超重、肥胖與2型糖尿病相關性的Meta分析_《中國循證醫學雜志》

作者：

劉俊 ¹ , 郭毅 ^1,2 , 劉晴 ¹ , 周旻馨 ¹ ,  張慶軍 ³

1. 武漢大學公共衛生學院流行病學教研室（武漢 430071）；2. 武漢大學病毒學重點實驗室（武漢 430071）；3. 湖北省疾病預防控制中心慢病所（武漢 430079）;

關鍵詞：

超重肥胖 2型糖尿病系統評價 Meta分析隊列研究

DOI：

10.7507/1672-2531.20130033

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目的　系統評價超重、肥胖與2型糖尿病（T2DM）發病風險的相關性。
方法　計算機檢索PubMed、EMbase、The Cochrane Library（2012年第3期）、CNKI、VIP、CBM和WanFang Data，查找關于超重、肥胖與T2DM發病風險相關性的隊列研究，檢索時限均從建庫至2012年5月。由2位研究者嚴格按照納入與排除標準篩選文獻、提取資料并評價質量后，采用RevMan 5.1和Stata 11.0軟件進行Meta分析。
結果　最終納入8個研究，共101 864例研究對象。Meta分析結果顯示：與正常體重人群相比，超重和肥胖人群的T2DM發病風險均明顯增高［超重：RR=2.59，95%CI（2.11，3.19），P lt;0.000 01；肥胖：RR=6.28，95%CI（4.99，7.91），P lt;0.000 01］。西方肥胖人群的T2DM發病風險［RR=6.91，95%CI（5.59，8.56）］高于東方人群［RR=4.19，95%CI（2.93，5.99）］。將超重和肥胖對T2DM發病影響的研究按GRADE系統推薦分級，質量分別為低級和中等。
結論　超重、肥胖均能增加T2DM的發病風險，且女性肥胖人群比男性發病風險高，西方肥胖人群比東方肥胖人群發病風險高。

引用本文： 劉俊,郭毅,劉晴,周旻馨,張慶軍. 超重、肥胖與2型糖尿病相關性的Meta分析. 中國循證醫學雜志, 2013, 13(2): 190-195. doi: 10.7507/1672-2531.20130033 復制

