摘要
目的:探讨超重/肥胖与血浆致动脉粥样硬化指数(AIP)及其交互作用对45岁及以上人群2型糖尿病(T2DM)患病风险的影响。方法:选取中国健康与养老追踪调查(CHARLS)数据库2011和2015年中年龄≥45岁者,收集性别、年龄、受教育程度、饮酒史、吸烟史、BMI、生化指标以及T2DM患病情况。通过ROC曲线确定AIP诊断T2DM的截断值,并根据截断值将研究对象分为高、低AIP组,比较2组T2DM患病率。应用Logistic回归模型分析超重/肥胖和AIP与T2DM的关系,并分析两因素的交互作用。结果:12 288名研究对象中,超重/肥胖5 763(46.9%),T2DM 1 853人(15.1%),高AIP 4 893人(39.8%)。高AIP组T2DM患病率(22.1%)高于低AIP组(10.4%)(P<0.001)。调整性别、年龄、婚姻状况、受教育程度、吸烟史、饮酒史后,超重/肥胖(OR=2.50,95%CI 2.16~2.89),高AIP(OR=2.43,95%CI 2.11~2.78)是45岁及以上人群T2DM患病的危险因素。超重/肥胖与高AIP对T2DM患病有相加交互作用[交互作用超额相对危险度、交互作用归因比和交互作用指数(95%CI)分别为1.49(1.13~1.85)、0.30(0.15~0.46)和2.68(1.58~3.79)],但二者无相乘交互作用(P>0.05)。结论:超重/肥胖和高AIP是T2DM患病的危险因素,超重/肥胖与高AIP对T2DM患病风险存在相加交互作用,且为协同作用。
Aim:To investigate the effects of overweight/obesity and atherogenic index of plasma(AIP)on risk of type 2 diabetes mellitus(T2DM)for population with age≥45 years and their interaction.Methods:Data of population with age≥45 years from the China Health and Retirement Longitudinal Study(CHARLS)database of 2011 and 2015 were collected,including gender,age,education level,alcohol history,smoking history,BMI,biochemical indicators,and the incidence of T2DM.The cut-off value of AIP predicting T2DM was determined based on ROC curve,all the subjects were accordingly allocated into 2 groups(high AIP group and low AIP group),and the prevalence of T2DM of the 2 groups was compared.Logistic regression model was used to analyze the association of overweight/obesity and AIP with T2DM.The additive and multiplicative models were used to analyze the interactions between the 2 factors.Results:A total of 12288 subjects were included in this study,among whom,5763(46.9%)were overweight/obese,1853(15.1%)were T2DM,and 4893(39.8%)had high AIP.The prevalence of T2DM in the high AIP group was 22.1%,significantly higher than that(10.4%)in the low AIP group(P<0.001).After adjusting all confounding factors,overweight/obesity(OR=2.50,95%CI 2.16-2.89)and high AIP(OR=2.43,95%CI 2.11~2.78)were risk factors for T2DM.The additive interaction results showed that overweight/obesity and high AIP had a significant additive interaction on T2DM prevalence[the relative excess risk of interaction,attributable proportion due to interaction and synergy index(95%CI)were 1.49(1.13-1.85),0.30(0.15-0.46)and 2.68(1.58-3.79),respectively].The multiplicative interaction results showed that there was no multiplicative interaction between overweight/obesity and high AIP on the risk of T2DM(P>0.05).Conclusion:Both overweight/obesity and high AIP are risk factors for T2DM.Overweight/obesity combined with high AIP has an additive interaction effect on the risk of T2DM.
作者
方堃
丁岩
霍康
FANG Kun;DING Yan;HUO Kang(Department of Nephrology,the First Affiliated Hospital,Xi'an Jiaotong University,Xi'an 710061;School of Life Science and Technology,Xi'an Jiaotong University,Xi′an 710049;Department of Neurology,the First Affiliated Hospital,Xi′an Jiaotong University,Xi′an 710061)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2023年第4期489-493,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
国家自然科学基金项目(32270188)。
