摘要： 目的: 分析上海社區(qū)40歲及以上居民的代謝健康型肥胖與隨訪4年中的糖尿病發(fā)病風(fēng)險(xiǎn)間的相關(guān)性,并進(jìn)一步探究胰島素抵抗在兩者關(guān)系中的作用。方法: 采用整群抽樣的方法,選取上海寶山區(qū)淞南社區(qū)常住居民中非糖尿病者1 967名,根據(jù)體質(zhì)量指數(shù)和代謝水平分為代謝健康型非肥胖（metabolically healthy non-obese,MHNO）組、代謝不健康型非肥胖（metabolically unhealthy non-obese,MUNO）組、代謝健康型肥胖（metabolically healthy obese,MHO）組及代謝不健康型肥胖（metabolically unhealthy obese,MUO）組。對(duì)其進(jìn)行4年隨訪,針對(duì)相關(guān)病史進(jìn)行問卷調(diào)查,并完成人體指標(biāo)測量及相關(guān)實(shí)驗(yàn)室檢查,觀察各組間臨床指標(biāo)及隨訪時(shí)糖尿病發(fā)生率的差異。結(jié)果: 研究人群中,MHNO、MUNO、MHO和MUO組隨訪4年中的糖尿病發(fā)生率分別為3.4%、16.4%、7.7%和17.5%。多元Logistic回歸分析顯示,在校正年齡、性別、體質(zhì)量指數(shù)、當(dāng)前吸煙、當(dāng)前飲酒、積極運(yùn)動(dòng)及糖尿病家族史后,與MHNO組相比,MHO組隨訪4年中的糖尿病發(fā)病風(fēng)險(xiǎn)增加了1.25倍（OR=2.25, 95%CI為1.31~3.85）。將4組人群再按胰島素抵抗情況（胰島素抵抗指數(shù)≥2.5）分組,與MHNO不合并胰島素抵抗組相比,MHO不合并胰島素抵抗組隨訪4年中的糖尿病發(fā)生風(fēng)險(xiǎn)沒有顯著增加,而MHO合并胰島素抵抗組隨訪4年中的糖尿病發(fā)生風(fēng)險(xiǎn)增加了4.20倍（OR=5.20, 95%CI為2.56~10.56）。結(jié)論: MHO組較MHNO組隨訪4年中的糖尿病發(fā)生風(fēng)險(xiǎn)高,且胰島素抵抗可能在上述相關(guān)性中起了一定作用。

關(guān)鍵詞: 肥胖, 代謝健康, 糖尿病, 胰島素抵抗

Abstract: Objective: To investigate the association between metabolically healthy obesity (MHO) and risk of diabetes in population in Shanghai and to assess the role of insulin resistance in their relationship. Methods: A prospective study was performed among 1 967 participants aged 40 years or older in Baoshan community, Shanghai. The participants were categorized into four groups according to obesity and metabolic status: metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese(MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Questionnaire interview, anthropometric measurements, and biochemical measurements were obtained in the participants. Metabolic profiles and rate of incident diabetes were compared between the groups. Results: After a median follow-up period of 4 years, the rate of incident diabetes in group MHNO, group MUNO, group MHO, and group MUO were 3.4%, 16.4%, 7.7%, and 17.5%, respectively. Multivariate logistic analysis revealed that patients in group MHO had an increased risk of incident diabetes [odds ratio (OR)=2.25, 95% confidence interval (CI) 1.31-3.85] when compared with subjects in MHNO. Compared with patients in group MHNO, patients resistant to insulin [homeostasis model assessment of insulin resistance(HOMA-IR≥2.5)] in group MHO had an increased OR for incident diabetes (OR=5.20, 95% CI 2.56-10.56). Conclusions: The 4-year follow-up revealed that patients of MHO have a high incidence of diabetes in which insulin resistance might play a role.

Key words: Obesity, Metabolic healthy, Diabetes, Insulin resistance

中圖分類號(hào): 

R587.1

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網(wǎng)址: 上海社區(qū)人群代謝健康型肥胖、胰島素抵抗與糖尿病發(fā)病風(fēng)險(xiǎn)的相關(guān)性研究 http://www.u1s5d6.cn/newsview431344.html