不同体质指数和血脂水平老年人糖尿病患病情况的纵向数据研究

背景国内外多项研究表明肥胖、超重以及血脂水平异常对糖尿病均有不同程度的影响，但是缺少纵向数据对其的验证。目的纵向研究2016—2019年泸州市老年人糖尿病患病情况以及体质指数（BMI）和血脂情况对糖尿病的影响，为制定适合老年人的糖尿病防治策略提供科学依据。方法采用回顾性研究方法，以泸州市2016—2019年连续4年参与健康体检的老年人体检数据进行统计分析，收集性别、年龄、BMI、吸烟、饮酒、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）的资料。采用广义估计方程（GEE），分析BMI和TC、TG、LDL-C、HDL-C对糖尿病患病率的影响。结果泸州市老年人2016—2019年糖尿病患病率分别为10.5%（15 893/151 132）、11.5%（17 375/151 132）、11.9%（18 019/151 132）、13.5%（20 394/151 132）。经GEE分析，在控制所有相关因素后，肥胖〔OR=2.610，95%CI（2.523，2.700）〕、超重〔OR=1.749，95%CI（1.710，1.790）〕、TC升高〔OR=1.073，95%CI（1.040，1.106）〕、TG边缘升高〔OR=1.151，95%CI（1.126，1.177）〕、TG升高〔OR=2.091，95%CI（2.042，2.140）〕、LDL-C边缘升高〔OR=1.208，95%CI（1.178，1.240）〕、LDL-C升高〔OR=1.264，95%CI（1.219，1.310）〕、HDL-C降低〔OR=1.552，95%CI（1.506，1.599）〕是老年人糖尿病患病的危险因素（P<0.01）。偏瘦〔OR=0.763，95%CI（0.730，0.798）〕、TC边缘升高〔OR=0.868，95%CI（0.850，0.886）〕是老年人糖尿病患病的保护因素（P<0.01）。结论四川省泸州市64岁以上老年人的糖尿病患病率较高，超重、肥胖和血脂异常对糖尿病的影响较大，应针对以上两项因素采取有效措施预防糖尿病的发生。

Correlations of BMI and Blood Lipids with Diabetes in an Elderly Health Check-up Population of Luzhou:a Longitudinal Study

Background A number of studies have shown that obesity,overweight and dyslipidemia have various strength of correlation with diabetes,but there is a lack of longitudinal studies to verify this issue.Objective To perform a longitudinal study of diabetes prevalence,and the strength of correlationof body mass index(BMI)and blood lipid with diabetes in an older health check-up population of Luzhou during 2016 to 2019,providing a scientific basis for the formulation of diabetes prevention and treatment strategies for the elderly.Methods A longitude study design was used.Health check-up data of Luzhou older adults(≥64 years old)in four consecutive years(from 2016 to 2019)were retrospectively collected,including gender,age,BMI,smoking and alcohol consumption,total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C).Generalized estimating equation was used to analyze the strength of correlation of BMI,TC,TG,LDL-C and HDL-C with diabetes.Results The prevalence of diabetes in the participants during 2016—2019 was 10.5%(15893/151132),11.5%(17375/151132),11.9%(18019/151132)and 13.5%(20394/151132),respectively.After controlling for gender,age,smoking and alcohol consumption,the analysis using generalized estimating equation revealed that obesity〔OR=2.610,95%CI(2.523,2.700)〕,overweight〔OR=1.749,95%CI(1.710,1.790)〕,increased TC〔OR=1.073,95%CI(1.040,1.106)〕,marginally increased TG〔OR=1.151,95%CI(1.126,1.177)〕,increased TG〔OR=2.091,95%CI(2.042,2.140)〕,marginally increased LDL-C〔OR=1.208,95%CI(1.178,1.240)〕,increased LDL-C〔OR=1.264,95%CI(1.219,1.310)〕,and decreased HDL-C〔OR=1.552,95%CI(1.506,1.599)〕were correlated with increased risk of diabetes(P<0.01).Slightly underweight〔OR=0.763,95%CI(0.73,0.798)〕and marginally increased TC〔OR=0.868,95%CI(0.850,0.886)〕were correlated with decreased risk of diabetes(P<0.01).Conclusion The prevalence of diabetes was relatively high in the elderlyhealth check-up population of Sichuan’s Luzhou,which may be closely correlated with overweight/obesity and dyslipidemia.In view of this,it is suggested to lose weight and lower blood lipids to reduce diabetes prevalence and to prevent diabetes in this group.