Thelin Anders, Holmberg Sara
Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Sections, Uppsala University, Gatugård, SE- 35594 Wederslöf, Sweden.
Asia Pac J Clin Nutr. 2014;23(2):301-8. doi: 10.6133/apjcn.2014.23.2.09.
Few studies have examined the risk of type 2 diabetes in various occupational groups. Farmers in Sweden have a low risk of coronary heart disease, but less is known about diabetes.
To analyze the cumulative incidence and relative risk of type 2 diabetes among farmers and referents taking lifestyle factors and components of the metabolic syndrome into account.
In a longitudinal observational cohort study we followed 1,220 farmers, 1,130 rural non-farmer referents and 1,219 urban referents over 20 years. Outcomes were generated from national registers and from two surveys 12 years apart. Baseline data were assessed at the first survey conducted in 1990-91.
Farmers had a significantly lower risk of all diabetes compared with urban and rural referents (p<0.05). A total of 91 farmers (8.4%) and 102 non-farming rural referents (11.5%) were identified with type 2 diabetes over the 20 year study period (OR=0.70; 95% CI 0.52-0.95). Fractional analyses of lifestyle factors and components of the metabolic syndrome showed that the low risk of type 2 diabetes among farmers was explained in terms of physical activity and meal quality. Farmers had significantly higher physical capacity (p<0.001) and scored higher in a meal quality index than rural referents (p<0.001).
The prevalence of type 2 diabetes was significantly lower among farmers. The low relative risk was explained by high physical activity and better meal quality, indicating that farmers' lifestyles and their work environment are health-promoting.
很少有研究调查不同职业群体患2型糖尿病的风险。瑞典农民患冠心病的风险较低，但对糖尿病的了解较少。
分析农民和对照人群中2型糖尿病的累积发病率和相对风险，并考虑生活方式因素和代谢综合征的组成部分。
在一项纵向观察队列研究中，我们对1220名农民、1130名农村非农民对照者和1219名城市对照者进行了20年的随访。结局数据来自国家登记册和相隔12年的两次调查。基线数据在1990 - 1991年进行的首次调查中进行评估。
与城市和农村对照者相比，农民患所有糖尿病的风险显著较低（p<0.05）。在20年的研究期间，共识别出91名农民（8.4%）和102名农村非农民对照者（11.5%）患有2型糖尿病（OR = 0.70；95% CI 0.52 - 0.95）。对生活方式因素和代谢综合征组成部分的分层分析表明，农民中2型糖尿病风险较低可通过体力活动和饮食质量来解释。农民的体能显著更高（p<0.001），饮食质量指数得分高于农村对照者（p<0.001）。
农民中2型糖尿病的患病率显著较低。相对风险较低是由高体力活动和更好的饮食质量所解释的，这表明农民的生活方式及其工作环境对健康有益。
