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成人颈围和腰围对糖尿病患病的联合效应

辛鹏 江国虹 李静 李昌昆 范莉莉 郑文龙

辛鹏, 江国虹, 李静, 李昌昆, 范莉莉, 郑文龙. 成人颈围和腰围对糖尿病患病的联合效应[J]. 中华疾病控制杂志, 2024, 28(2): 171-175. doi: 10.16462/j.cnki.zhjbkz.2024.02.007
引用本文: 辛鹏, 江国虹, 李静, 李昌昆, 范莉莉, 郑文龙. 成人颈围和腰围对糖尿病患病的联合效应[J]. 中华疾病控制杂志, 2024, 28(2): 171-175. doi: 10.16462/j.cnki.zhjbkz.2024.02.007
XIN Peng, JIANG Guohong, LI Jing, LI Changkun, FAN Lili, ZHENG Wenlong. Combined effect of adult neck circumference and waist circumference on diabetes mellitus[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(2): 171-175. doi: 10.16462/j.cnki.zhjbkz.2024.02.007
Citation: XIN Peng, JIANG Guohong, LI Jing, LI Changkun, FAN Lili, ZHENG Wenlong. Combined effect of adult neck circumference and waist circumference on diabetes mellitus[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(2): 171-175. doi: 10.16462/j.cnki.zhjbkz.2024.02.007

成人颈围和腰围对糖尿病患病的联合效应

doi: 10.16462/j.cnki.zhjbkz.2024.02.007
基金项目: 

天津市医学重点学科(专科)建设项目 TJYXZDXK-051A

详细信息
    通讯作者:

    郑文龙,E-mail: zhengwenlong2006@126.com

  • 中图分类号: R512.91

Combined effect of adult neck circumference and waist circumference on diabetes mellitus

Funds: 

Tianjin Key Medical Discipline (Specialty) Construction Project TJYXZDXK-051A

More Information
  • 摘要:   目的  探索成人颈围(neck circumference, NC)现状及其与糖尿病关系,并分析颈围和腰围(waist circumference, WC)对糖尿病患病风险的联合效应。  方法  根据中国成人慢性非传染性疾病与营养监测方案,在天津市调查4 136名成人,收集其NC、WC数据,并采集静脉血检测空腹血糖、服用无水葡萄糖2 h后血糖和糖化血红蛋白。将男性成人NC < 37 cm或女性成人NC < 33 cm者划分为NC1组,其余为NC2组。分析调查人群NC的分布状况及不同NC分组的糖尿病患病率情况,用WC将人群分为WC正常、中心型肥胖前期、中心型肥胖组,在此基础上分析其与NC对糖尿病患病率及患病风险的联合效应。  结果  调查人群平均NC为36.3 cm,男性平均NC高于女性,且与年龄呈正相关(β=0.271, t=3.452, P=0.001);NC2组糖尿病患病率为27.7%,高于NC1组的17.9%;在WC正常组和中心型肥胖组中,NC2组糖尿病患病率均高于NC1组;多因素logistic回归分析模型分析结果显示,与WC正常组+NC1组相比,随着WC、NC的增加罹患糖尿病的风险也随之增大,其中中心型肥胖组+NC2组罹患糖尿病的风险最高(OR=2.939, 95%CI: 2.227~3.880, P<0.001)。  结论  天津市颈围较大成人糖尿病患病率较高,WC和NC对糖尿病患病风险的联合效应较强,未来需要进一步研究NC与糖尿病患病的生物学机制,以便应用于大人群筛查达到早期发现、控制糖尿病的效果。
  • 图  1  调查人群WC、NC与糖尿病患病率的关联

    WC:腰围;NC: 颈围;WC分层: 1=WC正常组,2=中心型肥胖前期组,3=中心型肥胖组;NC1组:男性成人NC < 37 cm或女性成人NC < 33 cm;NC2组:男性成人NC≥37 cm或女性成人NC≥33 cm。

    Figure  1.  Correlation between WC, NC and prevalence of diabetes mellitus in participants

    WC: waist circumference; NC: neck circumference; WC stratification: 1=normal WC group, 2=pre-central obesity group, 3=central obesity group; NC1 group: male adult NC < 37 cm or female adult NC < 33 cm; NC2 group: male adult NC≥37 cm or female adult NC≥33 cm.

