总胆固醇与2型糖尿病关联性的前瞻性队列研究

目的  探讨总胆固醇与2型糖尿病(type 2 diabetes, T2DM)发病的关系。 方法  筛选20~90岁入队列时未患糖尿病并且体检次数≥2次者, 应用t检验或χ²检验比较有无发生T2DM两组人群基线特征, 按总胆固醇四分位数由低到高划分4组(2.10~mmol/L组、4.16~mmol/L组、4.76~mmol/L组和5.42~13.29 mmol/L组), 应用广义估计方程(generalized estimating equation, GEE)分析总胆固醇对2型糖尿病发病的影响。 结果  此队列共纳入12 928人, 共随访45 626人年, 平均随访时间为3.53年。随访期间, 新发T2DM患者447人, 发病密度为9.80‰, 随着总胆固醇水平增高, T2DM高发病密度呈上升趋势, 在多因素GEE分析中, 调整年龄、高密度脂蛋白、是否患高血压、是否肥胖后, 以2.10~mmol/L组为参照, 4.16~mmol/L组、4.76~mmol/L组和5.42~13.29 mmol/L组的相对危险度(relative risk, RR)值分别为1.24(95%CI:0.83~1.86)、1.75(95%CI:1.19~2.56)、3.60(95%CI:2.51~5.17)。 结论  总胆固醇与T2DM存在相关性, 随着总胆固醇水平的上升, 发生T2DM的危险性逐渐增大。

Association between total cholesterol and type 2 diabetes:a prospective cohort study

  Objective  To explore the association between total cholesterol and type 2 diabetes(T2 DM).  Methods  Non-diabetic people who aged 20 to 90 years at the baseline and who had physical examination more than 2 times were screened. Comparisons of the baseline characteristics were conducted with Student-t test or Pearson chi-square test. Generalized estimating equation(GEE) was used to analyze the effect of total cholesterol of quantiles groups(2.10-mmol/L, 4.16-mmol/L, 4.76-mmol/L and 5.42-13.29 mmol/L) to type 2 diabetes.  Results  The cohort with an average age of 3.53 years per person included 12 928 subjects and 45 626 person-years. During the follow-up, 447 cases of new-onset diabetes occurred and the incidence density was 9.80‰. The high incidence of type 2 diabetes increased with the increase of total cholesterol. After adjusting the factors including age, high density lipoprotein, hypertension and obesity, based on the 2.10-mmol/L group, the relative risk(RR) of the 4.16-mmol/L, 4.76-mmol/L and 5.42-13.29 mmol/L group were 1.24(95% CI:0.83-1.86), 1.75(95% CI:1.19-2.56)and 3.60(95% CI:2.51-5.17), respectively.  Conclusions  Total cholesterol is associated with type 2 diabetes, and as the total cholesterol increases, the risk of developing type 2 diabetes increases.