新疆维吾尔自治区农村人群2型糖尿病发病状况及影响因素的前瞻性研究

乔政; 马儒林; 郭恒; 张向辉; 何佳; 王馨平; 木拉提别克·克尔曼; 郭淑霞

doi:10.16462/j.cnki.zhjbkz.2024.11.012

新疆维吾尔自治区农村人群2型糖尿病发病状况及影响因素的前瞻性研究

doi: 10.16462/j.cnki.zhjbkz.2024.11.012

石河子大学医学院预防医学系，832000 石河子

基金项目:

国家自然科学基金 81560551

详细信息

通讯作者:
郭淑霞，E-mail: 2320100252@qq.com

中图分类号: R195.4
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- 被引次数: 0
出版历程
- 收稿日期: 2024-04-24
- 修回日期: 2024-08-31
- 网络出版日期: 2024-12-23
- 刊出日期: 2024-11-10

A prospective study on the incidence and influencing factors of type 2 diabetes mellitus in rural population in Xinjiang

Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi 832000, China

Funds:

National Natural Science Foundation of China 81560551

More Information

Corresponding author: GUO Shuxia, E-mail: 2320100252@qq.com

摘要

摘要: 目的探究新疆维吾尔自治区农村人群2型糖尿病(type 2 diabetes mellitus, T2DM)发病情况及影响因素，对比维吾尔族和哈萨克族人群T2DM影响因素的差异，为该地区人群开展有针对性的T2DM预防措施提供依据。方法选择2010年和2016年新疆维吾尔自治区2个具有代表性的地区，对研究对象进行问卷调查、体格检查和血液样本采集。于2013―2017年对哈萨克族进行随访调查，于2019―2022年对维吾尔族进行随访调查，以随访满5年的人群作为研究对象。采用Cox比例风险模型评估影响因素与T2DM事件发病风险之间的关联。结果共纳入5 714名研究对象，其中3 304名维吾尔族和2 410名哈萨克族研究对象，随访期间新发T2DM分别为428例和165例，累积发病率分别为13.0%、6.8%；两组人群的常见危险因素包括年龄增长、T2DM家族史、肥胖、高血压、三酰甘油(triglyceride, TG)异常。低密度脂蛋白胆固醇(low density lipoprotein cholesterol, LDL-C)异常和高密度脂蛋白胆固醇(high density lipoprotein cholesterol, HDL-C)异常是维吾尔族人群T2DM特有的危险因素，男性、超重和总胆固醇(total cholesterol, TC)异常是哈萨克族人群T2DM特有的危险因素。结论维吾尔族人群T2DM发病率高于哈萨克族，两民族T2DM发病因素及其关联强度均有一定差异，针对不同生活方式和民族特点，应开展相应的T2DM防控措施。
- 农村人群 /
- 2型糖尿病 /
- 前瞻性研究
Abstract: Objective This study aims to explore the incidence and influencing factors of type 2 diabetes mellitus (T2DM) among rural populations in Xinjiang, comparing risk factors between the Uyghur and Kazakh ethnic groups and proposing targeted prevention measures. Methods Two representative regions in the Xinjiang were selected for questionnaire surveys, physical exams, and blood sample collection from the study subjects in 2010 and 2016, with follow-up studies from 2013 to 2017 (Kazakh) and 2019 to 2022 (Uyghur), Populations with a follow-up period of at least 5 years were selected as the study subjects. The Cox proportional hazards regression model was employed to assess the relationship between influencing factors and the risk of T2DM. Results The study included a total of 5 714 participants, including 3 304 Uygur ethnic group participants and 2 410 Kazakh ethnic group participants. During the follow-up period, 428 new cases of T2DM were reported in the Uygur group and 165 new cases in the Kazakh group. The cumulative incidence of new-onset T2DM was 13.0% in the Uyghur population, higher than the 6.8% in the Kazakh population. Common risk factors for both groups include older age, family history of T2DM, obesity, hypertension, and abnormal triglycerides (TG). Additional risk factors specific to the Uyghur group are abnormal LDL-C and HDL-C, while those specific to the Kazakh group include male, being overweight, and abnormal total cholesterol (TC). Conclusions T2DM incidence is higher among the Uyghur population than the Kazakh population. There are notable differences in the incidence factors and correlation strengths of T2DM between the two ethnic groups. Given the varying lifestyles and ethnic characteristics, it is essential to implement tailored prevention and control measures for T2DM.
- People living in rural areas /
- Type 2 diabetes mellitus /
- Prospective study

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图 1 两民族2型糖尿病发病影响因素的关联分析

A：维吾尔族人群；B：哈萨克族人群。
A: Uyghurs; B: Kazak.

