摘要目的 探讨糖尿病家族史与腰高比(WHtR)异常对2型糖尿病(T2DM)患病的交互作用.方法 本研究以金昌队列47 998例基线调查对象为研究平台,金昌队列于2012年6月建立,并于2013年12月完成基线数据的收集.将金昌队列基线人群中1 943例T2DM患者作为病例组,其中男1109例,女834例,另在基线人群中按1:1性别匹配选取1 943例未患糖尿病及相关疾病的个体作为对照组,进行病例对照研究.交互作用采用相加模型,多因素Logistic回归分析求出待分析危险因素调整后的OR值及回归系数β,然后采用Andersson等编制的EXCEL软件分析因素间的交互作用.结果 排除腰围信息缺失个体后,共21 292例调查对象纳入本次研究,糖尿病患病率为9.13％(1 943/21 292),其中男性患病率为9.11％(1 109/12 175),女性患病率为9.15％(834/9 117).调整年龄、吸烟、饮酒等混杂因素后,糖尿病家族史与WHtR异常对T2DM患病存在正向相加交互作用.当糖尿病家族史与WHtR异常同时存在时,男性和女性糖尿病患病风险分别为两者均正常的9.09倍(95％CI:5.64～14.64)和13.08倍(95％CI:6.99～ 24.47).在男性中,协同效应指数为1.58,归因交互效应为2.98,归因交互效应百分比为32.8％;在女性中,协同效应指数为1.90,归因交互效应为5.72,归因交互效应百分比为43.7％.结论 糖尿病家族史与WHtR异常对T2DM患病风险有协同作用.

abstractsObjective To explore the interaction between family history of diabetes and abnormal waist-to-height ratio (WHtR) on risk of type 2 diabetes mellitus (T2DM).Methods The Jinchang cohort (established in June,2012) was used in this study,and the baseline data were collected in December 2013.For case-control study,1 109 male patients and 834 female patients with T2DM were included in diabetic group,whereas 1 943 healthy subjects matched with gender were included in control group.The additive model was used to study the interaction;the adjusted OR values of risk factors and regression coefficient were analyzed by multivariate logistic regression analysis;and the interaction between the factors were analyzed by the EXCEL software developed by Andersson et al.Results After excluding 26 706 cases without data of waist circumeference,a total of 21 292 cases were included in our study.The prevalence of diabetes was 9.13％ (1 943/21 292) in all subjects,but 9.11％ (1 109/12 175) in male subjects and 9.15％ (834/9 117) in female subjects.After adjusting for age,smoking,drinking and other confounding factors,there was positive additive interaction between family history of diabetes and abnormal WHtR on risk of T2DM.While the family history of diabetes and abnormal WHtR existing at the same time,the risk of diabetes was 9.09 (95％CI:5.64-14.64) in male and 13.08 (95％CI:6.99-24.47) in female compared with control.In male,the index of synergistic effect,the attribution of interaction effect,and the percentage of attribution of interaction effect was 1.58,2.98 and 32.8％,respectively.In female,the index of synergistic effect,the attribution of interaction effect,and the percentage of attribution of interaction effect was 1.90,5.72 and 43.7％,respectively.Conclusion Family history of diabetes and abnormal WHtR may havesynergistic effect on risk of T2DM.