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1.
目的 分析不同肥胖状态与2型糖尿病(T2DM)患者全因死亡风险的关联。方法 研究对象来自浙江农村社区T2DM队列,该队列2016年完成基线调查,本研究使用的随访数据截至 2021年12月31日,剔除随访期间失访或资料不全者,共纳入10 310例研究对象。根据BMI和腰围将研究对象分为低体重、正常体型、单纯中心性肥胖、单纯全身肥胖、复合超重和复合肥胖6种状态,采用Cox比例风险回归模型分析不同肥胖状态T2DM患者的全因死亡风险比(HR)值及其95%CI结果 研究对象累计随访57 049.47人年,随访(5.53±0.89)人年,随访期间共死亡971例,死亡密度为1 702.03/10万人年。以正常体型患者为对照,调整混杂因素后低体重患者全因死亡风险增加104%(HR=2.04,95%CI:1.42~2.92),单纯全身肥胖、复合超重、复合肥胖患者的全因死亡风险分别下降34%(HR=0.66,95%CI:0.53~0.82)、22%(HR=0.78,95%CI:0.66~0.92)、38%(HR=0.62,95%CI:0.49~0.78),单纯中心性肥胖患者全因死亡风险差异无统计学意义。亚组分析显示,不同性别和不同年龄组低体重T2DM患者全因死亡风险增加,女性复合肥胖患者全因死亡风险较正常体型患者下降50%,而男性该肥胖状态患者全因死亡风险差异无统计学意义;≥65岁老年患者中,单纯全身肥胖、复合超重、复合肥胖患者的全因死亡风险均明显低于正常体型组(HR=0.61,95%CI:0.48~0.78;HR=0.76,95%CI:0.63~0.91;HR=0.56,95%CI:0.42~0.73),而<65岁的各种肥胖状态患者全因死亡风险差异无统计学意义。敏感性分析结果未见明显变化。结论 T2DM患者全因死亡风险存在“肥胖悖论”现象,低体重患者的全因死亡风险明显高于正常体型者,全身型或复合型超重/肥胖患者的死亡风险明显降低。  相似文献   

2.
目的 探索出生体重对成年期罹患高血压、糖尿病等慢性病的患病风险,并研究出生体重与血尿酸的关系。方法 根据中国成年人慢性病与营养监测方案,在天津市河西、南开、红桥、武清、津南、宝坻、蓟州区共计调查1 131名成年人,收集其出生体重、血压等数据,并采集空腹静脉血检测血尿酸、血糖和血脂等。描述调查人群出生体重状况分布,并分析出生体重对其成年期罹患高血压、糖尿病等慢性病风险及与血尿酸的关系。结果 天津市调查人群平均出生体重为3.37 kg,男性高于女性;无论是超重/肥胖、高血压还是糖尿病,正常出生体重者成年期患病率最低,经单因素logistic回归分析,校正年龄、性别、吸烟、饮酒后发现,与正常出生体重者相比,低出生体重与成年期罹患糖尿病(OR=2.91,95%CI:1.46~5.76)、血脂异常(OR=1.79,95%CI:1.01~3.19)关联较强,巨大儿与成年期罹患超重/肥胖关联较强(OR=1.47,95%CI:1.08~2.01);不同出生体重的血尿酸差异无统计学意义。结论 天津市调查人群低出生体重与其成年期糖尿病、血脂异常患病风险关联较大,巨大儿与其成年期超重/肥胖患病风险关联较大。  相似文献   

3.
目的 了解我国成年人自报经常牙龈出血与2型糖尿病(T2DM)患病相关性。方法 利用2010年中国慢性病及其危险因素监测数据,描述性分析成年人中经常牙龈出血者的人口学及主要慢性疾病(糖尿病、高血压、血脂异常)患病情况,多因素分析经常牙龈出血与主要慢性疾病患病的相关性,进而分析年龄、高血压、血脂异常等因素与牙龈出血频率交互作用对T2DM患病的影响。结果 93 647名调查对象以汉族为主占87.4%(81 872/93 647),女性调查对象经常牙龈出血的比例高于男性,分别为63.6%(2 020/3 178)和36.4%(1 158/3 178);经常牙龈出血人群中初中文化程度者所占比例最高为30.1%。在45~60岁人群中有12.8%(2 839/22 179)无牙龈出血但患T2DM,15.6%(163/1 044)经常牙龈出血且患T2DM,经常牙龈出血与患T2DM相关(OR=1.29,95% CI:1.08~1.54,P<0.005),年龄和经常牙龈出血对T2DM患病有交互作用(P<0.005);30 316名男性无牙龈出血者中有3 638例患T2DM,与之相比,经常牙龈出血者患T2DM(152/1 143)的风险高1.30倍(95% CI:1.08~1.56,P=0.005);在高血压人群中,与无牙龈出血者T2DM患病率(4 817/26 467)相比,经常牙龈出血者患T2DM的患病率高(21.1%,220/1 043),OR=1.25(95% CI:1.07~1.46,P=0.006),且高血压和牙龈出血频率与T2DM患病有交互作用(P<0.05)。结论 经常牙龈出血与T2DM患病有相关性,且与年龄、患高血压有交互作用;男性并且经常牙龈出血同样与T2DM患病相关。  相似文献   