Figure 1. Correlation analysis of influencing factors of type 2 diabetes mellitus in the two ethnic groups

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表 1 新疆维吾尔自治区农村人群基线特征

Table 1. Baseline characteristics of rural populations in Xinjiang

特征 Characteristic	维吾尔族Uyghurs^① (n=3 304)	哈萨克族Kazak^① (n=2 410)	t/χ²值value	P值 value
年龄/岁 Age/years	40.48±13.22	44.23±14.45	10.17	0.001
男性 Male	1 436(43.5)	985(40.9)	3.832	0.050
文化程度：高中及以上 Education leve: high school l or above	258(7.8)	263(10.9)	1 233.688	0.001
婚姻状况: 已婚 Marital status: married	2 865(86.7)	2 074(86.1)	38.862	0.001
T2DM家族史 Family history of T2DM	241(7.3)	87(3.6)	34.958	0.001
高血压家族史 Family history of high blood pressure	268(6.3)	406(17.0)	101.020	0.001
冠心病家族史 Family history of coronary heart disease	205(6.2)	149(6.2)	0.001	0.973
BMI/(kg·m^-2)	26.56±4.76	23.93±4.09	20.848	0.001
中心性肥胖 Central obesity	1 319(39.9)	897(37.2)	762.830	0.001
高血压 Hypertension	988(29.9)	900(37.2)	34.877	0.001
吸烟 Smoking	642(19.4)	487(20.2)	0.530	0.467
饮酒 Drinking	228(6.9)	199(8.3)	3.709	0.054
冠心病 Coronary heart disease	183(5.5)	56(2.3)	35.942	0.001
慢性胆囊炎 Chronic gallbladder disease	82(2.5)	97(4.0)	10.934	0.001
慢性肾脏病 Chronic kidney disease	99(3.0)	36(0.5)	13.639	0.001
高尿酸血症 Hyperuricemia	193(5.8)	104(4.3)	6.586	0.010
TG/(mmol·L^-1)^②	602(18.2)	203(8.4)	749.472	0.001
TC/(mmol·L^-1)^②	267(8.1)	99(4.1)	36.695	0.001
LDL-C/(mmol·L^-1)^②	189(5.7)	35(1.5)	67.396	0.001
HDL-C/(mmol·L^-1)^②	349(10.6)	385(16.0)	9.082	0.003
ALT/(IU·L^-1)^②	598(18.1)	75(3.1)	301.237	0.001
AST/(IU·L^-1)^②	256(7.7)	424(17.6)	128.832	0.001
ALP/(IU·L^-1)^②	581(17.6)	426(17.7)	0.008	0.928
GGT/(IU·L^-1)^②	326(9.9)	123(5.1)	43.665	0.001
GFR/(mL·min^-1·1.73m^-2)^②	42(1.3)	26(1.1)	0.438	0.508
注：T2DM, 2型糖尿病; TG，三酰甘油；TC，总胆固醇；LDL-C，低密度脂蛋白胆固醇；HDL-C，高密度脂蛋白胆固醇；ALT，丙氨酸氨基转移酶；AST，门冬氨酸氨基转移酶；ALP，碱性磷酸酶；GGT，血清γ-谷氨酰转肽酶；GFR，肾小球滤过率。 ①以人数(占比/%)或x±s表示；②为该指标异常人数的占比。 Note: T2DM, type 2 diabetes mellitus; TG, triglyceride; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high density lipoprotein cholesterol; ALT, alanine aminotransferase; AST, aspartate transaminase; ALP, alkaline phosphatase; GGT, γ-glutamyl transferase; GFR, glomerular filtration rate. ① Number of people(proportion/%) or x±s; ② The proportion of people who are abnormal in this indicator.

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表 2 两民族按年龄、性别分层的2型糖尿病发病率

Table 2. The incidence of type 2 diabetes mellitus stratified by age and gender in both ethnic groups

年龄/岁 Age/years	维吾尔族 Uyghurs^①				哈萨克族 Kazak^①
年龄/岁 Age/years	男性 Male	女性 Female	χ²值 value	P值 value	男性 Male	女性 Female	χ²值 value	P值 value
18~ < 35	532(5.6)	756(5.0)	0.234	0.628	307(4.2)	480(3.8)	0.116	0.773
35~ < 45	393(12.5)	488(8.0)	4.852	0.028	232(6.5)	367(4.6)	0.945	0.331
45~ < 55	259(23.6)	335(20.6)	0.746	0.388	202(13.9)	286(7.0)	6.297	0.012
55~ < 65	158(21.5)	209(31.1)	4.193	0.041	120(11.7)	173(9.8)	0.254	0.615
≥65	94(26.6)	80(22.5)	0.390	0.532	124(11.3)	119(7.6)	0.984	0.321
合计 Total	1 436(13.9)	1 868(12.3)	1.841	0.175	985(8.5)	1 425(5.7)	6.906	0.009
χ_趋势²	71.673	143.459			12.113	9.217	22.929
P_趋势	0.001	0.001			0.001	0.002	0.001
注：①以人数(占比/%)表示。 Note: ① Number of people(proportion/%).

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