Body mass index and diabetes in Asia: a cross-sectional pooled analysis of 900,000 individuals in the Asia cohort consortium.
Body mass index and diabetes in Asia: a cross-sectional pooled analysis of 900,000 individuals in the Asia cohort consortium.
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DOI：
10.1371/journal.pone.0019930
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Potter JD
中科院分区：
文献类型：
--
作者：
Boffetta P;McLerran D;Chen Y;Inoue M;Sinha R;He J;Gupta PC;Tsugane S;Irie F;Tamakoshi A;Gao YT;Shu XO;Wang R;Tsuji I;Kuriyama S;Matsuo K;Satoh H;Chen CJ;Yuan JM;Yoo KY;Ahsan H;Pan WH;Gu D;Pednekar MS;Sasazuki S;Sairenchi T;Yang G;Xiang YB;Nagai M;Tanaka H;Nishino Y;You SL;Koh WP;Park SK;Shen CY;Thornquist M;Kang D;Rolland B;Feng Z;Zheng W;Potter JD
在低收入和中等收入国家，特别是在亚洲，糖尿病的发病率大大增加，超重和肥胖的流行率也大大增加;在欧洲来源的人口中，超重和肥胖是糖尿病的既定原因。超重和肥胖与糖尿病风险的关系及其总体影响在亚洲尚未得到充分研究。 对来自孟加拉国、中国、印度、日本、韩国、新加坡和中国台湾的18个队列中招募的90多万人进行了汇总横断面分析，以评估基线体重指数（BMI，测量为体重（kg）除以身高（m）的平方）与自我报告的糖尿病状态之间的关联。在调整潜在的混杂因素后，拟合Logistic回归模型，计算BMI增加类别的糖尿病队列特异性比值比（OR）。使用随机效应荟萃分析汇总各队列的OR。在总人群中，经性别和年龄调整的糖尿病患病率为4.3%，参与队列的患病率范围为0.5%至8.2%。使用类别22.5-24.9 Kg/m2作为参考，糖尿病的OR范围为BMI低于15.0 kg/m2的0.58（95%置信区间[CI] 0.31，0.76）至BMI高于34.9 kg/m2的2.23（95% CI 1.86，2.67）。BMI和糖尿病患病率之间的正相关性在所有队列和研究人群的所有亚组中都存在，尽管在基线时年龄低于50岁的个体中这种相关性更强（相互作用p值<0.001），来自印度和孟加拉国的队列（p<0.001）、低教育程度个体（p值0.02）和吸烟者（p值0.03）;性别、城市居住或饮酒没有观察到差异。这项研究估计了亚洲人群中BMI与糖尿病患病率之间关联的形式和强度，并确定了年龄，国家和其他糖尿病风险因素的关联模式。
The occurrence of diabetes has greatly increased in low- and middle-income countries, particularly in Asia, as has the prevalence of overweight and obesity; in European-derived populations, overweight and obesity are established causes of diabetes. The shape of the association of overweight and obesity with diabetes risk and its overall impact have not been adequately studied in Asia. A pooled cross-sectional analysis was conducted to evaluate the association between baseline body mass index (BMI, measured as weight in kg divided by the square of height in m) and self-reported diabetes status in over 900,000 individuals recruited in 18 cohorts from Bangladesh, China, India, Japan, Korea, Singapore and Taiwan. Logistic regression models were fitted to calculate cohort-specific odds ratios (OR) of diabetes for categories of increasing BMI, after adjustment for potential confounding factors. OR were pooled across cohorts using a random-effects meta-analysis. The sex- and age-adjusted prevalence of diabetes was 4.3% in the overall population, ranging from 0.5% to 8.2% across participating cohorts. Using the category 22.5–24.9 Kg/m2 as reference, the OR for diabetes spanned from 0.58 (95% confidence interval [CI] 0.31, 0.76) for BMI lower than 15.0 kg/m2 to 2.23 (95% CI 1.86, 2.67) for BMI higher than 34.9 kg/m2. The positive association between BMI and diabetes prevalence was present in all cohorts and in all subgroups of the study population, although the association was stronger in individuals below age 50 at baseline (p-value of interaction<0.001), in cohorts from India and Bangladesh (p<0.001), in individuals with low education (p-value 0.02), and in smokers (p-value 0.03); no differences were observed by gender, urban residence, or alcohol drinking. This study estimated the shape and the strength of the association between BMI and prevalence of diabetes in Asian populations and identified patterns of the association by age, country, and other risk factors for diabetes.
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