中老年人群脂质蓄积指数与糖尿病发生风险关系研究-现代医学

中老年人群脂质蓄积指数与糖尿病发生风险关系研究

作者：丁有红¹ 吴洵² 覃玉² 苏健² 陈路路² 崔岚² 毕海涛³ 陶然² 周金意²

单位：1. 南京市溧水区人民医院(东南大学附属中大医院溧水分院) 内分泌科, 江苏南京 211200;
2. 江苏省疾病预防控制中心慢非传所, 江苏南京 210009;
3. 包头市疾病预防控制中心学校卫生科, 内蒙古包头 014000

分类号：R181.3

出版年·卷·期（页码）：2024·52·第四期（515-522）

摘要：

目的：探讨脂质蓄积指数(LAP)与中老年人群糖尿病发生风险的关系，并分析LAP等不同肥胖评价指标对糖尿病发生风险的预测价值。方法：研究数据来源于江苏省心脑血管疾病综合防控项目的基线数据。将2021年5月—2023年5月参与调查的109 735例糖尿病新发患者作为研究对象，进行问卷调查、体格检查和实验室检测。采用SPSS 23.0进行 χ²检验，建立Logistic回归模型探讨LAP对糖尿病发生风险的影响，同时，采用受试者工作特征(ROC)曲线下面积(AUC)评估LAP对糖尿病发生风险的预测作用。结果：Logistic回归分析显示，在总人群中，以LAP Q1组为参照，LAP Q2组、Q3组和Q4组糖尿病发生风险逐渐增高，OR分别为1.643(95%CI 1.494~1.806)、2.624(95%CI 2.401~2.866)、5.034(95%CI 4.633~5.471)，差异均有统计学意义(P＜0.01)。ROC曲线分析显示，在总人群中，LAP预测糖尿病罹患风险的AUC(0.680)高于体质指数、腰围、腰高比和腰臀比的AUC(P＜0.01)。男性和女性人群LAP预测糖尿病罹患风险的AUC分别为0.656和0.704，均高于体质指数、腰围、腰高比和腰臀比的AUC(P＜0.01)。结论:LAP是糖尿病发生的危险因素，对糖尿病发生有一定的预测作用，且其预测作用优于体质指数、腰围、腰高比和腰臀比等传统肥胖指标。此外，LAP对于女性糖尿病的判断价值高于男性。

Objective: To explore the relationship between lipid accumulation product(LAP) and the risk of diabetes in middle-aged and elderly people, and to analyze the predictive value of different obesity evaluation indicators such as LAP on the risk of diabetes. Methods: The research data comes from the baseline data of the comprehensive prevention and control project of cardiovascular and cerebrovascular diseases in Jiangsu Province. 109 735 patients with new-onset diabetes who participated in the survey from May 2021 to May 2023 were used as research subjects, and questionnaire surveys, physical examinations and laboratory tests were conducted. The χ² test was used to analyze the data, and a Logistic regression model was established to explore the impact of LAP on the risk of diabetes. Meanwhile, the receiver operating characteristic(ROC) curve was used to calculate the area under the curve(AUC) to evaluate the predictive effect of LAP on the risk of diabetes. The used software was SPSS 23.0. Results: Logistic regression analysis showed that in the total population, taking the LAP Q1 group as a reference, the risk of new-onset diabetes in the LAP Q2, Q3 and Q4 groups gradually increased, with OR of 1.643(95%CI 1.494~1.806) and 2.624(95%CI 2.401~2.866), 5.034(95%CI 4.633~5.471), the differences are statistically significant(P<0.01). ROC curve analysis showed that in the total population, the AUC of LAP in predicting the risk of diabetes(0.680) was higher than those of body mass index(BMI), waist circumference(WC), waist-to-hip ratio(WHR) and waist-to-height ratio(WHtR)(P<0.01). The AUCs of LAP in predicting the risk of diabetes in different groups of men and women were 0.656 and 0.704 respectively, which were higher than those of BMI, WC, WHR and WHtR(P<0.01). Conclusion: LAP is a risk factor for the occurrence of diabetes and has a certain predictive effect on the occurrence of diabetes, and its predictive effect is better than traditional obesity indicators such as BMI, WC, WHR and WHtR. In addition, LAP has a higher diagnostic value for diabetes in women than in men.

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