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目的了解中国成年人群糖尿病(DM)筛查肥胖相关身体测量指标分布特征及其适宜切点,为DM的预防控制提供科学依据。方法于2009年9—12月采用分层整群随机抽样方法对在黑龙江、辽宁、河南、山东、江苏、湖北、湖南、广西和贵州9个省抽取的8 824名中国成年人群进行体格检查和空腹血糖检测;采用受试者工作特征曲线(ROC)分析各肥胖相关身体测量指标筛检DM的价值,并根据约登指数确定其适宜切点值。结果调查的8 824名中国成年人群中,DM患病673例,DM患病率为7.63%;男性DM患病率为8.85%,高于女性的6.50%,差异有统计学意义(χ~2=17.04,P<0.001);不同年龄成年人群比较,不同年龄男性和女性人群肥胖相关身体测量指标差异均有统计学意义(均P<0.001);在中国成年男性中,腰围(WC)是最适宜筛检DM的肥胖相关身体测量指标,其在18岁~、35岁~、55岁~和≥75岁年龄组筛检DM的受试者工作特征曲线下面积(AUC)均>0.70,WC的适宜切点分别为88.10、84.15、86.90和87.5 cm;在中国成年女性中,筛检DM的适宜肥胖相关身体测量指标随年龄不同呈多元化,腰臀比(WHpR)、腰围身高比(WHtR)和体质指数(BMI)分别为18岁~、35岁~、≥55岁女性人群最适宜筛检DM的肥胖相关身体测量指标,各AUC均>0.67,18岁~人群WHpR、35岁~人群WHtR、35岁~和≥75岁人群BM I的适宜切点分别为0.824、0.528、23.110 kg/m2和21.432 kg/m~2。结论 WC对中国成年男性人群DM具有较好的筛检价值,WHpR、WHtR和BMI分别对中国18岁~、35岁~、≥55岁女性人群具有较好的筛检价值。
Objective To understand the distribution characteristics of obesity-related body measurements and their suitable cut-points in the screening of diabetes mellitus (DM) in Chinese adult population and provide a scientific basis for the prevention and control of DM. Methods From September to December 2009, stratified cluster random sampling method was used to examine the physical status of 8 824 Chinese adults sampled from 9 provinces in Heilongjiang, Liaoning, Henan, Shandong, Jiangsu, Hubei, Hunan, Guangxi and Guizhou and Fasting blood glucose (FBG) test was used to measure the value of body mass index (DM) of each obesity-related body using the receiver operating characteristic curve (ROC), and the appropriate cut-off value was determined according to the Youden index. Results Among the 8 824 Chinese adult population surveyed, 673 were DM and 7.63% were DM. The prevalence rate of DM in male was 8.85%, which was higher than that in female (6.50%), the difference was statistically significant (χ ~ 2 = 17.04, P <0.001). Compared with adults of different age groups, there were significant differences in obesity-related body measurements between men and women of different ages (all P <0.001); in Chinese adults, waist circumference Suitable for the screening of obesity-related physical measurement of DM, the area under the working characteristic curve (AUC) of subjects who were screened for DM at 18 years old, 35 years old, 55 years old and ≥75 years old were all> 0.70, WC The suitable cutoff points for Chinese adults were as follows: age, WHpR, WHtR (WHtR), waist circumference ratio (WHtR) ) And body mass index (BMI) were 18-year-old, 35-year-old, ≥55-year-old female population most suitable for screening DM obesity-related body measurements, each AUC> 0.67,18 years of age ~ population WHpR, 35 years of age ~ population WHtR, suitable cut points for BM I in 35-year-olds and ≥75-year-olds were 0.824, 0.528, 23.110 kg / m2 and 21.432 kg / m2, respectively. Conclusion WC has a good screening value for DM in Chinese adult male population. WHpR, WHtR and BMI have good screening value for Chinese women aged 18 ~ 35, ~ 55 years old, respectively.