Deng X Q, Zhang M, Zhang X, Zhao Z P, Li C, Huang Z J, Song Z W, Jiang B, Guo X H, Yu N, Wang L M
Division of Chronic Disease and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China Department of Health Statistics, School of Public Health, China Medical University, Shenyang 110122, China.
Division of Chronic Disease and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Aug 10;43(8):1178-1188. doi: 10.3760/cma.j.cn112338-20211011-00782.
To describe and compare blood glucose levels in adults aged 18 years old and above in China and explore the relationship between BMI and waist circumference with blood glucose. China Chronic Disease and Risk Factor Surveillance were conducted in 298 counties/districts in China in 2018, covering 31 provinces (autonomous regions, municipalities). A multi-stage stratified cluster random sampling method selected permanent residents aged 18 years and above. Information on demographics, behavior-related risk factors, BMI, waist circumference, and blood glucose were collected through a face-to-face questionnaire, physical measurement, and laboratory examination. After complex weighting of data, they described the blood glucose levels of people with different characteristics and explored the relationship of BMI and waist circumference with blood glucose by multiple linear regression model analysis. A total of 177 816 adults were included in the study. The average fasting blood glucose and average glycosylated hemoglobin were (5.73±1.46) mmol/L and (5.37±0.83) %, with people aged 60 years old and above group highest than that of other, with males higher than females (<0.001); and urban was higher slightly than rural for the average of average glycosylated hemoglobin (<0.001). The average fasting blood glucose and average glycosylated hemoglobin increased with increased BMI and waist circumference (<0.001). Results from multiple linear regression model analysis showed that: 1) for each increase in BMI unit and waist circumference, the fasting glucose levels increased by 0.019 mmol/L and 0.008 mmol/L (all <0.001) in those not diagnosed with diabetes, 2) by 0.021 mmol/L (=0.163) and 0.014 mmol/L (=0.004) in those newly detected as diabetes, and 3) by 0.028 mmol/L (=0.088) and 0.023 mmol/L (<0.001) in those self-reported as having been diagnosed as diabetes, respectively. However, glycosylated hemoglobin levels increased: 1) by 0.015% and 0.006% in those not diagnosed as diabetes (all <0.001), 2) by 0.050% and 0.019% in those newly detected as diabetes (all <0.001), and 3) by 0.033% and 0.019% in those self-reported as having been diagnosed as diabetes (all <0.001), respectively. These associations with waist circumference were more robust than with BMI. Adults not diagnosed with diabetes with abnormal BMI or waist circumference are the key population for prevention and control. Measures improving the awareness rate of waist circumference should be taken to maintain average blood glucose in various groups.
描述和比较中国18岁及以上成年人的血糖水平，并探讨体重指数（BMI）和腰围与血糖之间的关系。2018年在中国298个县/区开展了中国慢性病及危险因素监测，覆盖31个省（自治区、直辖市）。采用多阶段分层整群随机抽样方法选取18岁及以上的常住人口。通过面对面问卷调查、体格测量和实验室检查收集人口统计学、行为相关危险因素、BMI、腰围和血糖等信息。对数据进行复杂加权后，描述不同特征人群的血糖水平，并通过多元线性回归模型分析探讨BMI和腰围与血糖的关系。本研究共纳入177816名成年人。空腹血糖平均值和糖化血红蛋白平均值分别为（5.73±1.46）mmol/L和（5.37±0.83）%，60岁及以上人群高于其他人群，男性高于女性（<0.001）；糖化血红蛋白平均值城市略高于农村（<0.001）。空腹血糖平均值和糖化血红蛋白平均值随BMI和腰围增加而升高（<0.001）。多元线性回归模型分析结果显示：1）在未诊断为糖尿病的人群中，BMI每增加1个单位和腰围每增加1个单位，空腹血糖水平分别升高0.019 mmol/L和0.008 mmol/L（均<0.001）；2）在新诊断为糖尿病的人群中，分别升高0.021 mmol/L（=0.163）和0.014 mmol/L（=0.004）；3）在自我报告已诊断为糖尿病的人群中，分别升高0.028 mmol/L（=0.088）和0.023 mmol/L（<0.001）。然而，糖化血红蛋白水平升高：1）在未诊断为糖尿病的人群中分别升高0.015%和0.006%（均<0.001）；2）在新诊断为糖尿病的人群中分别升高0.050%和0.019%（均<0.001）；3）在自我报告已诊断为糖尿病的人群中分别升高0.033%和0.019%（均<0.001）。这些与腰围的关联比与BMI的关联更强。BMI或腰围异常但未诊断为糖尿病的成年人是防控的重点人群。应采取措施提高腰围知晓率，以维持各人群的平均血糖水平。
