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心血管病高危人群腰围和体质指数变化与空腹血糖水平变化关系纵向数据研究

吴洵 覃玉 苏健 陈路路 崔岚 陶然 周金意

吴洵, 覃玉, 苏健, 陈路路, 崔岚, 陶然, 周金意. 心血管病高危人群腰围和体质指数变化与空腹血糖水平变化关系纵向数据研究[J]. 中国公共卫生. doi: 10.11847/zgggws1141575
引用本文: 吴洵, 覃玉, 苏健, 陈路路, 崔岚, 陶然, 周金意. 心血管病高危人群腰围和体质指数变化与空腹血糖水平变化关系纵向数据研究[J]. 中国公共卫生. doi: 10.11847/zgggws1141575
WU Xun, QIN Yu, SU Jian, CHEN Lulu, CUI Lan, TAO Ran, ZHOU Jinyi. Associations of changes in waist circumference and BMI with variation of fasting blood glucose among middle aged and elderly at high cardio-vascular risk: a follow-up study in Jiangsu province[J]. Chinese Journal of Public Health. doi: 10.11847/zgggws1141575
Citation: WU Xun, QIN Yu, SU Jian, CHEN Lulu, CUI Lan, TAO Ran, ZHOU Jinyi. Associations of changes in waist circumference and BMI with variation of fasting blood glucose among middle aged and elderly at high cardio-vascular risk: a follow-up study in Jiangsu province[J]. Chinese Journal of Public Health. doi: 10.11847/zgggws1141575

心血管病高危人群腰围和体质指数变化与空腹血糖水平变化关系纵向数据研究

doi: 10.11847/zgggws1141575
基金项目: 国家重大公共卫生项目
详细信息
    作者简介:

    吴洵(1992 – ),主管医师,硕士,研究方向:慢性病预防控制

    通信作者:

    覃玉,E-mail:qinyu@jscdc.cn

Associations of changes in waist circumference and BMI with variation of fasting blood glucose among middle aged and elderly at high cardio-vascular risk: a follow-up study in Jiangsu province

More Information
  • 摘要:   目的  探讨心血管病高危人群腰围和体质指数变化与空腹血糖水平变化的关系,为糖尿病和心血管病的防治提供理论参考依据。  方法   于2015年9月 — 2016年6月基于“中国心血管病高危人群早期筛查与综合干预项目”在江苏省徐州市、连云港、盐城市等8个项目点招募71 758名 ≥ 35岁常住居民进行基线调查,对筛查出的12 369名初筛血糖水平记录完整的心血管病高危人群分别于2017、2018和2019年每年进行1次随访调查,采用广义估计方程分析心血管病高危人群腰围和体质指数变化与空腹血糖水平变化的关系。  结果  江苏省完成3次随访且随访血糖水平完整的9 952名心血管病高危人群中,正常腰围、中心性肥胖前期和中心性肥胖分别有3045人(30.6%)、2130人(21.4%)和4777人(48.0%),体重过轻、正常体重、超重和肥胖分别有56人(0.6%)、2669人(26.8%)、4540人(45.6%)和2687人(27.0%)。在调整了性别、年龄、文化程度、居住地、吸烟情况、饮酒情况、是否高血压、是否糖尿病、是否血脂异常、基线腰围、基线体质指数和随访次序等混杂因素后,广义估计方程分析结果显示,腰围减少和腰围增加心血管病高危人群的空腹血糖升高风险分别为腰围稳定心血管病高危人群的0.911倍(OR = 0.911,95%CI = 0.867~0.958)和1.070倍(OR = 1.070,95%CI = 1.022~1.120);基线腰围每增加1 cm和基线体质指数每增加1,心血管病高危人群空腹血糖水平分别增加0.011(β = 0.011,95%CI = 0.008~0.014)mmol/L和0.027(β = 0.027,95%CI = 0.013~0.041)mmol/L。亚组分析结果显示,基线腰围每增加1 cm,男性、女性、城市、农村、非糖尿病和糖尿病心血管病高危人群空腹血糖水平分别增加0.011、0.010、0.014、0.005、0.007和0.021mmol/L(均P < 0.001);基线体质指数每增加1,女性、城市、农村和非糖尿病心血管病高危人群空腹血糖水平分别增加0.030、0.026、0.024和0.031 mmol/L(均P < 0.05)。  结论  心血管高危人群的腰围和体质指数变化均与空腹血糖水平变化存在正向线性相关关系。
  • 表  1  不同腰围分级心血管病高危人群基线特征比较

    Table  1.   Main baseline characteristics by normal waist, pre-central obesity and obesity among 9 952 middle aged and elderly residents at high cardiovascular risk surveyed in Jiangsu province, 2015

