Ding Ding, Chong Shanley, Jalaludin Bin, Comino Elizabeth, Bauman Adrian E
Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, The Charles Perkins Centre (D17), The University of Sydney, NSW 2006, Australia.
Healthy People and Places Unit, South Western Sydney Local Health District, Bangala Building, Eastern Campus, Liverpool Hospital, Liverpool, NSW 2170, Australia.
Diabetes Res Clin Pract. 2015 May;108(2):306-15. doi: 10.1016/j.diabres.2015.02.002. Epub 2015 Feb 14.
To describe the incidence of type 2 diabetes mellitus (T2DM) among middle-aged and older Australian adults and to examine a broad range of risk factors of T2DM.
A large cohort of Australian adults aged 45 and up was sampled from the general population and was followed up for approximately 3 years (n=60,404). Physician-diagnosed T2DM was self-reported at baseline (2006-2008) and follow-up (2010). Incident T2DM was determined as not reporting T2DM at baseline, but reporting T2DM at follow-up. A broad range of risk factors, including socio-demographic characteristics, health status, family history, and lifestyle behaviors were examined at baseline. Multiple logistic regression was used for selecting potential predictors of incident T2DM, and age and reported family history of T2DM were tested as potential effect modifiers.
Of the 54,997 without T2DM at baseline, 888 reported T2DM at follow-up (cumulative incidence 1.6% over 3.4 years, annual incidence rate 0.44%). Adjusted for other risk factors, being male, older age, higher relative socio-economic disadvantage, being born in Asia, lower educational attainment, medical history of hypertension and dyslipidemia, family history of T2DM, overweight/obese, smoking, long sleeping hours, and psychological distress were significantly associated with higher odds of developing T2DM. Particularly, hypertension, dyslipidemia, and overweight/obesity were stronger predictors of T2DM among middle-aged than older adults (≥60 years).
Understanding risk factors for incident T2DM could help identify at-risk populations and develop upstream preventive strategies to combat the epidemic of diabetes.
描述澳大利亚中老年成年人2型糖尿病（T2DM）的发病率，并研究T2DM的广泛危险因素。
从普通人群中抽取一大群年龄在45岁及以上的澳大利亚成年人，随访约3年（n = 60404）。医生诊断的T2DM在基线期（2006 - 2008年）和随访期（2010年）通过自我报告获得。新发T2DM定义为在基线期未报告T2DM，但在随访期报告T2DM。在基线期检查了广泛的危险因素，包括社会人口学特征、健康状况、家族史和生活方式行为。采用多元逻辑回归选择新发T2DM的潜在预测因素，并将年龄和报告的T2DM家族史作为潜在效应修饰因素进行检验。
在基线期无T2DM的54997人中，888人在随访期报告了T2DM（3.4年累积发病率1.6%，年发病率0.44%）。在调整其他危险因素后，男性、年龄较大、相对社会经济劣势较高、出生在亚洲、教育程度较低、有高血压和血脂异常病史、T2DM家族史、超重/肥胖、吸烟、睡眠时间长和心理困扰与发生T2DM的较高几率显著相关。特别是，高血压、血脂异常和超重/肥胖在中年人群中比老年人（≥60岁）是T2DM更强的预测因素。
了解新发T2DM的危险因素有助于识别高危人群，并制定上游预防策略以应对糖尿病流行。
