健康生活方式与糖尿病前期人群糖尿病发病关系的前瞻性研究

目的 探讨健康生活方式对糖尿病前期人群糖尿病发病风险的影响，为糖尿病前期人群的生活方式干预提供参考依据。方法 数据来源于贵州省自然人群队列研究。组合分析9种健康生活方式对糖尿病发病的影响，采用SPSS 26.0对数据进行χ2检验、单因素方差分析、Cox风险回归模型分析及分位数回归模型分析。结果 单种健康生活方式与糖尿病发病关联分析显示，烹调油摄入≤30 g/d、18.5≤BMI＜24 kg/m2能有效降低糖尿病发病风险，HR分别为0.500（95%CI:0.335～0.747）、0.420（95%CI:0.290～0.610），未发现其他生活方式与糖尿病的发病相关。多种健康生活方式组合分析显示与0～3种相比，保持6种、7种及以上健康生活方式的人群发生糖尿病的风险分别为HR = 0.478（95%CI:0.239～0.956）、HR = 0.282（95%CI:0.108～0.737）。分位数回归结果显示，与0～3种健康生活方式相比，健康生活方式为4/5种以上，能降低0.9分位点的空腹血糖/OGTT 2 h血糖值；当健康生活方式达7种以上，能降低0.3～0.9分位点的血糖值，且分位水平越高，降低的血糖值越多。结论 健康生活方式能有效降低糖尿病前期人群血糖水平，且健康生活方式种类越多，糖尿病发病的风险越小。

Impact of healthy lifestyle on the risk of diabetes in prediabetic population: a prospective cohort study

Objective To explore the influence of healthy lifestyle on the risk of diabetes in prediabetic population, and to provide reference for lifestyle intervention in prediabetic population. Methods Data were collected from the natural population cohort study of Guizhou Province. Combined analysis of the impact of nine healthy lifestyles on the incidence of diabetes was performed using Chi-square test, one-way ANOVA, Cox risk regression model and quantile regression model (SPSS 26.0). Results Association analyses between single healthy lifestyle and the onset of diabetes showed that edible oil intake≤30 g/d and 18.5≤BMI<24 kg/m2 were associated with a lower risk of diabetes with HR of 0.500 (95%CI: 0.335-0.747) and 0.420 (95%CI: 0.290-0.610), respectively. No other lifestyle was found to be associated with diabetes. A combination analysis of multiple healthy lifestyles showed the risk of developing diabetes was HR=0.478 (95%CI: 0.239-0.956) and HR=0.282 (95%CI: 0.108-0.737) in those with six or more than seven healthy lifestyles compared with 0 to 3, respectively. The results of quantile regression showed that more than 4/5 healthy lifestyles reduced the fasting blood glucose /OGTT 2h blood glucose by 0.9 quantile compared with 0 to 3 healthy lifestyles. Seven or more healthy lifestyles were associated with a 0.3 to 0.9 quantile reduction in blood glucose, and the higher the quantile, the greater the reduction in blood glucose. Conclusion Healthy lifestyles can effectively reduce blood glucose levels in prediabetic people, and the more types of healthy lifestyles, the lower the risk of developing diabetes.