中国全科医学 ›› 2026, Vol. 29 ›› Issue (28): 4132-4140.DOI: 10.12114/j.issn.1007-9572.2025.0525

所属专题: 社区卫生服务最新研究合辑

• 论著 • 上一篇    下一篇

社区老年人空腹血糖与体质指数及腰围的相关性研究

余新艳1, 张芳2, 顾志乐3, 王艳芳3, 苏鹏4, 张海澄5,*()   

  1. 1.750001 宁夏回族自治区银川市第一人民医院社区管理部
    2.750001 宁夏回族自治区银川市第一人民医院新华街社区卫生服务中心
    3.750001 宁夏回族自治区银川市第一人民医院富宁街大庙社区卫生服务站
    4.066100 河北省秦皇岛市,联勤保障部队北戴河康复疗养中心
    5.100044 北京市,北京大学人民医院心内科
  • 收稿日期:2025-11-10 修回日期:2026-05-20 出版日期:2026-10-05 发布日期:2026-09-02
  • 通讯作者: 张海澄

  • 作者贡献:

    余新艳负责研究的实施与可行性分析,纳排标准的制定、撰写论文,对主要研究结果进行分析与解释;张芳负责文献检索、最终版本修订;顾志乐、王艳芳负责数据整理、核对;苏鹏负责统计学处理;张海澄负责提出研究思路,设计研究方案,进行文章的构思与设计,对文章整体负责、监督管理。

  • 基金资助:
    宁夏回族自治区卫生健康适宜技术推广科研项目(2025-NWSY-A022)

Correlation between Fasting Plasma Glucose, Body Mass Index, and Waist Circumference among Community-dwelling Elderly Individuals

YU Xinyan1, ZHANG Fang2, GU Zhile3, WANG Yanfang3, SU Peng4, ZHANG Haicheng5,*()   

  1. 1. Community Management Department, Yinchuan First People's Hospital, Yinchuan 750001, China
    2. Xinhua Street Community Health Service Center, Yinchuan First People's Hospital, Yinchuan 750001, China
    3. Funing Street Damiao Community Health Service Station, Yinchuan First People's Hospital, Yinchuan 750001, China
    4. Beidaihe Rehabilitation and Recuperation Center, Joint Logistics Support Force, Qinhuangdao 066100, China
    5. Department of Cardiology, Peking University People's Hospital, Beijing 100044, China
  • Received:2025-11-10 Revised:2026-05-20 Published:2026-10-05 Online:2026-09-02
  • Contact: ZHANG Haicheng

摘要: 背景 肥胖是2型糖尿病(T2DM)可控危险因素之一,BMI和腰围(WC)是国内外评估肥胖的常用指标,探讨老年人空腹血糖(FPG)与BMI、WC之间的关系,不但能为社区医生在老年人T2DM防控上提供精准且更加简单、便捷的指标,也为社区健康宣教提供了新的方向和思路,更可为老年人自我监测和管理FPG提供了更加简单、可持续实施的无创方法。 目的 研究社区老年人FPG与BMI、WC的关系。 方法 选取2022—2024年宁夏回族自治区银川市第一人民医院富宁街大庙社区卫生服务站5 122例65岁以上健康体检的老年人作为研究对象,在银川市医共体平台收集患者基本信息、家族史、有无心血管疾病史、生活方式、实验室检查指标、心电图异常情况、用药情况等资料,以FPG<7.0 mmol/L为对照组(4 590例)、FPG≥7.0 mmol/L为研究组(532例)。通过1∶1比例行倾向性评分匹配校正混杂因素,卡钳值为0.02,以逆概率处理加权法作为参考,验证倾向性评分匹配的匹配效果,采用单因素和多因素Logistic回归分析,探究BMI、WC对社区老年人FPG增高的影响。采用限制性立方样条(RCS)分析FPG与BMI、WC之间是否存在非线性关联。 结果 本研究成功匹配513对,对照组和研究组各513例。单因素及多因素Logistic回归分析均显示,WC、BMI、婚姻状况、白细胞计数、丙氨酸氨基转移酶、结合胆红素、血清肌酐、血尿素氮、高密度脂蛋白胆固醇、心电图异常、心血管疾病史是老年人FPG增高的影响因素[OR(95%CI)=1.025(1.006~1.045)、1.395(1.224~1.586)、1.012(1.005~1.019)、1.155(1.090~1.224)、1.020(1.010~1.030)、1.058(1.009~1.108)、0.992(0.986~0.999)、1.183(1.112~1.258)、0.625(0.457~0.836)、1.306(1.061~1.614)、2.178(1.592~2.950),P<0.05]。匹配前后FPG与BMI、WC均呈正相关(P<0.05);RCS分析显示匹配前后FPG与BMI、WC均呈非线性关联(P<0.05),且匹配前后BMI在>24 kg/m2、>25 kg/m2,WC在>86 cm、>87 cm时,对FPG的影响由保护因素转为危险因素。 结论 社区老年人的FPG与BMI及WC均呈正相关,且均呈非线性关联,并且BMI分别在>24 kg/m2、>25 kg/m2,WC在>86 cm、>87 cm时存在风险转化趋势。