    特征正常腰围(n = 3045)中心性肥胖前期(n = 2130)中心性肥胖(n = 4777)χ2P
    人数%人数%人数%
    性别 男性 1279 32.0 808 20.2 1 908 47.8 8.791 0.012
    女性 1766 29.6 1322 22.2 2869 48.2
    年龄(岁) 35~44 256 41.0 132 21.1 237 37.9 55.559 < 0.001
    45~54 813 31.2 591 22.7 1202 46.1
    55~64 1060 28.2 776 20.6 1 924 51.2
    ≥ 65 916 30.9 631 21.3 1414 47.8
    文化程度 小学及以下 1603 29.5 1166 21.4 2671 49.1 27.485 < 0.001
    初中 836 30.7 571 21.0 1316 48.3
    高中/中专 372 31.7 270 23.0 530 45.2
    大专及以上 205 39.4 104 20.0 211 40.6
    居住地 城市 1414 25.5 1282 23.1 2844 51.3 151.724 < 0.001
    农村 1631 37.0 848 19.2 1 933 43.8
    吸烟情况 不吸烟 2354 29.8 1716 21.7 3834 48.5 12.082 0.002
    吸烟 691 33.7 414 20.2 943 46.0
    饮酒情况 不饮酒 2472 30.3 1756 21.5 3937 48.2 2.211 0.331
    饮酒 573 32.1 374 20.9 840 47.0
    是否高血压 835 45.7 400 21.9 591 32.4 281.497 < 0.001
    2210 27.2 1730 21.3 4186 51.5
    是否糖尿病 2432 33.5 1561 21.5 3268 45.0 123.888 < 0.001
    613 22.8 569 21.1 1509 56.1
    是否血脂异常 1 926 34.0 1260 22.2 2486 43.8 143.628 < 0.001
    959 24.0 825 20.7 2208 55.3
    下载: 导出CSV

    表  2  不同体质指数分级心血管病高危人群基线特征比较

    Table  2.   Main baseline characteristics by underweight, normal weight, overweight, and obesity among 9 952 middle aged and elderly residents at high cardiovascular risk surveyed in Jiangsu province, 2015

    特征体重过轻(n = 56)正常体重(n = 2669)超重(n = 4540)肥胖(n = 2687)χ2P
    人数%人数%人数%人数%
    性别 男性 14 0.4 1014 25.4 1 904 47.7 1063 26.6 16.954 0.001
    女性 42 0.7 1655 27.8 2636 44.3 1624 27.3
    年龄(岁) 35~44 6 1.0 209 33.4 254 40.6 156 25.0 31.902 < 0.001
    45~54 9 0.3 672 25.8 1187 45.5 738 28.3
    55~64 22 0.6 950 25.3 1744 46.4 1044 27.8
    ≥ 65 19 0.6 838 28.3 1355 45.8 749 25.3
    文化程度 小学及以下 35 0.6 1455 26.7 2442 44.9 1508 27.7 28.223 0.001
    初中 11 0.4 705 25.9 1238 45.5 769 28.2
    高中/中专 6 0.5 320 27.3 577 49.2 269 23.0
    大专及以上 3 0.6 169 32.5 235 45.2 113 21.7
    居住地 城市 17 0.3 1347 24.3 2592 46.8 1584 28.6 59.241 < 0.001
    农村 39 0.9 1322 30.0 1 948 44.2 1103 25.0
    吸烟情况 不吸烟 44 0.6 2086 26.4 3603 45.6 2171 27.5 5.756 0.124
    吸烟 12 0.6 583 28.5 937 45.8 516 25.2
    饮酒情况 不饮酒 49 0.6 2187 26.8 3716 45.5 2213 27.1 1.448 0.694
    饮酒 7 0.4 482 27.0 824 46.1 474 26.5
    是否高血压 24 1.3 757 41.5 779 42.7 266 14.6 333.434 < 0.001
    32 0.4 1 912 23.5 3761 46.3 2421 29.8
    是否糖尿病 49 0.7 2091 28.8 3314 45.6 1 807 24.9 89.631 < 0.001
    7 0.3 578 21.5 1226 45.6 880 32.7
    是否血脂异常 35 0.6 1751 30.9 2554 45.0 1332 23.5 202.516 < 0.001
    15 0.4 767 19.2 1 901 47.6 1309 32.8
    下载: 导出CSV

    表  3  心血管病高危人群腰围和体质指数变化与空腹血糖水平变化的关系

    Table  3.   Estimated gender-, residence place-, and diabetes-specific changes in fasting blood glucose associated with variations of waist circumference and body mass index: generalized estimating equation analysis on the data on 9 952 middle aged and elderly residents at high cardiovascular risk followed-up during 2015 - 2019 in Jiangsu province

    分组腰围变化体质指数变化
    β95%CIPβ95%CIP
    性别 a男性0.0110.006~0.016 < 0.0010.019– 0.002~0.0410.069
    女性0.0100.006~0.014 < 0.0010.0300.013~0.0470.001
    居住地 b城市0.0140.011~0.018 < 0.0010.0260.009~0.0430.003
    农村0.0050.000~0.0100.0380.0240.002~0.0460.036
    是否糖尿病 c0.0070.005~0.009 < 0.0010.0310.021~0.041 < 0.001
    0.0210.011~0.030 < 0.0010.016– 0.025~0.0580.442
      注:a 调整了年龄、文化程度、居住地、吸烟情况、饮酒情况、是否高血压、是否糖尿病、是否血脂异常、基线腰围、基线体质指数和随访次序等混杂因素;b 调整了性别、年龄、文化程度、吸烟情况、饮酒情况、是否高血压、是否糖尿病、是否血脂异常、基线腰围、基线体质指数和随访次序等混杂因素;c 调整了性别、年龄、文化程度、居住地、吸烟情况、饮酒情况、是否高血压、是否血脂异常、基线腰围、基线体质指数和随访次序等混杂因素。
    下载: 导出CSV
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  • 接收日期:  2023-02-24
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