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目的探讨江苏省南京市35岁～人群体质指数(BMI)、腰围(WC)、腰臀比(WHR)和腰身比(WHtR)与2型糖尿病(T2DM)关系。方法 2004年7月对南京市的3个城区和1个郊县的35岁～居民进行横断面调查;对无T2DM的研究对象于2007年7月进行随访;采用多因素Logistic回归和受试者工作特征曲线(ROC)评估基线4个肥胖指标对T2DM发生的预测作用。结果基线调查中无T2DM共4 058人,3年后共随访3 031人,随访率为74.7%;3年后新发生的T2DM患者共计72例,累计发病率为2.4%;其中男性33例,女性39例。随着基线肥胖程度的增加,T2DM的发病危险增加;WC超标和WHtR≥0.5者发生T2DM的风险无论男女性均较高。4个肥胖指标中,ROC曲线下面积WHtR最大。结论 BMI、WC、WHR和WHtR的增加均能提升T2DM发病的危险;WHtR可能是最重要的肥胖与T2DM相关预测指标。
Objective To explore the relationship between body mass index (BMI), waist circumference (WHR) and waist-to-hip ratio (WHtR) and type 2 diabetes mellitus (T2DM) in Nanjing City, Jiangsu Province. Methods A cross-sectional survey of 35-year-old residents in 3 urban areas and 1 suburban area in Nanjing City was conducted in July 2004. The subjects without T2DM were followed up in July 2007 and the multivariate Logistic regression and the subjects The working characteristic curve (ROC) was used to assess the predictive value of 4 obesity markers on the occurrence of T2DM at baseline. Results There were 4 058 non-T2DM patients in the baseline survey. After 3 years, a total of 3 031 follow-up visits were performed, with a follow-up rate of 74.7%. A total of 72 T2DM patients were newly diagnosed after 3 years, with a cumulative incidence of 2.4%; 33 males, Female 39 cases. With the increase of baseline obesity, the risk of T2DM increased; the risk of T2DM with WC excess and WHtR≥0.5 was higher in both men and women. Four obesity indicators, the area under the ROC curve WHtR maximum. Conclusions The increase of BMI, WC, WHR and WHtR can increase the risk of T2DM. WHtR may be the most important predictor of obesity and T2DM.