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目的 探讨杭州市社区居民肥胖发生情况及体重指数 (BMI)和腰臀比值 (WHR)与糖尿病、糖耐量低减患病率的关系。方法 采用分层整群抽样方法 ,随机抽取市区 2个社区 ,郊县 2个乡镇的 15岁及以上居住 5年以上的常住居民 ,共计 4682人。进行问卷调查 ,测量身高、体重、腰围、臀围 ,测定空腹血糖和空腹口服 75g葡萄糖后 2h血糖。结果 杭州市社区人群超重和肥胖 (BMI≥ 2 4)发生率达 3 4 3 9% ,其中腹型肥胖占 5 3 95 % ;糖尿病(DM)与糖耐量低减 (IGT)患病率分别为 4 5 9%和 7 0 7% ;超重和肥胖组DM和IGT患病率明显高于正常组和低体重组 ,相对危险度 (OR)分别为 2 0 2和 2 82 ,95 %CI分别为 1 5 0～ 2 72和 1 87～ 4 2 8;腹型肥胖组DM和IGT患病率分别达 8 0 2 %和 10 2 9% ,明显高于正常体型组 ,OR值为 2 83 ,95 %CI为 2 15～ 3 73。结论 肥胖是糖尿病和糖耐量低减的重要危险因素 ,建议开展糖尿病宣传教育 ,对肥胖人群进行行为干预 ,控制膳食 ,适当运动 ,减轻体重。
Objective To investigate the incidence of obesity and the relationship between body mass index (BMI) and waist-hip ratio (WHR) and the prevalence of diabetes mellitus and impaired glucose tolerance in community residents in Hangzhou. Methods A stratified cluster sampling method was used to randomly select 2,882 permanent residents who lived for 5 years in two communities in urban area and two towns in suburban counties. A questionnaire survey, height, weight, waist circumference, hip circumference, fasting blood glucose and fasting oral glucose 75g 2h after oral glucose. Results The prevalence of overweight and obesity (BMI≥24) in Hangzhou community was 34.39%, and the prevalence of abdominal obesity was 53.95%. The prevalences of diabetes mellitus (DM) and impaired glucose tolerance (IGT) were The prevalences of DM and IGT in overweight and obesity group were significantly higher than those in normal group and low-weight group, respectively. The relative risk (OR) were 202 and 82 2, 95% CI were The prevalence rates of DM and IGT in abdominal obesity group were 82.02% and 102.9%, respectively, which were significantly higher than those in normal body type group (OR = 2.83, 95%) % CI is 2 15 ~ 3 73. Conclusion Obesity is an important risk factor for diabetes mellitus and impaired glucose tolerance. It is advisable to carry out diabetes publicity and education, conduct behavioral interventions for obese people, control diet, exercise properly and lose weight.