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目的探讨南昌市中老年常住居民吸烟与葡萄糖调节受损(IGR)的关系,为糖尿病的一级预防提供依据。方法于2011年6-12月,采用横断面调查方法,随机抽取南昌市10 071名中老年居民进行问卷调查、体格检查及实验室检查,包括调查社会人口学资料、吸烟史,测量血压、身高、体重、腰围和臀围,检测空腹血糖及餐后2 h血糖。最终完成调查8 931人。结果不吸烟组与吸烟组的IGR患病率分别是35.0%、44.7%,且吸烟及戒烟对IGR均有明显影响,差异有统计学意义(P<0.05)。采用吸烟指数作定量研究,logistic回归调整相关因素分析显示,吸烟指数>40.5包年可能是男性患IGR的危险因素,>26.7包年可能是女性患IGR的危险因素。变通寿命表法分析与曲线拟合显示,不同吸烟指数的IGR患病概率曲线方程相关指数R2男=0.963,R2女=0.959;Cox回归分析显示,不同吸烟指数的IGR累计患病率不断升高(Scoreχ2男=91.39,Scoreχ2女=161.71,P<0.01)。结论南昌市中老年常住居民吸烟与IGR有关,其吸烟剂量与IGR患病概率存在剂量-反应关系。
Objective To investigate the relationship between smoking and impaired glucose regulation (IGR) in middle-aged and elderly residents in Nanchang and provide a basis for primary prevention of diabetes mellitus. METHODS: From June to December 2011, 10 071 middle-aged and elderly residents in Nanchang City were randomly selected for questionnaire survey, physical examination and laboratory examination by cross-sectional survey. The survey included socio-demographic data, smoking history, blood pressure measurement, height , Body weight, waist circumference and hip circumference, fasting blood glucose and postprandial blood glucose 2 h. The final survey completed 8,931 people. Results The prevalence of IGR in nonsmokers and smokers was 35.0% and 44.7%, respectively. Smoking and smoking cessation had significant effects on IGR, with statistical significance (P <0.05). The use of smoking index for quantitative study, logistic regression analysis of relevant factors showed that smoking index> 40.5 years may be risk factors for men suffering from IGR,> 26.7 years may be risk factors for women suffering from IGR. Variation of life table analysis and curve fitting showed that the correlation coefficient of IGR prevalence curve equation with different smoking index was R2 = 0.963, R2 = 0.959; Cox regression analysis showed that the cumulative prevalence of IGR in different smoking index increased (Scoreχ2 male = 91.39, Scoreχ2 female = 161.71, P <0.01). Conclusion Smoking in middle-aged and elderly residents in Nanchang is related to IGR. There is a dose-response relationship between the smoking dose and the prevalence of IGR.