摘要目的 研究社区成年人2型糖尿病(T2DM)的患病情况和分布,探讨既往最大体重指数(MAxBMI)与T2DM的关系.方法 2005年6-8月对牡丹江市4个区和1个县级市分层整群抽样20岁以上社区常住居民,研究T2DM患病状况及其与不同水平MAXBMI和当前BMI的关系.结果纳入研究的社区居民为1071名,T2DM患病率7.09%;以MAXBMI为肥胖的T2DM患病率为12.10%.随MAXBMI水平升高,患T2DM的危险增大(趋势X~2=17.387 23,P<0.0001).多因素分析显示,MAXBMI高者患T2DM的OR值为3.06(P=0.0013).分组后的分层分析显示,T2DM患者中血糖水平在MAXBMI≥27.4 kg/m~2组,比MAXBMI低水平组显著升高(P=0.0408);血糖正常组,MAXBMI处于高值(≥25.4 kg/m~2)的人群比低值人群当前BMI相对MAXBMI下降的更大,血糖水平更高.结论 在T2DM患者和血糖正常组人群中,MAXBMI值与T2DM具有相关性;可作为肥胖指标预测糖尿病患病的风险.

abstractsObjective To determine the prevalence and distribution of type 2 diabetes mellitus (T2DM) and the relationship between maximum body mass index (MAXBMI) and T2DM. Methods From June to August, 2005, a stratified cluster sampling of 1071 permanent residents in communities, over 20 years old, from 4 districts and 1 county of Mudanjiang was chosen. The prevalence of T2DM, and the association between T2DM and different levels of the MAXBMI, current BMI were studied. Results The prevalence in the communities was 7.09% and in those with past maximum BMI≥28 kg/m~2, it was 12.10%. With the increase of past MAXBMI levels, the risk of T2DM patients also increased significantly(trend X~2=17.387 23, P<0.0001). Data from multifactor analysis showed that MAXBMI in the past was positively related to T2DM (OR=3.06, P=0.0013). In T2DM patients, the group with MAXBMI≥27.4 kg/m~2 had higher 2-hour postprandial blood glucose than those with lower MAXBMI (P=0.0408). When compared with low maximum BMI group in normal blood glucose population, the group with higher MAXBMI (≥ 25.4 kg/m~2) had higher blood glucose and greater change of BMI. Conclusion In both groups that patients with T2DM and with normal glucose, in order to control blood glucose better, researchers should not only concern about the influence of the MAXBMI in the past, but also pay attention to constantly keep BMI at the normal range.