【摘要】 目的 分析不同肥胖类型与糖尿病患病风险的关联及其可能存在的联合作用，为制定糖尿病的干预策略提供科学依据。方法 2021—2024年，采取分层整群抽样方法在江苏省开展社区≥35岁人群调查，依据肥胖症诊疗指南(2024年版)定义，根据体质量指数(BMI)和腰围(WC)评判整体性肥胖和中心性肥胖，采用多元logistic回归探索肥胖与糖尿病的关联。结果 共调查137 582人，平均年龄(54.36±10.46)岁，超重、肥胖、中心性肥胖患病率(标化患病率)分别为42.40%(40.75%)、19.62%(19.69%)、44.67%(41.02%)。检出糖尿病患者24 163人(其中筛查糖尿病患者占30.91%),患病率为17.56%,标化患病率为13.71%。超重(OR=1.132、1.259)、轻度肥胖(OR=1.263、1.468)、中度肥胖(OR=1.375、1.625)、重度肥胖(OR=1.457、1.992)均增加空腹血糖受损、筛查糖尿病患病风险(P值均<0.05);超重(OR=0.869)、轻度肥胖(OR=0.757)、中度肥胖(OR=0.758)、重度肥胖(OR=0.685)与自报糖尿病呈负向关联(P值均<0.05);偏瘦减少空腹血糖受损风险(OR=0.766,P<0.05),而与筛查糖尿病、自报糖尿病无统计学关联(OR=1.046、0.813,P值均>0.05)。中心性肥胖增加空腹血糖受损(OR=1.193)、筛查糖尿病(OR=1.362)和自报糖尿病(OR=1.391)患病风险(P值均<0.05)。整体性肥胖与中心性肥胖对筛查糖尿病存在相加交互作用(RERI=0.424,95%CI:0.190～0.658;API=0.170,95%CI:0.078～0.261;SI=1.394,95%CI:1.129～1.721)。结论 江苏省≥35岁成人糖尿病、整体性肥胖、中心性肥胖患病率较高，整体性肥胖、中心性肥胖增加筛查糖尿病风险，且具有相加交互作用。更多还原

【Abstract】 Objective To analyze the correlation between different types of obesity and the risk of diabetes as well as their possible combined effects, so as to provide scientific basis for formulating intervention strategies for diabetes. Methods The stratified cluster sampling method was adopted to carry out a community survey of population aged ≥35 in Jiangsu Province from 2021 to 2024.In accordance with the definitions of obesity diagnosis and treatment guidelines(2024),the overall obesity and central obesity were judged according to body mass index(BMI) and waist circumference(WC).Multiple logistic regression was used to explore the correlation between obesity and diabetes. Results A total of 137 582 people were surveyed, with an average age of(54.36±10.46) years and the prevalence rates(standardized prevalence rates) of overweight, obesity and central obesity being 42.40%(40.75%),19.62%(19.69%) and 44.67%(41.02%) respectively.A total of 24 163 diabetic patients were detected(30.91% of them were screened for diabetic patients),the prevalence rate was 17.56%,and the standardized prevalence rate was 13.71%.Overweight(OR=1.132,1.259),mild obesity(OR=1.263,1.468),moderate obesity(OR=1.375,1.625) and severe obesity(OR=1.457,1.992) all increased the risk of impaired fasting glucose and screening for diabetes(P<0.05).Overweight(OR=0.869),mild obesity(OR=0.757),moderate obesity(OR=0.758) and severe obesity(OR=0.685) were negatively correlated with self-reported diabetes(P<0.05).Slimming reduced the risk of impaired fasting blood glucose(OR=0.766,P<0.05),but had no statistical correlation with screening for diabetes and self-reported diabetes(OR=1.046,0.813,P>0.05 in both cases).Central obesity increased the risks of impaired fasting blood glucose(OR=1.193),screening for diabetes(OR=1.362) and self-reported diabetes(OR=1.391)(P<0.05 in all cases).There was an additive interaction between overall obesity and central obesity on screening for diabetes(RERI=0.424,95%CI:0.190-0.658;API=0.170,95%CI:0.078-0.261;SI=1.394,95%CI:1.129-1.721). Conclusions There is a high prevalence rate of diabetes, overall obesity and central obesity in adults aged ≥35 in Jiangsu Province.Overall obesity and central obesity increase the risk of screening diabetes and have an additive interaction.更多还原