4.
目的 分析1991-2015年中国9省份18~64岁成年男性居民吸烟状况与肥胖患病风险的关系。方法 利用"中国健康与营养调查"1991-2015年9轮调查资料,选取参加两轮及以上、有完整人口统计学特征、吸烟状况和体格测量数据的18~64岁成年男性居民作为研究对象,共计32 169名。依据研究对象是否吸烟以及吸烟者每日吸烟数量将研究对象分为不吸烟、轻度吸烟(1~14支/d)、中度吸烟(15~24支/d)和重度吸烟(≥ 25支/d)组。观察不同吸烟程度下研究对象的BMI、腰围、全身性肥胖和中心性肥胖的分布情况,利用两水平混合效应线性回归模型和logistic回归模型分析男性吸烟状况与肥胖患病风险的关系。结果 不同吸烟程度下调查对象的BMI、腰围、全身性肥胖和中心性肥胖的患病率呈现逐年上升的趋势。在校正混杂因素后,轻、中和重度吸烟者BMI分别比不吸烟人群减少了0.19 kg/m2(95%CI:-0.27~-0.10)、0.40 kg/m2(95%CI:-0.49~-0.31)和0.36 kg/m2(95%CI:-0.53~-0.19);腰围分别减少了0.49 cm (95%CI:-0.76~-0.21)、0.80 cm (95%CI:-1.08~-0.51)和0.79 cm (95%CI:-1.38~-0.36)。男性轻、中和重度吸烟者患全身性肥胖的风险分别是不吸烟者的0.70倍(OR=0.70,95%CI:0.62~0.79)、0.61倍(OR=0.61,95%CI:0.55~0.69)和0.78倍(OR=0.78,95%CI:0.65~0.96);患中心性肥胖的风险分别是不吸烟者的0.78倍(OR=0.78,95%CI:0.73~0.84)、0.74倍(OR=0.74,95%CI:0.70~0.79)和0.84倍(OR=0.84,95%CI:0.76~0.95)。结论 1991-2015年间,男性不吸烟与吸烟(轻、中和重度)居民的BMI、腰围和肥胖患病率均呈现显著上升趋势。成年男性居民吸烟与肥胖患病风险呈显著性负向关联。  相似文献   

5.
目的 探讨心血管病高危人群中腰围和体重变化与血压水平变化的关系,为高血压及心血管病防治提供理论依据和参考。方法 选取2016年纳入随访调查的12 931名心血管病高危人群作为研究对象,将其2017-2019年长期随访数据纳入分析。统计学分析采用t检验、χ2检验和广义估计方程。结果 在心血管病高危人群中,腰围、体重和BMI增加,血压水平升高的风险高;腰围、体重和BMI减少,血压水平升高的风险低。腰围每增加1 cm,SBP增加0.200(95%CI:0.164~0.236) mmHg,DBP增加0.085(95%CI:0.066~0.105) mmHg;体重每增加1 kg,SBP增加0.355(95%CI:0.289~0.421) mmHg,DBP增加0.182(95%CI:0.144~0.220)mmHg;BMI每增加1 kg/m2,SBP增加1.100(95%CI:1.194~1.258) mmHg,DBP增加0.365(95%CI:0.273~0.456) mmHg。心血管病高危人群中农村居民相对于城市居民,SBP随腰围和体重变化更大,DBP随腰围变化更大(交互作用P<0.05);随访高血压不患病相对于随访高血压患病人群,SBP随腰围和BMI变化更大,DBP随BMI变化更大(交互作用P<0.05)。结论 在心血管病高危人群中,腰围、体重和BMI的变化与血压水平的变化均存在正向线性相关。  相似文献   

