摘要
背景我国老年糖尿病的发病率日益升高,而治愈率和控制率较低,有研究表明,体力活动(PA)能够缓解老年糖尿病的发生发展,但不同种类、不同强度的PA及其运动能量消耗对老年糖尿病的影响作用大小尚未明确,有关研究报道较少。目的了解老年糖尿病患病风险与PA的关联程度和趋势,为制定老年人糖尿病防控策略提供科学依据。方法采用分层整群随机抽样,于2017年10月至2018年6月抽取江苏省南通市港闸区、通州区、启东市、海门市、如皋市和海安市有户籍且实际连续居住1年以上的13022例60岁及以上老年居民,其中糖尿病患者2698例,依据倾向性评分法按照年龄1∶1匹配无糖尿病者2698例。收集调查对象一般人口学、体格检查、实验室检查指标等信息,并参照国际体力活动量表调查PA和静坐时间等行为生活方式。采用多因素条件Logistic回归分析与样条回归分析探究PA各指标与老年糖尿病的关联。结果多因素条件Logistic回归分析结果显示,休闲体力活动(LPA)、职业体力活动(OPA)每增加1个强度等级,老年糖尿病患病风险分别平均下降18%和24%(P<0.0001);且LPA、OPA、交通体力活动(CPA)和总PA能量消耗越高,老年糖尿病患病风险越低(P<0.0001)。每日步数≥6000步可降低66%的糖尿病患病风险(P<0.05)。每周静坐时间越长,老年糖尿病患病风险越高(P<0.0001)。样条回归分析结果显示,随着OPA能量消耗的增加,老年糖尿病患病风险随之单调降低;随着CPA、LPA和总PA能量消耗的增加,老年糖尿病患病风险均为先降低后趋于平缓,不同性别与总人群的结果一致。结论中度、重度的LPA和OPA可降低老年糖尿病的患病风险,且随着不同种类运动能量消耗的增加,降低老年糖尿病患病风险作用增强,增强幅度先明显上升后趋于平缓,建议LPA能量消耗、CPA能量消耗和总PA能量消耗分别到达28 MET-h/w、18 MET-h/w和45 MET-h
Background The prevalence of elderly diabetes is increasing in China recently,with lower cure and control rates.Some epidemiology studies have shown that physical activity(PA)can alleviate the prevalence and the development of elderly diabetes.However,the effects of different types and intensities of PA and their metabolic equivalent on elderly diabetes have not been clarified,and there are few related studies.Objective To understand the size and trend of the relationship between the risk of elderly diabetes and PA,in order to provide a scientific basis for formulating strategies for the prevention and control of elderly diabetes.Methods Based on the stratified cluster random sampling,a total of 13022 elderly people aged 60 and above who had registered residence actually lived continuously for more than 1 year in Gangzha District,Tongzhou District,Qidong City,Haimen City,Rugao City,and Haian City of Jiangsu Province were selected from October 2017 to June 2018,including 2698 diabetic patients.2698 non-diabetes people in the control group were matched with a age 1∶1 propensity score.The general demographic characters,laboratory indicators were collected,behavioral lifestyles such as physical activity and sitting time were investigated refer to the International Physical Activity Scale.Multivariate conditional Logistic regression and spline regression models were used to analyze the association between PA and elderly diabetes.Results Multivariate Logistic regression analysis showed that with the Leisure physical activity(LPA)and occupational physical activity(OPA)increased by one intensity level,the risk of elderly diabetes decreased by 18%and 24%(P<0.0001).The higher the metabolic equivalent of LPA,OPA,commuting physical activity(CPA),and total PA,the lower the risk of elderly diabetes(P<0.0001).Daily steps≥6000 were associated with a 66%lower risk of diabetes(P<0.0001),compared with daily steps<6000.The longer thesitting time per week,the higher the risk of elderly diabetes(P<0.05).The results of spline regre
作者
顾云娟
吴尚熹
吕婧怡
周阳
陈伦文
陆青云
鲁菊英
张晓义
梁源源
肖静
GU Yunjuan;WU Shangxi;LYU Jingyi;ZHOU Yang;CHEN Lunwen;LU Qingyun;LU Juying;ZHANG Xiaoyi;LIANG Yuanyuan;XIAO Jing(Department of Epidemiology and Health Statistics,School of Public Health,Nantong University,Nantong 226019,China;Department of Endocrinology,Affiliated Hospital of Nantong University,Nantong 226001,China)
出处
《中国全科医学》
CAS
北大核心
2022年第6期750-755,共6页
Chinese General Practice
基金
南通市科技局项目(MS12020015,MS22019005,MS12019033)
2020年度南通市基层卫生健康研究课题(2020JCC032)。
关键词
糖尿病
老年人
体力活动
倾向性评分
Diabetes mellitus
Aged
Physical activity
Propensity score