1.	中國肥胖問題工作組數據匯總分析協作組. 我國成人體重指數和腰圍對相關疾病危險因素異常的預測價值: 適宜體重指數和腰圍切點的研究. 中華流行病學雜志, 2002, 23(1): 10-15.
2.	Hitman GA, Sudagani J. Searching for genes in diabetes and the metabolic syndrome. Int J Clin Pract Suppl, 2004, 10(143): 3-8.
3.	Field AE, Mason JE, Laird N, et al. Weight cycling and the risk of developing type 2 diabetes among adult women in the United States. Obes Res, 2004, 12(2): 267-274.
4.	Astrup A, Finer N. Redefining type 2 diabetes: ’diabesity’ or ’obesity dependent diabetes mellitus’? Obes Rev, 2000, 1(2): 57-59.
5.	Nemesure B, Wu SY, Hennis A, et al. The relationship of body mass index and waist-hip ratio on the 9-year incidence of diabetes and hypertension in a predominantly African-origin population. Ann Epidemiol, 2008, 18(8): 657-663.
6.	Krishnan S, Rosenberg L, Djousse L, et al. Overall and central obesity and risk of type 2 diabetes in U.S. black women. Obesity (Silver Spring), 2007, 15(7): 1860-1866.
7.	Hu FB, Mason JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med, 2001, 345(11): 790-797.
8.	Wells GA, Shea B, O’Connel D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available from:URL:http//www.ohri.ca/ programs /clinical_ epidemiology/oxford.asp.
9.	Balshem H, Helfanda M, Schunemann HJ, 等. GRADE指南: Ⅲ.證據質量分級. 中國循證醫學雜志, 2011, 11(4): 451-455.
10.	Weinstein AR, Sesso HD, Lee IM, et al. Relationship of physical activity vs body mass index with type 2 diabetes in women. JAMA, 2004, 292(10): 1188-1194.
11.	Harati H, Hadaeqh F, Saadat N, et al. Population-based incidence of Type 2 diabetes and its associated risk factors: results from a six-year cohort study in Iran. BMC Public Health, 2009, 9: 186.
12.	Wannamethee SG, Shaper AG, Walker M. Overweight and obesity and weight change in middle aged men: impact on cardiovascular disease and diabetes. J Epidemiol Community Health, 2005, 59(2): 134-139.
13.	Sung EJ, Sunwoo S, Kim SW, et al. Obesity as a risk factor for non-insulin-dependent diabetes mellitus in Korea. J Korean Med Sci, 2001, 16(4): 391-396.
14.	Wang Z, Hoy WE, Si D. Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study. BMC Public Health, 2010, 10: 487.
15.	Patja K, Jousilahti P, Hu G, et al. Effects of smoking, obesity and physical activity on the risk of type 2 diabetes in middle-aged Finnish men and women. J Intern Med, 2005, 258(4): 356-362.
16.	Meigs JB, Wilson PW, Fox CS, et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab, 2006, 91(8): 2906-2912.
17.	Meisinger C, Doring A, Thorand B, et al. Body fat distribution and risk of type 2 diabetes in the general population: are there differences between men and women? The MONICA/KORA Augsburg cohort study. Am J Clin Nutr, 2006, 84(3): 483-489.
18.	Ni MC, Parag V, Nakamura M, et al. Body mass index and risk of diabetes mellitus in the Asia-Pacific region. Asia Pac J Clin Nutr, 2006, 15(2): 127-133.
19.	Abdullah A, Stoelwinder J, Shortreed S, et al. The duration of obesity and the risk of type 2 diabetes. Public Health Nutr, 2011, 14(1): 119-126.
20.	Nagaya T, Yoshida H, Takahashi H, et al. Increases in body mass index, even within non-obese levels, raise the risk for Type 2 diabetes mellitus: a follow-up study in a Japanese population. Diabet Med, 2005, 22(8): 1107-1111.
21.	Seidell JC. Obesity, insulin resistance and diabetes–a worldwide epidemic. Br J Nutr, 2000, 83 Suppl 1: S5-8.
22.	Ko GT, Tang JS. Waist circumference and BMI cut-off based on 10-year cardiovascular risk: evidence for "central pre-obesity". Obesity (Silver Spring), 2007, 15(11): 2832-2839.
23.	Rosengren A. Overweight, obesity and BMI. The INTERHEART study shows that the BMI should probably be abolished--the waist-hip ratio is better. Lakartidningen, 2006, 103(9): 628.
24.	Balkau B, Sapinho D, Petrella A, et al. Prescreening tools for diabetes and obesity-associated dyslipidaemia: comparing BMI, waist and waist hip ratio. The D.E.S.I.R. Study. Eur J Clin Nutr, 2006, 60(3): 295-304.