6.
孕中期血糖水平与新生儿出生体重的队列研究   总被引:1,自引:1,他引:0       下载免费PDF全文
目的 探讨孕中期孕妇75 g口服糖耐量试验(OGTT)的3项血糖值与出生体重的关系。方法 参与前瞻性队列研究的3 081名孕妇于孕≤14周时收集基础人口统计学信息,在孕24~28周行75 g OGTT,利用多项logistic回归法分析新生儿出生体重的影响因素及孕中期FPG和OGTT-1 h、OGTT-2 h值四分位分组的大于胎龄儿(LGA)发生风险,以多元线性回归法分析血糖值与新生儿出生体重的关系。结果 孕前超重(24.0 kg/m2≤BMI <28.0 kg/m2)(OR=1.4,95%CI:1.0~2.0,P=0.029)、妊娠期糖尿病(OR=2.4,95%CI:1.8~3.2,P <0.001)是LGA发生的危险因素;孕前消瘦(BMI <18.5 kg/m2)(OR=1.6,95%CI:1.2~2.2,P=0.003)、子痫前期(OR=4.0,95%CI:1.9~8.4,P <0.001)可增加小于胎龄儿出生的风险。多元线性回归分析调整孕前BMI、产次、高血压情况、新生儿性别后,FPG、OGTT-1 h和OGTT-2 h均与新生儿出生体重呈正相关关系(β 值分别为91.99、33.60、32.00,P值均 <0.001)。随着孕妇3项血糖水平四分位升高各组出生体重呈增大趋势,且LGA发生风险逐渐增大。结论 孕中期血糖水平与子代出生体重呈正相关。随着血糖水平升高,新生儿出生体重增大,LGA发生风险升高,但小于胎龄儿与血糖无关联。FPG值对发生LGA有很好的预测作用。  相似文献   

7.
目的 分析不同肥胖类型、不同BMI和腰围水平与成年人糖尿病患病风险的关联。方法 利用2018年中国健康与营养调查数据,依据《成人体重判定》(WS/T 428-2013)重新划分肥胖定义,包括非肥胖、单纯一般性肥胖、单纯中心性肥胖和复合型肥胖。应用两水平logistic回归模型及限制性立方样条模型分析不同肥胖类型、不同BMI和腰围水平与糖尿病患病风险的关联。结果 共纳入7 030名18~65岁居民,其中一般性肥胖率、中心性肥胖率分别为男性16.29%(502/3 082)和42.28%(1 303/3 082);女性14.41%(569/3 948)和37.87%(1 495/3 948);其中复合型肥胖率男、女性分别为14.70%和12.97%。糖尿病患病率为11.28%,其中男、女性复合型肥胖人群糖尿病患病率分别为18.98%和22.07%,高于单纯中心性肥胖人群(16.24%,15.26%)和非肥胖人群(9.65%,5.18%)。男性单纯中心性肥胖、复合型肥胖患糖尿病的可能性分别是非肥胖人群的1.61(95%CI:1.24~2.08)和2.11(95%CI:1.56~2.86)倍;女性单纯一般性肥胖、单纯中心性肥胖和复合型肥胖患糖尿病的可能性分别是非肥胖人群的2.70(95%CI:1.16~6.28)、2.62(95%CI:2.01~3.40)和4.47(95%CI:3.35~5.98)倍。限制性立方样条模型显示:BMI水平与糖尿病患病风险间呈近乎线性正关联;腰围水平与糖尿病患病风险呈显著正关联,其中女性呈非线性升高(非线性P=0.024)。男性BMI≥22.5 kg/m2、女性BMI≥23.0 kg/m2;男性腰围≥85.0 cm、女性腰围≥80.0 cm时,糖尿病患病风险显著上升。结论 复合型肥胖人群患糖尿病的风险更高。BMI处于正常高值、腰围水平处于中心性肥胖前期时,糖尿病患病风险明显上升。  相似文献   

