丘陵地区的邻里环境与老年人的糖尿病有关吗？来自 JAGES 2010 研究的结果。
Is a hilly neighborhood environment associated with diabetes mellitus among older people? Results from the JAGES 2010 study.
机构信息
Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
出版信息
Soc Sci Med. 2017 Jun;182:45-51. doi: 10.1016/j.socscimed.2017.04.008. Epub 2017 Apr 10.
BACKGROUND
Although living in a hilly environment may promote muscular activity in the daily lives of residents, and such activity may prevent diabetes mellitus, few studies have focused on the impact of living in a hilly environment on diabetes mellitus. The purpose of this study was to investigate the impact of a hilly neighborhood environment on DM in older people.
METHODS
We used data from the Japan Gerontological Evaluation Study, a population-based, cross-sectional study of individuals aged 65 or older without long-term care needs in Japan, which was conducted in 2010. A total of 8904 participants in 46 neighborhoods had responded to the questionnaire and undergone a health check. Diabetes mellitus was diagnosed as HbA ≥ 6.5% and those undergoing treatment for diabetes mellitus. Poorly controlled diabetes mellitus was diagnosed in those without other chronic diseases who had an HbA > 7.5%, and in those with other chronic diseases if their HbA was >8.0%. Neighborhood environment was evaluated based on the percentage of positive responses in the questionnaire and geographical information system data. A multilevel analysis was performed, adjusted for individual-level risk factors. Furthermore, sensitivity analysis was conducted for those who were undergoing treatment for diabetes mellitus (n = 1007).
RESULTS
After adjustment for other physical environmental and individual covariates, a 1 interquartile range increase (1.48°) in slope in the neighborhood decreased the risk of poorly controlled diabetes mellitus by 18% (odds ratio [OR]: 0.82, 95% confidence interval [CI]: 0.70-0.97). Sensitivity analysis confirmed that larger slopes in the neighborhood showed a significant protective effect against diabetes mellitus among those who were undergoing treatment for diabetes mellitus (OR: 0.73, 95% CI: 0.59-0.90).
CONCLUSION
A hilly neighborhood environment was not associated with diabetes mellitus, but was protective against poorly controlled diabetes mellitus.
背景
尽管居住在丘陵环境中可能会促进居民日常生活中的肌肉活动，而这种活动可能预防糖尿病，但很少有研究关注居住在丘陵环境对糖尿病的影响。本研究旨在探讨丘陵邻里环境对老年人糖尿病的影响。
方法
我们使用了来自日本老年评估研究的数据，这是一项针对日本无长期护理需求的 65 岁及以上人群的基于人群的横断面研究，于 2010 年进行。共有来自 46 个邻里的 8904 名参与者回答了问卷并接受了健康检查。糖尿病的诊断标准为 HbA≥6.5%和正在接受糖尿病治疗的人群。在无其他慢性疾病的人群中，HbA>7.5%或在有其他慢性疾病的人群中 HbA>8.0%时，诊断为控制不佳的糖尿病。邻里环境根据问卷中的阳性应答率和地理信息系统数据进行评估。采用多水平分析，调整了个体水平的危险因素。此外，还对正在接受糖尿病治疗的人群（n=1007）进行了敏感性分析。
结果
在调整了其他物理环境和个体协变量后，邻里环境中坡度增加 1 个四分位间距（1.48°），控制不佳的糖尿病风险降低 18%（比值比[OR]：0.82，95%置信区间[CI]：0.70-0.97）。敏感性分析证实，邻里环境中较大的坡度对正在接受糖尿病治疗的人群有显著的保护作用（OR：0.73，95%CI：0.59-0.90）。
结论
丘陵邻里环境与糖尿病无关，但对控制不佳的糖尿病有保护作用。
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