吸烟与肥胖对糖尿病前期患病的交互作用

目的 分析40～79岁人群吸烟与肥胖对糖尿病前期（prediabetes mellitus, PDM）患病的交互作用。方法 采用多阶段随机抽样的方法，在荣昌区21个街道或镇开展调查，每个调查点随机抽取3～5个村或社区，每个村或社区随机抽取20～50名符合条件的调查对象，调查包括问卷调查、体格检查和血生化检测。PDM影响因素及吸烟与肥胖对PDM患病的交互作用采用软件R 4.1.1进行多因素logistic回归分析。结果 3 017例调查对象中，PDM患病率为38.98%。调整混杂因素后，吸烟（OR=1.570,95%CI:1.303～1.892）、肥胖（OR=1.391,95%CI:1.113～1.737）与PDM患病高风险相关。相乘交互作用分析发现，吸烟×肥胖对PDM存在相乘交互作用（OR=2.122,95%CI:1.251～3.601）；相加交互作用分析发现，吸烟且肥胖风险高于不吸烟且不肥胖者（OR=3.978,95%CI:2.543～6.224），相加作用评价指标RERI、AP和SI分别为2.200(0.444～3.956)(P>0.05)、0.553(0.336～0.770...

Interaction effect between smoking and obesity on prediabetes mellitus

Objective To analyze the interaction effect between smoking and obesity on prediabetes mellitus (PDM) in people aged 40 to 79 years old. Methods By using the method of multi-stage random sampling, a survey was carried out in 21 streets or towns in Rongchang District. Three villages or communities were randomly selected from each survey site, and 20 to 50 eligible subjects were randomly selected from each village or community. The survey included questionnaire, physical examination, and blood biochemical tests. The influencing factors of PDM and the interaction effect between smoking and obesity on PDM were analyzed by multivariate logistic regression analysis with the use of software R4.1.1. Results Among the 3 017 research subjects, the prevalence rate of PDM was 38.98%. After adjusting for confounding factors, smoking (OR=1.570, 95%CI: 1.303-1.892) and obesity (OR=1.391, 95%CI: 1.113-1.737) were associated with a higher risk of PDM. Multiplicative interaction analysis showed that there was a multiplicative interaction between smoking × obesity and PDM (OR=2.122, 95%CI: 1.251-3.601). Additive interaction analysis showed that the risk of PDM was higher in the obese smoking people than in non-smoking and non-obese people (OR=3.978, 95%CI: 2.543-6.224). The additive effect evaluation indexes RERI, AP and SI were 2.200 (0.444-3.956), 0.553 (0.336-0.770), and 3.827 (1.711-8.560), respectively. Conclusion The prevalence rate of PDM in Rongchang District is relatively high. Smoking and obesity have a positive synergistic effect on the risk of PDM. Smoking cessation education should be carried out in time, and physical exercise and reasonable diet should be promoted.