| Objectives:To study the factors influencing type 2 diabetes and discuss the interaction between diabetes family history and overall obesity,hypertension, hyperlipaemia and abnormal waist-to-hip ratio respectively.Methods:Using matched nested case-control study by matching each patient with two controls,the cohort study population came from 1426 community residents surveyd in 2006,then their blood glucose was examined again in 2010.The subjects were divided into a case group and a control group according to their blood glucose result in 2010. There were 106 cases and 212 controls in this study.A Cox model was used by fitting matching a Logistic model.An additive model was used to analyse the interaction between diabetes family history and overall obesity,hypertension, hyperlipaemia and waist-to-hip ratio respectively.Results:1 The factors influencing type 2 diabetesUnifactor model showed:diabetes family history(χ2=6.90,P=0.009,OR=2.03,95%CI: 1.19～3.46),obesity in 2006(χ2=17.4,P<0.001,OR=2.82,95%CI:1.72～4.62), obesity at 40(χ2=9.18,P=0.002,OR=3.18,95%CI:1.46～6.94),obesity when fattest (χ2=10.9,P= 0.001,OR=2.24,95%CI:1.38～3.63),abnormal waist-to-hip ratio(χ2=6.51,P=0.011,OR= 1.86,95%CI:1.15～3.02), high fat diet (χ2=8.87, P=0.003, OR=2.38,95%CI:1.33～4.24),hypertension (χ2=6.75, P=0.009, OR=1.93,95%CI:1.17-3.17),hyperlipaemia(χ2= 6.05,P=0.014,OR=1.81,95%CI:1.12～2.91)and so on had a positive relation with the incidence of type 2 diabetes, while physical activity(x2=6.14,P=0.046, OR=0.59,95%CI: 0.39～0.90) had a negative relation with type 2 diabetes.Multi-factor model 1 showed:diabetes family history(OR=1.81,P=0.026), obesity in 2006(OR=2.58,P=0.005),hypertension(OR=1.35,P=0.012),hyperlipaemia(OR=1.52,P= 0.022), high fat diet(OR=3.53,P=0.002),abnormal waist-to-hip ratio(OR=2.44,P=0.038) and so on had a positive relation with the incidence of type 2 diabetes,while physical activity (OR= 0.57,P=0.031) had a negative relation with type 2 diabetes.Multi-factor model 2 showed:diabetes family history(OR=1.89,P=0.046),hypertension (OR=1.64,P=0.018),hyperlipaemia(OR=1.55,P=0.032),high fat diet(OR=3.53,P=0.004), abnormal waist-to-hip ratio(OR=2.69,P=0.017)and so on had a positive relation with the incidence of type 2 diabetes,while physical activity(OR=0.63, P=0.022) had a negative relation with type 2 diabetes.Multi-factor model 3 showed:diabetes family history(OR=1.93, P=0.036), obesity at 40 (OR=2.47, P=0.011),hypertension(OR=1.47, P=0.038),hyperlipaemia(OR=1.57, P= 0.022), high fat diet(OR=3.52,P=0.002),abnormal waist-to-hip ratio(OR=2.67, P=0.02) and so on had a positive relation with the incidence of type 2 diabetes,while physical activity (OR=0.59,P=0.042) had a negative relation with type 2 diabetes.Multi-factor model 4 showed:diabetes family history(OR=1.84,P=0.025),obesity when fattest(OR=1.56,P=0.039),hypertension(OR=1.51,P=0.028),hyperlipaemia(OR=1.55,P= 0.012),high fat diet(OR=3.37,P=0.003),abnormal waist-to-hip ratio(OR= 2.51,P=0.03)and so on had a positive relation with the incidence of type 2 diabetes.Before adjusting confounding factors,the synergy index between diabetes family history and obesity in 2006 was 1.81 attributable interaction was 2.10;attributable proportion due to interaction was 36.8%;pure attributable proportion due to interaction was 44.6%.After adjusting confounding factors,their synergy index was 2.11;attributable interaction was 2.42;attributable proportion due to interaction was 43.2%;pure attributable proportion due to interaction was 52.6%.Before adjusting confounding factors,the synergy index between diabetes family history and hypertension was 2.61;attributable interaction was 1.97;attributable proportion due to interaction was 47.0%;pure attributable proportion due to interaction was 61.5%.After adjusting confounding factors,their synergy index was 2.17;attributable interaction was 1.17;attributable proportion due to interaction was 36.9%;pure attributable proportion due to interaction was 53.9%.Before adjusting confounding factors,the synergy index between diabetes family history and hyperlipaemia was 2.06;attributable interaction was 1.46;attributable proportion due to interaction was 38.0%;pure attributable proportion due to interaction was 51.4%.After adjusting confounding factors,their synergy index was 2.53;attributable interaction was 1.59;attributable proportion due to interaction was 43.9%;pure attributable proportion due to interaction was 60.4%.Before adjusting confounding factors,the synergy index between diabetes family history and abnormal waist-to-hip ratio was 3.34;attributable interaction was 2.48;attributable proportion due to interaction was 54.6%;pure attributable proportion due to interaction was 70.1%.After adjusting confounding factors,their synergy index was 4.98;attributable interaction was 2.70;attributable proportion due to interaction was 61.6%;pure attributable proportion due to interaction was 79.9%.Conclusions:Overall obesity,hypertension,diabetes family history, hyperlipaemia, high fat diet, abnormal waist-to-hip ratio and so on can raise the incidence of type 2 diabetes;while physical activity can reduce the incidence of type 2 diabetes. A person with both diabetes family history and overall obesity or abnormal waist-to-hip ratio or hypertension or hyperlipaemia has a higher probability to suffer type 2 diabetes than those without these risk factors.As a result,a series of measures should be taken to reduce the incidence of type 2 diabetes.
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