摘要
背景与传统肥胖指标相比,新型肥胖指标脂质蓄积指数(LAP)是预测人群2型糖尿病患病风险更好的指标。LAP对中国北方地区人群2型糖尿病患病风险也有着较好的预测价值。由于国内南北方气候环境、生活方式、饮食习惯之间存在较大的差异,南北方人群的三酰甘油、腰围也大有不同,因此LAP在国内南方地区的适用性仍有待研究。目的探讨LAP对珠三角社区人群2型糖尿病患病风险的预测价值。方法2017年7—9月,采用多阶段分层随机抽样方法抽取常住于珠三角地区不同社区的828例居民为调查对象。调查对象接受问卷调查、体格检查和实验室检查。根据LAP四分位数将调查对象分为Q1组(LAP<11.22),Q2组(LAP:11.22~22.05),Q3组(LAP:22.06~44.50),Q4组(LAP>44.50),采用二分类Logistic回归分析探讨LAP与2型糖尿病的关系,并采用受试者工作特征(ROC)曲线分析各肥胖指标对2型糖尿病患病风险的预测价值。结果排除研究资料不完整18例,最终纳入810例调查对象,其中Q1组203例,Q2组202例,Q3组202例,Q4组203例。LAP与空腹血糖、2型糖尿病粗患病率呈正相关(P<0.05)。Q4组2型糖尿病患病风险是Q1组的12.22倍〔OR=12.22,95%CI(2.83,52.67),P<0.001〕。当控制年龄、性别、婚姻状况、教育水平时,Q4组2型糖尿病患病风险是Q1组的6.65倍〔OR=6.65,95%CI(1.49,29.77),P<0.05〕。当控制年龄、性别、婚姻状况、教育水平、体育锻炼、收缩压、舒张压时,Q4组2型糖尿病患病风险是Q1组的5.04倍〔OR=5.04,95%CI(1.07,23.64),P<0.05〕。LAP预测2型糖尿病患病风险的ROC曲线下面积大于BMI(Z=-2.210,P=0.027)。LAP预测2型糖尿病患病风险的灵敏度为85.37%,最佳临界值为25.485。结论LAP对珠三角社区人群2型糖尿病患病风险的预测效果优于BMI,但与WHR预测效果相似。
Background Compared with the traditional obesity index,lipid accumulation product(LAP)is a new index that can better predict the risk of type 2 diabetes.In the population in northern China,LAP also shows high accuracy in predicting the risk of type 2 diabetes.However,it is unclear whether LAP also has high accuracy in predicting type 2 diabetes risk in populations in southern China,because the triglyceride(TC)and waist circumstance vary obviously in southern and northern populations due to significant differences in climate,lifestyle and eating habit.Objective To evaluate the predictive value of LAP for type 2 diabetes risk in community-dwelling people in Pearl River Delta.Methods By stratified multistage random sampling,828 community-dwelling residents from Pearl River Delta were enrolled from July to September 2017.They received a questionnaire survey,anthropometric tests,and laboratory examinations.According to quartiles of LAP,they were divided into group Q1(LAP<11.22),group Q2(LAP:11.22-22.05),group Q3(LAP:22.06-44.50)and group Q4(LAP>44.50).Binary Logistic regression models were used to assess the relationship between LAP and type 2 diabetes.Receiver operating characteristic(ROC)curve analysis was used to analyze diagnostic value of BMI,WHR and LAP for type 2 diabetes.Results Excluding 18 cases of incomplete research data,810 cases were finally included in the survey,including 203 cases in group Q1,202 cases in group Q2,202 cases in group Q3 and 203 cases in group Q4.LAP was positively correlated with fasting blood glucose,and crude prevalence rate of type 2 diabetes(P<0.05).The risk of type 2 diabetes in group Q4 was 12.22 times higher than that in group Q1〔OR=12.22,95%CI(2.83,52.67),P<0.001〕.When controlling for age,gender,marital status and education level,the risk of type 2 diabetes in group Q4 was 6.65 times higher than that in group Q1〔adjusted OR=6.65,95%CI(1.49,29.77),P<0.05〕.After controlling age,gender,marital status,education level,physical exercise,systolic and diastolic blood pressure,t
作者
黄俊轩
张晓霞
彭欣
谢易娴
鲍欣雨
刘焱
程梦娇
李宇斯
郭卓源
马金香
HUANG Junxuan;ZHANG Xiaoxia;PENG Xin;XIE Yixian;BAO Xinyu;LIU Yan;CHENG Mengjiao;LI Yusi;GUO Zhuoyuan;MA Jinxiang(School of Public Health,Guangzhou Medical University,Guangzhou 511436,China)
出处
《中国全科医学》
CAS
北大核心
2020年第24期3012-3017,共6页
Chinese General Practice
关键词
糖尿病
2型
脂质蓄积指数
人体质量指数
珠三角地区
Diabetes mellitus
type 2
Lipid accumulation product
Body mass index
Pearl river delta
