酒精摄入量与糖尿病患病关系的横断面研究

Relationship between alcohol intake and prevalence of diabetes mellitus：a cross-sectional study

摘要:

目的：探讨酒精摄入量与糖尿病患病的关系。方法：采用分层随机抽样方法，先随机抽取泸州市3个社区，每个社区内再随机抽取到个人，共抽取泸州市区40岁及以上常驻居民4 000人，对其进行调查问卷及体格检查，生化检查。结果：调查有效人数共3 970名，其中糖尿病患病率为19.47%。饮酒率为41.2%，其中男性饮酒率为60.9%，女性饮酒率为30.9%，男性明显高于女性。按饮酒量不同分组：男女新诊糖尿病患病率少量饮酒组（男5.09%，女4.26%）均低于不饮酒组（男9.17%，女7.11%），男性大量饮酒组（男21.76%，女15.19%）均高于其他3组；男女既诊糖尿病患病率均随饮酒量的增加而下降，大量饮酒组最低。总体而言，少量饮酒组新诊患病率最低，并明显低于不饮酒组，大量饮酒组明显高于其他3组。既诊患病率饮酒组均低于不饮酒组。各组生化指标比较：少量和中量饮酒组餐后2 h血糖（2-hour postprandial glucose，2hPG）、糖化血红蛋白（hemoglobin A1C，HbA1C）均明显低于不饮酒组，大量饮酒组空腹血糖、2hPG及HbA1C水平明显高于其他3组。大量饮酒组胆固醇明显高于少量和中量饮酒组，高密度脂蛋白明显低于其他3组，低密度脂蛋白明显高于其他3组。logistic回归分析调整混杂因素后，少量饮酒是糖尿病的保护因素（OR=0.641，95%CI=0.508～0.807）。结论：少量饮酒是糖尿病的保护因素，大量饮酒则升高血糖、血脂水平。

Abstract:

Objective：To investigate the relationship between alcohol intake and prevalence of diabetes mellitus（DM）. Methods：Stratified sampling was used to select 4 000 permanent residents aged 40 years and above. All participants completed standardized questionnaire，physical examination and biochemical tests. Results：The total effective number was 3 970 and the prevalence of DM was 19.47%. The percentage of drinking was 41.2%，of which the male was 60.9%，the female was 30.9%；the percentage of male was significantly higher than that of female（P<0.05）. The prevalence of newly diagnosed DM in small-amount drinking group（male 5.09%，female 4.26%） was lower than that of non-drinking group（male 9.17%，female 7.11%）. The prevalence in large-amount drinking group（male 21.76%，female1 15.19%） was significantly higher than that of other three groups. The prevalence of previously diagnosed DM was decreased with the increase of drinking amount；the prevalence of large-amount drinking group was the lowest. In general，the prevalence of newly diagnosed DM in small-amount drinking group was lower than that of non-drinking group. The prevalence of large-amount drinking group was significantly higher than that of the other three groups. The prevalence of previously diagnosed DM in drinking groups was lower than that of non-drinking group. The levels of 2-hour postprandial glucose（2hPG） and hemoglobin A1C（HbA1C） in groups of small-amount and moderate-amount drinking groups were significantly lower than those of non-drinking group. In large-amount drinking group，the levels of fasting plasma glucose，2hPG and HbA1C were significantly higher than those of the other three groups；the level of cholesterol was significantly higher than that of small and moderate drinking group. The high-density lipoprotein was significantly lower than that of the other three groups，the low-density lipoprotein was significantly higher than that the other three groups（P<0.05）. The multivariate logistic regression analysis revealed that the group of small-amount drinking had a lower odds ratio for diabetes compared with that of non-drinking group（OR=0.641，95%CI=0.508 to 0.807），and it was a protective factor for diabetes even after the adjustment of gender，age，BMI，smoking，calorie intake，family history of diabetes. Conclusion：Small-amount drinking is a protective factor for DM. Large-amount drinking can increase the levels of blood glucose and blood lipid.