    表  1  调查对象基本情况及NC状况

    Table  1.   Basic information and NC of the investigated population

    分组  group 调查人数
    Number of people surveyed
    NC/cm NC1组人数(占比/%)
    Number of NC1 group people(proportion/%)
    NC2组人数(占比/%)
    Number of NC2 group people (proportion/%)
    性别  Gender
        男性  Male 1 827 38.4±3.5 539(29.5) 1 288(70.5)
        女性  Female 2 309 34.5±3.0 565(24.5) 1 744(75.5)
        t2值  value 50.337 13.201
        P值  value < 0.001 < 0.001
    地区  Region
        城镇 Town 3 043 36.6±3.8 682(22.4) 2 361(77.6)
        农村  Rural 1 093 35.4±3.5 422(38.6) 671(61.4)
        t2值  value 15.828 107.817
        P值  value < 0.001 < 0.001
    年龄组/岁  Age group/years
        18~ < 45 660 35.8±4.2 209(31.7) 451(68.3)
        45~ < 60 1 338 36.3±3.7 315(23.5) 1 023(76.5)
        ≥60 2 138 36.4±3.7 580(27.1) 1 558(72.9)
        t2值  value 22.686 15.337
        P值  value < 0.001 < 0.001
    合计  Total 4 136 36.3±3.8 1 104(26.7) 3 032(73.3)
    注:NC,颈围。
    ①以x±s表示。②NC1组,男性成人NC < 37 cm或女性成人NC < 33 cm。③NC2组,男性成人NC≥37 cm或女性成人NC≥33 cm。
    Note: NC: neck circumference.
    x±s; ②NC1 group, male adult NC < 37 cm or female adult NC < 33 cm; ③NC2 group, male adult NC≥37 cm or female adult NC≥33 cm.
    下载: 导出CSV

    表  2  年龄与NC趋势性检验分析

    Table  2.   Trend test and analysis of age and NC

    指标  Index β
    value
    sx t
    value
    P
    value
    常数项  Constant term 35.612 0.194 183.500 < 0.001
    年龄/岁  Age/years 0.271 0.079 3.452 0.001
    注:NC,颈围。
    Note: NC, neck circumference.
    下载: 导出CSV

    表  3  不同NC调查对象的糖化血红蛋白及糖尿病患病情况

    Table  3.   Glycosylated hemoglobin and diabetes mellitus prevalence in different NC investigated populations

    分组
    Group
    HbAlc 糖尿病
    Diabetes mellitus
    人数
    Number of people
    均值±标准差
    (x±s)
    人数
    Number of people
    患病率/%
    Prevalence/%
    NC1组  group 1 100 5.5±0.7 197 17.9
    NC2组  group 3 027 5.8±1.0 839 27.7
    t2值  value 76.440 41.632
    P值  value < 0.001 < 0.001
    合计  Total 4 127 5.7±0.9 1 036 25.1
    注:NC,颈围; HbA1c, 糖化血红蛋白; NC1组,男性成人NC < 37 cm或女性成人NC < 33 cm;NC2组,男性成人NC≥37 cm或女性成人NC≥33 cm。
    Note: NC: neck circumference; HbA1c, Glycosylated hemoglobin; NC1 group, male adult NC < 37 cm or female adult NC < 33 cm; NC2 group, male adult NC≥37 cm or female adult NC≥33 cm.
    下载: 导出CSV

    表  4  WC分层基础上增加不同NC情况的糖尿病患病率

    Table  4.   Prevalence rate of diabetes mellitus along with different NC based on WC stratification

