基于限制性立方样条模型分析中老年人群空腹血糖受损与体质指数的关系

Analysis of the relationship between impaired fasting blood-glucose and body mass index in middle-aged and elderly people based on restricted cubic spline model

摘要:

目的： 调查重庆地区中老年人群空腹血糖（fasting blood-glucose，FBG）水平，分析空腹血糖受损（impaired fasting glucose，IFG）相关的危险因素，为糖尿病的防控提供依据。方法： 回顾性分析2019年1至12月在重庆医科大学附属第一医院进行体检的中老年人群，收集空腹血糖FBG及相关生理生化指标，应用logistic回归模型结合限制性立方样条模型（restricted cubic splines，RCS）分析IFG与体质指数（body mass index，BMI）的剂量-反应关系。结果： 44 525名体检者共检出3 913例IFG，检出率为8.79%，其中男性检出率为10.71%；女性检出率为6.84%（P<0.001）。将研究对象分为正常血糖（normal glucose tolerance，NGT）组和IFG组，2组在性别、年龄、BMI、腰围（waist circumference，WC）、收缩压（systolic blood pressure，SBP）、舒张压（diastolic blood pressure，DBP）、高密度脂蛋白（high density lipoprotein-cholesterol，HDL-C）、低密度脂蛋白（low density lipoprotein-cholesterol，LDL-C）、总胆固醇（total cholesterol，TC）、甘油三酯（triacylglycerol，TG）、尿酸（uric acid，UA）水平差异均有统计学差异（P<0.001）。调整混杂因素之后，超重组（OR=1.178，95%CI=1.074~1.293）、肥胖组（OR=1.350，95%CI=1.157~1.574）与IFG关系具有统计学意义。RCS结果显示，男性、40~岁、50~岁、BMI连续变化与IFG关联呈非线性剂量-反应关系。结论： 超重和肥胖是IFG剂量依赖性的危险因素，随着BMI升高，发生IFG的危险性随之升高。

Abstract:

Objective: To investigate the fasting blood-glucose (FBG) levels of middle-aged and elderly people in Chongqing, and analyze the risk factors related to impaired fasting glucose (IFG), so as to provide a basis for the prevention and control of diabetes. Methods: The middle-aged and elderly people undergoing health examination in a tertiary Grade-A hospital in Chongqing from January to December in 2019 were retrospectively analyzed. FBG and related physiological and biochemical data were collected. The dose-response relationship between IFG and body mass index (BMI) was analyzed using Logistic regression model combined with restricted cubic splines (RCS). Results: A total of 3 913 IFG cases were detected in 44 525 subjects, with a detection rate of 8.79%, of which the detection rate was 10.71%in males and 6.84%in females (P<0.001). The study subjects were divided into normal glucose tolerance (NGT) group and IFG group. The two groups had statistical differences in gender, age, BMI, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), triacylglycerol (TG), and uric acid (UA) (P<0.001). After adjusting for confounding factors, the relationship between overweight group (OR=1.178, 95%CI=1.074-1.293) and obesity group (OR=1.350, 95%CI=1.157-1.574) and IFG was statistically significant. RCS analysis showed that there was a nonlinear dose-response relationship between the continuous changes of BMI and IFG in males, 40-years old and 50-years old. Conclusion: Overweight and obesity are dose-dependent risk factors for IFG. As BMI increases, the risk of IFG increases.