摘要
目的使用限制性立方样条模型探讨BMI连续变化与糖尿病患病关联强度的剂量-反应关系。方法采用代表中国45岁及以上中老年人群的2011年中国健康与养老追踪的基线调查数据,共纳入受访者9708名。应用非条件logistic回归和限制性立方样条模型分析BMI与糖尿病患病关联及剂量-反应关系。结果 2011年我国45岁及以上中老年人糖尿病患病率(95%CI)为14.77%(14.06%~15.48%)。调整混杂因素(性别、年龄、文化程度、饮酒、午睡、腰围、总胆固醇和C反应蛋白)之后,超重(OR=1.21,95%CI:1.04~1.41)、肥胖(OR=1.64,95%CI:1.37~1.97)与糖尿病患病相关具有统计学意义。限制性立方样条分析结果显示,不论性别和年龄分层,BMI连续变化与糖尿病患病的关联强度都呈非线性剂量-反应关系(非线性检验,P<0.001)。结论高BMI(超重/肥胖)是糖尿病患病的独立、剂量依赖性的危险因素,提示以关注BMI连续变化(而非传统BMI水平)为重点的糖尿病预防将变得更为迫切。
Objective To estimate the dose-response relationship between continuous body mass index （BMI）and the prevalence of diabetes based on restricted cubic spline method. Methods The data for this study are drawn from the baseline survey of the China Health and Retirement Longitudinal Study, a national survey representative of the middle-aged and elderly population （45 years old and above）in China. A total of 9708 participants were selected in this study. Logistic regression analysis and restricted cubic spline model were employed to estimate the dose-response relation between BMI and the risk of diabetes. Results The estimated prevalence of diabetes among middle-aged and elderly Chinese in 2011 was 14. 77% （14.06% - 15.48% ）. The multiple logistic regression analysis showed that overweight and obesity were significantly associated with the prevalence of diabetes, the odds ratios were 1.21 （95 % CI = 1.04 - 1.41 ） and 1.64 （95 % CI = 1.37 - 1.97 ） respectively, after ad- justing for potential confounders （ sex, age, education, alcohol, nap, waist circumference, total cholesterol, C-creative protein）. The multivariable restricted cubic spline regression indicated the nonlinear dose-response relation was found between continuous vari- ation in BMI and diabetes （ Non-linearity test, P 〈 0. 001 ） in both different gender and different age groups. Conclusion In- creased BMI is an independent and adjusted dose-dependent risk factor for diabetes among overweight and obesity participants;it is suggested that the prevention of diabetes which is paying attention to continuous BMI reduction （rather than traditional BMI levels） will become more urgent.
作者
朱云
史静琤
罗旋
程文炜
刘晓芳
闫晓芳
Zhu Yun;Shi Jingcheng;Luo Xuan;et al(Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University（410078 ）, Changsha)
出处
《中国卫生统计》
CSCD
北大核心
2017年第6期887-890,895,共5页
Chinese Journal of Health Statistics
关键词
限制性立方样条
糖尿病
体质指数
Restricted cubic spline
Diabetes
Body mass index （BMI）