1. 中國肥胖問題工作組數據匯總分析協作組. 我國成人體重指數和腰圍對相關疾病危險因素異常的預測價值: 適宜體重指數和腰圍切點的研究. 中華流行病學雜志, 2002, 23(1): 10-15.
2. Hitman GA, Sudagani J. Searching for genes in diabetes and the metabolic syndrome. Int J Clin Pract Suppl, 2004, 10(143): 3-8.
3. Field AE, Mason JE, Laird N, et al. Weight cycling and the risk of developing type 2 diabetes among adult women in the United States. Obes Res, 2004, 12(2): 267-274.
4. Astrup A, Finer N. Redefining type 2 diabetes: ’diabesity’ or ’obesity dependent diabetes mellitus’? Obes Rev, 2000, 1(2): 57-59.
5. Nemesure B, Wu SY, Hennis A, et al. The relationship of body mass index and waist-hip ratio on the 9-year incidence of diabetes and hypertension in a predominantly African-origin population. Ann Epidemiol, 2008, 18(8): 657-663.
6. Krishnan S, Rosenberg L, Djousse L, et al. Overall and central obesity and risk of type 2 diabetes in U.S. black women. Obesity (Silver Spring), 2007, 15(7): 1860-1866.
7. Hu FB, Mason JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med, 2001, 345(11): 790-797.
8. Wells GA, Shea B, O’Connel D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available from:URL:http//www.ohri.ca/ programs /clinical_ epidemiology/oxford.asp.
9. Balshem H, Helfanda M, Schunemann HJ, 等. GRADE指南: Ⅲ.證據質量分級. 中國循證醫學雜志, 2011, 11(4): 451-455.
10. Weinstein AR, Sesso HD, Lee IM, et al. Relationship of physical activity vs body mass index with type 2 diabetes in women. JAMA, 2004, 292(10): 1188-1194.
11. Harati H, Hadaeqh F, Saadat N, et al. Population-based incidence of Type 2 diabetes and its associated risk factors: results from a six-year cohort study in Iran. BMC Public Health, 2009, 9: 186.
12. Wannamethee SG, Shaper AG, Walker M. Overweight and obesity and weight change in middle aged men: impact on cardiovascular disease and diabetes. J Epidemiol Community Health, 2005, 59(2): 134-139.
13. Sung EJ, Sunwoo S, Kim SW, et al. Obesity as a risk factor for non-insulin-dependent diabetes mellitus in Korea. J Korean Med Sci, 2001, 16(4): 391-396.
14. Wang Z, Hoy WE, Si D. Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study. BMC Public Health, 2010, 10: 487.
15. Patja K, Jousilahti P, Hu G, et al. Effects of smoking, obesity and physical activity on the risk of type 2 diabetes in middle-aged Finnish men and women. J Intern Med, 2005, 258(4): 356-362.
16. Meigs JB, Wilson PW, Fox CS, et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab, 2006, 91(8): 2906-2912.
17. Meisinger C, Doring A, Thorand B, et al. Body fat distribution and risk of type 2 diabetes in the general population: are there differences between men and women? The MONICA/KORA Augsburg cohort study. Am J Clin Nutr, 2006, 84(3): 483-489.
18. Ni MC, Parag V, Nakamura M, et al. Body mass index and risk of diabetes mellitus in the Asia-Pacific region. Asia Pac J Clin Nutr, 2006, 15(2): 127-133.
19. Abdullah A, Stoelwinder J, Shortreed S, et al. The duration of obesity and the risk of type 2 diabetes. Public Health Nutr, 2011, 14(1): 119-126.
20. Nagaya T, Yoshida H, Takahashi H, et al. Increases in body mass index, even within non-obese levels, raise the risk for Type 2 diabetes mellitus: a follow-up study in a Japanese population. Diabet Med, 2005, 22(8): 1107-1111.
21. Seidell JC. Obesity, insulin resistance and diabetes–a worldwide epidemic. Br J Nutr, 2000, 83 Suppl 1: S5-8.
22. Ko GT, Tang JS. Waist circumference and BMI cut-off based on 10-year cardiovascular risk: evidence for "central pre-obesity". Obesity (Silver Spring), 2007, 15(11): 2832-2839.
23. Rosengren A. Overweight, obesity and BMI. The INTERHEART study shows that the BMI should probably be abolished--the waist-hip ratio is better. Lakartidningen, 2006, 103(9): 628.
24. Balkau B, Sapinho D, Petrella A, et al. Prescreening tools for diabetes and obesity-associated dyslipidaemia: comparing BMI, waist and waist hip ratio. The D.E.S.I.R. Study. Eur J Clin Nutr, 2006, 60(3): 295-304.

《中國循證醫學雜志》

超重、肥胖與2型糖尿病相關性的Meta分析

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《中國循證醫學雜志》

超重、肥胖與2型糖尿病相關性的Meta分析

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