8.
目的 探讨2型糖尿病(T2DM)患者饮食摄入种类和体力活动及其联合作用与全因死亡和特定原因死亡风险的关联。方法 2013年12月至2021年12月,对江苏省常熟市、淮安市清江浦区(原清河区)和淮安区纳入国家基本公共卫生服务管理的T2DM患者19 863人开展前瞻性队列研究。死亡信息和根本死因源于江苏省CDC死亡监测系统。利用Cox比例风险回归模型估计T2DM患者饮食摄入种类、体力活动以及联合作用与全因死亡及特定原因死亡风险的关联强度。结果 截至2021年12月31日,研究对象累计随访150 283人年,中位随访时间8.15年,随访期间共死亡3 293人,其中1 124人死于心血管疾病(CVD),875人死于肿瘤。Cox比例风险回归模型分析结果显示,与摄入0~1种食物的T2DM患者相比,摄入5~9种食物的患者全因死亡风险降低19%[风险比(HR)=0.81,95%CI:0.70~0.94],CVD死亡风险降低33%(HR=0.67,95%CI:0.52~0.87)。与体力活动Q1组的T2DM患者相比,Q4组全因、CVD和肿瘤死亡风险分别降低50%(HR=0.50,95%CI:0.45~0.56)、50%(HR=0.50,95%CI:0.41~0.61)和27%(HR=0.73,95%CI:0.60~0.88)。联合作用显示,与摄入0~2种食物和低体力活动的T2DM患者相比,摄入4~9种食物和高体力活动的T2DM患者全因、CVD和肿瘤死亡风险分别降低55%(HR=0.45,95%CI:0.38~0.53)、56%(HR=0.44,95%CI:0.32~0.59)和40%(HR=0.60,95%CI:0.44~0.82)。结论 饮食摄入种类和体力活动及其联合作用与T2DM患者死亡风险降低相关。  相似文献   

9.
目的 探讨静态生活方式和静坐时间对MS及T2DM的影响。方法 采用多阶段分层整群抽样的方法,2010-2011年对福建省6 016名≥18岁常住居民进行人口学信息及身体活动状况等问卷调查,同时测量身高、体重、WC和血压并检测血糖、血脂,依据2005年国际糖尿病联盟(IDF)MS诊断标准和1999年WHO糖尿病诊断标准进行MS及T2DM病例诊断,并应用logistic回归分析静态生活方式与MS及T2DM的相关性。结果 福建省≥18岁人群MS及 T2DM患病率分别为19.0%及8.0%,完全静坐行为的比例为18.1%,每日平均静坐时间为4.3 h,对照组(C)、单纯MS组(M)、单纯糖尿病组(T)、糖尿病合并MS组(MT)静坐行为比例不同,差异有统计学意义(P<0.001)。经年龄、性别、吸烟、饮酒、BMI、文化程度、职业和完全静坐/静坐时间校正后,与静坐时间<2.0 h/d组相比,2.0~3.5 h/d组与MT组患病显著相关(OR=1.44,95%CI:1.03~2.03,P<0.05),3.5~6.0 h/d组及≥6.0 h/d组与M、T及MT组患病均显著相关(OR值分别为 1.49~1.76及1.28~1.58,95%CI分别为1.19~2.45及1.02~2.23,P<0.05),完全静坐行为与MT组(OR=1.82,95%CI:1.33~2.48,P<0.01)及M组(OR=1.43,95%CI:1.14~1.78,P<0.01)患病风险存在独立的关联。结论 静坐生活方式与MS及T2DM患病风险可能存在相关,但仍需进一步在纵向研究中加以证实。  相似文献   

10.
目的 探讨不同性别和BMI水平社区老年人群的腰围与高血压患病率和控制率关系。 方法 2009年9月至2010年6月采用二阶段整群随机抽样,对北京市万寿路地区≥60岁老年人群进行横断面调查。结果 分析样本人群2 035人(男性828人,女性1 207人)。腰围增加可提高体重正常老年女性高血压患病率,且高血压控制率下降,调整OR(aOR)值(95%CI)分别为1.04(1.01~1.08)和0.96(0.92~1.00)。单纯中心性肥胖女性的高血压患病率(64.7%)显著高于腰围、体重均正常女性(52.2%),aOR=1.58(95%CI :1.07~2.32);而高血压控制率(32.9%)低于腰围正常者(43.5%),aOR=0.62(95%CI: 0.37~1.04),P=0.071。结论 腰围增加(中心性肥胖)可提高单纯肥胖和体重正常的社区老年女性高血压患病风险及降低高血压控制率。应关注老年女性单纯中心性肥胖者的高血压患病和血压控制情况。  相似文献   

11.
Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.  相似文献   

12.
This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.  相似文献   

13.
Worker education in the primary prevention of occupational dermatoses   总被引:1,自引:0,他引:1  
This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.  相似文献   

14.
To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.  相似文献   

15.
Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.  相似文献   

16.
深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.  相似文献   

17.
Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).  相似文献   

18.

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.  相似文献   

19.
20.
Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO2) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO2. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO2 at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO2 gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO2 also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO2.  相似文献   

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