哈尔滨市血压正常居民糖尿病家族史和高血脂交互作用与糖尿病关系的研究

目的 探索血压正常人群中糖尿病家族史、高血脂及其交互作用与糖尿病的关系。方法 多阶段分层随机整群抽样获得哈尔滨市城区20~74岁居民代表性样本，对其中血压正常的糖尿病患者376例、血压和空腹血糖及口服葡萄糖耐量试验2 h血糖均正常的3 692人，进行糖尿病家族史与高血脂症联合作用的叉生分析与相加模型评估交互作用。结果 多因素logistic回归模型控制混杂因素后，发现糖尿病家族史与高血脂可能存在正相加交互作用。交互作用相对超额危险度、交互作用归因比、交互作用指数分别为1.97（95%CI：-0.32~4.26）、0.30（95%CI：0.03~0.57）、1.54（95%CI：0.96~2.47）。糖尿病家族史与总胆固醇和甘油三酯水平均高、单纯总胆固醇水平升高、单纯甘油三酯水平升高联合作用的OR值及95%CI分别为10.55（5.62~19.80）、7.81（3.65~16.71）、5.13（3.22~8.16）。结论 血压正常人群中，糖尿病家族史与高血脂症对于糖尿病患病可能存在协同作用。

Interaction between family history of diabetes and hyperlipidemia on risk of diabetes in population with normotension in Harbin: a cross-sectional study

Objective To explore the interaction between family history of diabetes and hyperlipidemia on the risk of diabetes in population with normotension. Methods A multistage stratified probability random sampling was conducted to select a representative sample of urban residents aged 20-74 years in Harbin. A total of 376 diabetes patients with normotension and 3 692 residents with normal blood pressure, normal fasting glucose, and normal 2 hours glucose from OGTT were surveyed. The interaction was evaluated by using crossover analysis and additive model. Results Multivariate logistic regression analysis indicated that there was a possible additive interaction between family history of diabetes and hyperlipidemia on the risk of diabetes. The relative excess risk due to the interaction, the attributable proportion due to the interaction, and the synergy index were 1.97 (95%CI: -0.32-4.26), 0.30 (95%CI: 0.03-0.57), and 1.54 (95%CI: 0.96-2.47), respectively. There were significant combination effects between family history of diabetes and high both total cholesterol and triglyceride, isolated high total cholesterol, and isolated high triglyceride levels; the ORs were 10.55 (95%CI: 5.62-19.80), 7.81 (95%CI: 3.65-16.71) and 5.13 (95%CI: 3.22- 8.16), respectively. Conclusion There might be synergistic effect between family history of diabetes and hyperlipidemia on the risk of diabetes in population with normotension.