Zou Disha, Ye Yao, Zou Nina, Yu Jian
Department of Endocrinology, The Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.
The Nursing Group of Loudi Health School, Loudi, Hunan, China.
J Diabetes Investig. 2017 Mar;8(2):188-194. doi: 10.1111/jdi.12549. Epub 2016 Aug 9.
AIMS/INTRODUCTION: Type 2 diabetes is a metabolic disease characterized by insulin resistance, and is associated with the effects of genetic and environmental factors. The present study aimed to not only analyze the influence of a single factor for type 2 diabetes, but also to investigate the interaction effects between risk factors.
A total of 6,660 individuals selected by the method of cluster random sampling accepted a cross-sectional survey (questionnaire investigation, physical measurement, laboratory examination and liver ultrasound examination). The classification tree was used to analyze the risk factors and their interactions in type 2 diabetes. The clinical and metabolic characteristics were compared between type 2 diabetes patients and controls, and the non-conditional logistic regression model was used to quantitatively analyze the interactions.
A total of 338 participants were classified as type 2 diabetes (217 men and 121 women), the classification tree model showed three variables with close associations with type 2 diabetes: age, triglycerides (TG) and non-alcoholic fatty liver disease (NAFLD). Type 2 diabetes patients had higher age and incidences of high TG, NAFLD, hypertension, high body mass index, high uric acid, high total cholesterol, high low-density lipoprotein cholesterol and low high-density lipoprotein cholesterol. The multivariate logistic regression analysis showed that the following factors had interactions in type2 diabetes: high TG × advanced age (odds ratio 2.499, 95% confidence interval 1.868-3.344, P = 0.000), NAFLD × advanced age (odds ratio 1.250, 95% confidence interval 1.048-1.491, P = 0.013) and NAFLD × high TG (odds ratio 1.349, 95% confidence interval 1.144-1.590, P = 0.000).
The present study showed that type 2 diabetes resulted from the interactions of many factors; the interactions among age, TG and NAFLD are important risk factors for type 2 diabetes.
目的/引言：2型糖尿病是一种以胰岛素抵抗为特征的代谢性疾病，与遗传和环境因素的影响相关。本研究旨在不仅分析单一因素对2型糖尿病的影响，还调查危险因素之间的相互作用。
通过整群随机抽样方法选取的6660名个体接受了横断面调查（问卷调查、体格测量、实验室检查和肝脏超声检查）。采用分类树分析2型糖尿病的危险因素及其相互作用。比较2型糖尿病患者与对照组的临床和代谢特征，并使用非条件逻辑回归模型对相互作用进行定量分析。
共有338名参与者被归类为2型糖尿病患者（217名男性和121名女性），分类树模型显示与2型糖尿病密切相关的三个变量：年龄、甘油三酯（TG）和非酒精性脂肪性肝病（NAFLD）。2型糖尿病患者年龄更大，高TG、NAFLD、高血压、高体重指数、高尿酸、高总胆固醇、高低密度脂蛋白胆固醇和低高密度脂蛋白胆固醇的发生率更高。多因素逻辑回归分析显示，以下因素在2型糖尿病中存在相互作用：高TG×高龄（比值比2.499，95%置信区间1.868 - 3.344，P = 0.000），NAFLD×高龄（比值比1.250，95%置信区间1.048 - 1.491，P = 0.013）以及NAFLD×高TG（比值比1.349，95%置信区间1.144 - 1.590，P = 0.000）。
本研究表明，2型糖尿病是由多种因素相互作用导致的；年龄、TG和NAFLD之间的相互作用是2型糖尿病的重要危险因素。