    变量
    Variable
    WC分层WC stratification
    分层内总人数
    Number of people within stratification
    WC正常
    WC normal
    分层内总人数
    Number of people within stratification
    中心型肥胖前期
    Precentral obesity
    分层内总人数
    Number of people within stratification
    中心型肥胖
    Central obesity
    NC1 NC2 NC1 NC2 NC1 NC2
    男性  Male 437 35(13.7) 43(23.6) 348 27(23.1) 54(23.4) 1 042 51(30.5) 289(33.0)
        χ2值  value 7.100 0.004 0.395
        P值  value 0.008 0.950 0.529
    女性  Female 603 32(11.1) 42(13.3) 445 24(16.9) 66(21.8) 1 261 28(20.6) 345(30.7)
        χ2值  value 0.641 1.428 5.917
        P值  value 0.424 0.232 0.015
    城镇  Town 750 51(14.6) 74(18.5) 567 38(24.2) 99(24.2) 1 726 53(30.3) 517(33.3)
        χ2值  value 2.074 0.000 0.660
        P值  value 0.169 1.000 0.446
    农村  Rural 290 16(8.3) 11(11.2) 226 13(12.8) 21(16.9) 577 26(20.3) 117(26.1)
        χ2值  value 0.642 0.769 1.764
        P值  value 0.522 0.456 0.203
    18~ < 45岁years 252 7(5.6) 8(6.3) 144 3(6.7) 11(11.1) 264 5(12.8) 32(14.2)
        χ2值  value 0.055 0.696 0.054
        P值  value 1.000 0.549 1.000
    45~ < 60岁years 330 9(5.8) 26(14.9) 268 17(21.0) 27(14.4) 740 21(26.6) 192(29.1)
        χ2值  value 7.102 1.767 0.209
        P值  value 0.011 0.210 0.695
    ≥60岁  years 458 51(19.5) 51(26.0) 381 31(23.3) 82(33.1) 1 299 53(28.7) 410(36.8)
        χ2值  value 2.783 3.950 4.600
        P值  value 0.112 0.059 0.038
    合计  Total 1 040 67(12.4) 85(17.1) 793 51(19.7) 120(22.5) 2 303 79(26.1) 634(31.7)
        χ2值  value 4.607 0.797 3.898
        P值value 0.032 0.372 0.048
    注:WC,腰围;NC,颈围;NC1组,男性成人NC < 37 cm或女性成人NC < 33 cm;NC2组,男性成人NC≥37 cm或女性成人NC≥33 cm。
    ①以糖尿病患病人数(糖尿病患病率/%)表示。
    Note: WC, waist circumference. NC, neck circumference. NC1 group, male adult NC < 37 cm or female adult NC < 33 cm; NC2 group, male adult NC≥37 cm or female adult NC≥33 cm.
    ①Number of people with diabetes mellitus(prevalence rate of diabetes mellitus/%).
    下载: 导出CSV

    表  5  NC与WC对糖尿病患病风险的联合效应

    Table  5.   Combined effects of NC and WC on risk of diabetes

    分组  Group 糖尿病患病 Diabetes mellitus
    OR值value (95% CI) P值value
    WC正常+NC1  WC normal +NC1 1.000
    WC正常+NC2  WC normal +NC2 1.493(1.048~2.126) 0.026
    中心型肥胖前期+NC1  Pre-central obesity+NC1 1.702(1.135~2.554) 0.010
    中心型肥胖前期+NC2  Pre-central obesity+NC2 1.984(1.423~2.767) < 0.001
    中心型肥胖+NC1  Central obesity+NC1 2.293(1.586~3.315) < 0.001
    中心型肥胖+NC2  Central obesity+NC2 2.939(2.227~3.880) < 0.001
    注:WC,腰围;NC,颈围;NC1组,男性成人NC < 37 cm或女性成人NC < 33 cm;NC2组,男性成人NC≥37 cm或女性成人NC≥33 cm。
    1.控制因素为性别、年龄、城乡。
    Note: WC, waist circumference;NC, neck circumference; NC1 group, male adult NC < 37 cm or female adult NC < 33 cm; NC2 group, male adult NC≥37 cm or female adult NC≥33 cm.
    1.The controlling factors are gender, age and town and rural areas.
    下载: 导出CSV
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出版历程
  • 收稿日期:  2022-11-22
  • 修回日期:  2023-01-19
  • 网络出版日期:  2024-03-30
  • 刊出日期:  2024-02-10

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