目的：探讨围绝经期女性人体测量参数对2型糖尿病( T2DM)患病风险的预测价值。方法以2011年1月至2014年12月在广州市妇女儿童医疗中心体检中心参与体检并符合纳入标准的637例围绝经期女性为研究对象,进行T2DM患病筛查,测量身高、体重、腰围( WC )、臀围,计算体质指数( BMI )、腰臀比( WHR )和腰围身高比( WHtR )；采用Logistic回归和ROC曲线评估各指标对T2DM患病风险的预测价值。结果有20.3%的调查对象患T2DM；随着BMI(χ2=9.64,P=0.008)、WC(χ2=8.99,P=0.010)、WHR(χ2=18.78,P<0.001)和WHtR(χ2=10.97,P<0.001)反映肥胖程度的增加,T2DM患病率上升,差异均有统计学意义。在控制年龄差异之后的多因素Logistic回归分析结果显示,仅BMI≥28kg/m2( OR=2.61,95%CI：1.22~5.56)和WHR≥0.85(OR=2.35,95%CI：1.43~3.88)与T2DM的发生相关。 ROC测定结果显示,4项指标单独用于预测血糖异常状况的效果均不理想,WHR和WHtR相对较好,ROC曲线下面积(AUC)分别为0.67和0.64,BMI最差,为0.60。结论腹型肥胖指标WHR和WHtR对围绝经期女性T2DM的预测价值优于BMI和WC,其为该时期女性T2DM高危人群的筛查提供了合适的参数。%Objective To explore the predictive values of body anthropometric indices on risk of type 2 diabetes mellitus (T2DM) among peri-menopausal women. Methods The study included 637 peri-menopausal women attending general health screening program during the period of January 2011 to December 2014 in Guangzhou Women and Children Medical Center and meeting the criteria of recruitment. All participants’ body height, weight, waist circumference (WC) and hip circumference were measured to calculate body mass index (BMI), waist hip ratio ( WHR) and waist to height ratio ( WHtR) . Logistic regression analysis and receiver operating characteristics ( ROC) curve were used to predicate the risk of T2DM by each index. Results The prevalence rate of T2DM was 20. 3%. The T2DM morbidity increased with the increasing of BMI (χ2 =9. 64, P=0. 008), WC (χ2 =8. 99,P=0. 010), WHR (χ2 =18. 78,P<0. 001) and WHtR (χ2 =10. 97,P<0. 001), and the difference was statistically significant. After adjusted by age, multivariate logistic regression analysis showed that only BMI≥28kg/m2(OR=2. 61,95%CI:1. 22-5. 56) and WHR≥0. 85 (OR=2. 35,95%CI:1. 43-3. 88) were related with the incidence of T2DM. ROC curve indicated that WHR and WHtR had larger areas under ROC curve, which was 0. 67 and 0. 64, respectively, and AUC of BMI was only 0. 60. Conclusion The predicative value of WHR and WHtR is better than that of BMI and WC. They provide appropriate measurement parameters for screening high risk of T2DM among peri-menopausal women.
展开▼
