AstraZeneca, Gaithersburg, Maryland.
Division of Endocrinology, Diabetes and Metabolic Diseases, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.
Diabetes Obes Metab. 2018 Mar;20(3):667-671. doi: 10.1111/dom.13143. Epub 2017 Dec 1.
To assess whether the secular trends in type 2 diabetes prevalence differ between abdominally obese and non-obese individuals.
Data from the National Health and Nutrition Examination Surveys (NHANES) were used to estimate the prevalence of type 2 diabetes and abdominal obesity among individuals aged ≥20 years in the USA from 1999/2000 to 2013/2014, after standardization to the age, sex and ethnicity population distribution estimates on January 1, 2014, as published by the US Census Bureau.
The prevalence of abdominal obesity in the US population increased from 47.4% (95% confidence interval [CI] 42.6-52.2) in 1999/2000 to 57.2% (95% CI 55.9-58.5) in 2013/2014. A significant increase was observed in all age groups: 20 to 44, 45 to 64, and ≥65 years. The prevalence of type 2 diabetes has also increased from 8.8% (95% CI 7.2-10.4) in 1999/2000 to 11.7% (95% CI 10.9-12.6) in 2013/2014, with no substantial change in trend over the recent years. However, the increase in the prevalence of type 2 diabetes was limited to individuals with abdominal obesity, and more specifically to individuals aged ≥45 years with abdominal obesity, with no significant change in prevalence in the non-obese group and in individuals aged <45 years.
These findings highlight the critical importance of abdominal obesity-both as a likely key contributor to the continuing epidemic of type 2 diabetes in the USA and as a priority target for public health interventions.
评估 2 型糖尿病患病率的长期变化趋势在腹型肥胖和非肥胖个体之间是否存在差异。
利用美国国家健康和营养调查(NHANES)的数据,对 2013-2014 年美国≥20 岁人群的 2 型糖尿病和腹型肥胖患病率进行了评估,该数据基于美国人口普查局公布的 2014 年 1 月 1 日年龄、性别和种族人口分布估计数进行了标准化。
美国人群腹型肥胖的患病率从 1999-2000 年的 47.4%(95%置信区间[CI] 42.6-52.2)增加到 2013-2014 年的 57.2%(95% CI 55.9-58.5)。所有年龄组均观察到显著增长:20-44 岁、45-64 岁和≥65 岁。2 型糖尿病的患病率也从 1999-2000 年的 8.8%(95% CI 7.2-10.4)增加到 2013-2014 年的 11.7%(95% CI 10.9-12.6),但近年来趋势没有明显变化。然而,2 型糖尿病患病率的增加仅限于腹型肥胖者,特别是腹型肥胖且年龄≥45 岁者,而非肥胖者和年龄<45 岁者的患病率无显著变化。
这些发现突出表明了腹型肥胖的重要性——它不仅可能是美国 2 型糖尿病持续流行的关键因素,而且也是公共卫生干预的优先目标。