2型糖尿病危险因素的交互作用研究

目的探讨2型糖尿病危险因素及其交互作用，为开展糖尿病的预防、治疗工作提供科学依据。方法采用病例一对照研究方法．病例为在深圳市第一人民医院、深圳市第二人民医院及深圳市保健委员会办公室就诊及住院的2型糖尿病患者，共295例；对照为同期在门诊进行健康体检的非糖尿病人群，共214例。对研究因素进行单因素及多因素非条件Logistic回归分析．在此基础上进行对数线性模型分析。结果调查人群中，糖尿病家族史（OR=6．507，95％CI：3．788～11．178）、高血脂（TG：OR=2．625，95％CI：1．295—5．323；LDL—C：OR=6．337，95％CI：3．379-11．884）、工作压力（OR=1．901，95％CI：1．263—2．863）、高血压（SBP：OR=I．055，95％CI：1．022～1．089）是2型糖尿病的危险因素：文化程度（OR=0．724，95％CI：0．599—0．875）、运动锻炼（OR=0．499，95％CI：0．268～0．930）是保护因素。对数线性模型分析发现，糖尿病各危险因素之间广泛存在一阶或二阶交互作用，其中．糖尿病家族史、年龄和运动锻炼三者分别与多个危险因素有明显的交互作用。结论2型糖尿病是遗传因素与环境因素共同作用的结果。对糖尿病的防治应采取综合措施，尤其对于具有糖尿病家族史者以及中老年人群，更应控制各种危险因素。

The Interaction between Risk Factors of Type 2 Diabetes Mellitus

Objective To explore the risk factors of type 2 diabetes mellitus （T2DM） and their interactions. Methods A hospital-based case-control study was conducted among 295 patients of type 2 diabetes mellitus and 214 controls. The cases were acquired from Shenzhen People＇s Hospital, Shenzhen Secondary People＇s Hospital and Shenzhen office of health care committee from May to October in 2004 and the controls were acquired from health examination population in clinics of these hospitals. The relationship between risk factors of T2DM were analyzed by unconditional univariate and multivariate logistic regression, meanwhile, the interaction between risk factors of T2DM were analyzed by log linear model. Results Family history of diabetes mellitus （OR=6.507, 95% CI：3.788-11.178）, hyperlipidemia （TG： OR=2.625, 95% CI： 1.295-5.323; LDL-C ： OR=6.337, 95% CI：3.379- 11.884）, working pressure （OR=1.901, 95% CI：1.263-2.863） and hypertension （ SBP OR=1.055, 95% CI： 1.022-1.089） were the major risk factors, but education level （OR=0.724, 95% CI：0.599-0.875） and physical exercise （OR=0.499, 95% CI：0.268-0.930） were the protective factors of T2DM. There were extensive first or second order interaction in the risk factors of T2DM, especially between family history of diabetes mellitus, age, physical exercise and other risk factors respectively. Conclusion T2DM may be caused by the effect of both genetic and environmental factors, and the prevention of diabetes mellitus should adopt comprehensive measures, especially to the people with family history of diabetes mellitus and the elderly population.