关键词: 糖尿病,2型, 社区卫生服务, 空腹血糖, 人体质指数, 腰围, 老年人

Abstract:

Background

Obesity is one of the most modifiable risk factors for type 2 diabetes mellitus (T2DM). Body mass index (BMI) and waist circumference (WC) are widely used metrics for obesity assessment worldwide. Exploring the associations between fasting plasma glucose (FPG) and BMI as well as WC in elderly populations can not only provide accurate, simple and convenient indicators for community physicians in the prevention and management of T2DM among older adults, but also offer novel perspectives for community health education. Furthermore, it can facilitate older adults to conduct self-monitoring and management of FPG via simple, sustainable and non-invasive approaches.

Objective

The aim of this study is to investigate the correlation between FPG, BMI, and WC among community-dwelling older adults.

Methods

A total of 5 122 older adults (aged≥65 years) undergoing health examinations between January 2022 and December 2024 at Damiao Community Health Service Station, Yinchuan First People's Hospital, Ningxia, were enrolled. Data on demographics, family history, cardiovascular disease history, lifestyle, laboratory tests, electrocardiograms, and medications were collected via the Yinchuan Medical Consortium platform. Participants were stratified into a control group (FPG<7.0 mmol/L, n=4 590) and a study group (FPG≥7.0 mmol/L, n=532). Confounding factors were adjusted via 1∶1 propensity score matching with a caliper value of 0.02. Inverse probability treatment weighting was used as a reference to verify the matching efficiency of propensity score matching. Univariate and multivariate Logistic regression analyses were performed to explore the effects of BMI and WC on elevated FPG among community-dwelling older adults. Restricted cubic spline regression was further applied to examine the potential nonlinear associations of FPG with BMI and WC.

Results

Ultimately, 513 matched pairs were successfully established, with 513 subjects in each group. Both univariate and multivariate Logistic regression analyses demonstrated that WC, BMI, marital status, white blood cell count, serum alanine transaminase, conjugated bilirubin, serum creatinine, blood urea nitrogen, high-density lipoprotein cholesterol, abnormal electrocardiogram results and history of cardiovascular disease were influencing factors for elevated FPG in older adults [OR (95%CI)=1.025 (1.006-1.045), 1.395 (1.224-1.586), 1.012 (1.005-1.019), 1.155 (1.090-1.224), 1.020 (1.010-1.030), 1.058 (1.009-1.108), 0.992 (0.986-0.999), 1.183 (1.112-1.258), 0.625 (0.457-0.836), 1.306 (1.061-1.614), 2.178 (1.592-2.950), all P<0.05]. FPG was positively correlated with BMI and WC before and after matching, with statistically significant differences (P<0.05). Restricted cubic spline analysis indicated significant nonlinear relationships between FPG and BMI as well as WC before and after matching (P<0.05). When BMI exceeded 24 kg/m2 and 25 kg/m2, and WC exceeded 86 cm and 87 cm respectively, their effects on FPG shifted from protective factors to risk factors.

Conclusion

FPG is positively and nonlinearly correlated with BMI and WC among community-dwelling older adults. A risk transition occurs when BMI is higher than 24 kg/m2 and 25 kg/m2, and WC exceeds 86 cm and 87 cm.

Key words: Diabetes mellitus, type 2, Community health service, Fasting plasma glucose, Body mass index, Waist circumference, Aged