Wang Chao, Li Jianxin, Xue Haifeng, Li Ying, Huang Jianfeng, Mai Jingzhuang, Chen Jichun, Cao Jie, Wu Xianping, Guo Dongshuang, Yu Ling, Gu Dongfeng
Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Food and Environment, School of Public Health, Qiqihar Medical University, Qiqihar, China.
Diabetes Res Clin Pract. 2015 Mar;107(3):424-32. doi: 10.1016/j.diabres.2014.09.059. Epub 2014 Oct 8.
To estimate the incidence of Type 2 diabetes mellitus (T2DM) and the number of those with T2DM attributable to overweight and obesity in China.
We conducted a prospective cohort study among 15680 participants (46.4%, men) aged 35-74 years. The mean duration of follow-up was 8.0 years. We examined the relationship between overweight, obesity and risk of T2DM by Cox proportional hazards models. Population attributable risk (PAR) of overweight and obesity was also calculated. Moreover, we estimated the number of T2DM events attributed to overweight and obesity using PAR, incidence of T2DM and the population size of China in 2010.
During a mean follow-up of 8.0 years, the age-standardized incidence of T2DM was 9.5 per 1000 person-years in men and 9.2 in women. Overweight accounted for 28.3% (95% confidence interval [CI]: 20.1, 36.2) of incident T2DM among men and 31.3% (95% CI: 25.5, 36.9) among women. The corresponding PAR of obesity was 10.1% (95% CI: 6.0, 14.2) among men and 16.8% (95% CI: 12.0, 21.6) among women. Approximately 3.32 million (95% CI: 2.47, 4.24) incident T2DM were attributable to overweight and obesity in Chinese adults who were 35 to 74 years in 2010.
Our results indicate that incident T2DM is mainly attributable to overweight and obesity in China. It is extremely important to advocate healthy lifestyle and prevent excessive weight gain for reducing T2DM burden in China.
估算中国2型糖尿病(T2DM)的发病率以及归因于超重和肥胖的T2DM患者数量。
我们对15680名年龄在35 - 74岁的参与者(46.4%为男性)进行了一项前瞻性队列研究。平均随访时间为8.0年。我们通过Cox比例风险模型研究超重、肥胖与T2DM风险之间的关系。还计算了超重和肥胖的人群归因风险(PAR)。此外,我们使用PAR、T2DM发病率和2010年中国人口规模估算了归因于超重和肥胖的T2DM事件数量。
在平均8.0年的随访期间,T2DM的年龄标准化发病率男性为每1000人年9.5例,女性为每1000人年9.2例。超重导致男性新发T2DM的比例为28.3%(95%置信区间[CI]:20.1,36.2),女性为31.3%(95%CI:25.5,36.9)。肥胖对应的PAR男性为10.1%(95%CI:6.0,14.2),女性为16.8%(95%CI:12.0,21.6)。2010年,在中国35至74岁的成年人中,约332万例(95%CI:247,424)新发T2DM可归因于超重和肥胖。
我们的结果表明,在中国,新发T2DM主要归因于超重和肥胖。倡导健康的生活方式并预防体重过度增加对于减轻中国的T2DM负担极为重要。