking,overweight or obesity,abdominal obesity,high TG,high LDL-C,hypertension,and familial history of diabetes and the protective factor was frequent physical activity.Conclusion The major influencing factors of T2DM are alcohol drinking,body mass index,waist hip ratio,familial history of diabetes,blood pressure,TG content,and LDL-C level among community residents of Dalian city.

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