腰围身高比值与2型糖尿病关系的随访研究

目的探讨和评价腰围／身高比值（WHtR）作为腹型肥胖的指标与2型糖尿病发病危险的关系。方法以2000年参加石家庄市社区健康检查的35～55岁城市居民中筛选出无高血压、血脂异常、糖尿病或糖耐量异常及其他疾病的单纯肥胖者558例作为研究对象，2007年对上述人群进行随访，随访到520例，分析评价WHtR与2型糖尿病发病风险的关系，应用logistic回归进一步分WHtR、腰围（WC）、体质指数（BMI）、腰臀比（WHR）对2型糖尿病的预测作用。结果WHtR≥0．5组2型糖尿病的发病率26．7％（86／322）明显高于WHtR〈0．5组10．6％（21／198），2组差异有统计学意义（x2=19．40，P〈0．01）；WHtR≥0．5组的血压、TC、TG、LDL-C、HOMA-IR明显高于WHtR〈0．5组，HDL-C明显低于WHtR〈0．5组；Logistic逐步回归分析显示，WHtR、WC、BMI、WHR均进入回归方程，但WHtR成为2型糖尿病的主要危险因素，比数比分别为4．68、3．72、2．49、2．28。结论WHtR与WC高度相关，可成为腹型肥胖的有效参考指标，同时WHtR可作为预测单纯肥胖人群发生2型糖尿病的指标。

Prospective study of the correlation between waist circumference/height ratio and type 2 diabetes

Objective To assess the waist circumference/height ratio as an abdominal obesity index of pre-dicting the risk of type 2 diabetes(T2DM). Methods A total of 558 obesity residents aged 33～55 years were se-lected as the subjects who underwent medical examination in Shijiazhuang in 2000 and did not suffer from hyperten-sion, hyperlipidemia, T2DM, impared glucose tolerance and other chronic disease. The conrrelation among waist circumference/height ratio and type 2diabetes was analyzed. The Logistic regression analysis was used to study the predictive value of waist circumference/height ratio(WHtR), waist circumference (WC), body mass index (BMI), waist hip ratio(WHR) to type 2 diabetes. Results The incidence of type 2 diabetes in WHtR≥0.5 group was higher than in WHtR <0.5 group. Total cholesterol (TC), triglycerides(TG), Low-density hpoprotein cholesterol (LDL) in WHtR≥0.5 group was significantly higher than those in WHtR <0.5 group and high-density lipoprotein cholesterol was significantly lower than those in WHtR < 0.5 group. Multiple logistic regression analysis indicated that WHtR, WC, BMI, WHR entered equationodds ratio(OR):4.68, 3.72, 2.49, 2.28], WHtR was the most important predictive factors of type 2 diabetes. Conclusion WHtR significantly correlates with WC and can serve as an effective abdominal obesity index of predicting the risk of type 2 diabetes.