Influence of Central Obesity and Obesity Level on the Prevalence of Niddm and Impaired Glucose Tolerance

中央型肥胖和肥胖程度對非胰島素依賴型糖尿病和葡萄糖耐受性不良之盛行率的影響

張家禎(Chai-Jan Chang) ； 章錫璋(Shyi-Jang Shin) ； 李威龍(Wen-Long Lee) ； 洪南川(Nan-Chuan Horng) ； 李洮俊(Yau-Jiunn Lee) ； 劉宏文(Hong-Wen Liu)

《The Kaohsiung Journal of Medical Sciences》 8卷12期 (1992/12) Pp. 647-655

https://doi.org/10.6452/KJMS.199212.0647

摘要

本研究的目的在了解非胰島依賴型糖尿病的盛行率和中央型肥胖(central obesity)，肥胖(obesity)及糖尿病家族史的關係。從高雄市三民區30歲以上的人隨機抽樣1590位(男性646位，女性944)位。採用過病史和世異衛生組織所制定的葡萄糖耐受性試驗標準來決定血糖情形。
不管男女，中央型肥胖者(腰臂比在男性大於0.92，在女性大於0.85)和肥胖者(體質量係數在男性大於27.6kg/m²，在女性大於28.3kg/m2)有明顯較高的葡萄糖耐受性不良和糖尿病盛行率，而男女肥胖者糖尿病盛行率和女性中央型肥胖者葡萄糖耐受性不良之盛行率卻沒達到統計上顯著差界。依體質量系數(BMI)和腰臂比(waist-hip ratio)來分為四分位(quartile)，從第一分位在第四分的男性糖尿病盛行率有明顯增加(體質量係數從4.48%至9.21%，腰臂比從3.67%至13.61%)，而女性糖尿病成行率，從第一分位至第四分位也是一樣有明顯增加(體質量係數從2.45%至11.76%，腰臂比從2.04%至13.49%)。在邏輯迴歸分析中，當體質量係數每增加1kg/m²或腰臂比每增加0.05，男女糖尿病盛行率約略相同(體質量係數1.07倍和1.09倍，腰臂比1.34倍和1.32倍)。在體質量系數和腰臂比對葡萄糖耐受性不良和新診斷型糖尿病之盛行率的關係，發現女性比男性顯著。中央型肥胖者，對糖尿病盛行率的關係，也是女性較顯著有關。腰臂比和糖尿病的關係，不管男女，均較體質量係數有顯著相關。
本研究發現，體質量係數和腰臂比對葡萄糖耐受性不良和非胰島素依賴型糖尿病成行率的增加有明顯相關，尤其女性更為顯著。而中央型肥胖者相對於肥胖者對非胰島素依賴型糖尿病的盛行率較有相關，若只能使用一種測量方法，腰臂比 測量可能比體質量係數較適宜。

並列摘要

The purpose of this study was to determine the association of the prevalence of non-insulin-dependent diabetes (NIDDM) with central obesity, obesity, and family history of diabetes. This survery consisted of 1590 subjects (646 men, 944 women) aged 30 years or more from the Sun-Ming district of Kaoshiung city. Glucose tolerance status was ascertained by both medical history and a 75-g oral glucose tolerance test a cording to World Health Organization criteria.
In men and women with central obesity (WHR≧0.92 in men and ≧0.85 in women) or obesity (BMI≧27.6 kg/m² in men and ≧28.3kg/m² in women) (WHR: waist-hip ratio; BMI: body mass index), the prevalence of impaired glucose tolerance (IGT) and diabetes was significantly higher, except the prevalence of diabetes in both sexes with obesity and the prevalence of IGT in women with central obesity were not statistically different, as compared with nonobese subjects. The prevalence of diabetes in men significantly increased from the first quartile to the fourth quartile of BMI and the waist-hip ratio (WHR) (4.48% to 9.21% in BMI, 3.67% to 13.61% in WHR), while the prevalence in women also significantly increased from the first to fourth quartile (2.45% to 11.76% in BMI, 2.04% to 13.49% in WHR). Multiple logistic regression analyses revaled similar increase in the prevalence of diabetes among both men and women for every 1kg/m² increase in BMI and every 0.05 increase in WHR(1.07-fold and 1.09 fold in BMI, 1.34-fold and 1.32-fold in WHR, respectively). The association of both indices (BMI and WHR) with IGT and undiagnosed NIDDM was more significant in women than in men. The association of central obesity with the prevalence of diabetes was also more stronger in women than in men. The correlation of diabetic subjects with WHR was stronger than with BMI in both men and women.
These findings suggest that both indices are significantly associated with an increased prevalence of IGT and NIDDM, especially in women. The central obesity was associated with a greater increase in the prevalence of NIDDM than obesity. If only a single measure is to be used, waist-hip ratio seems superior to BMI.

並列關鍵字

central obesity ； IGT ； NIDDM