| ObjecetivDiabetes mellitus(DM) was a set of metabolic diseases characterized by the chronic increased blood sugar level , hyperglycaemia was caused by the defection of insulin secretion and(or) insulin effectiveness. DM had become the main cause of death and mutilation to result in the increasing medical expenses in many countries; it had become a public health problem which was paid close attention to increasingly by countries all over the world include China. Shenyang city located in the northeast of China, the people living in Shenyang city had their local unique life styles and eating habits, there was no reports at present yet to investigate the associations between heredity, life style, food factor and T2DM in Shenyang city area. We investigated the risk factors for T2DM by analysis the life style, family history, degree of heritability and T2DM prevalence in the first degree relatives, and so on of T2DM patients in Shenyang residents, aimed to provide evidences based on science for formulating preservation strategy to T2DM.MethodsCase control study was used in our research. The study comprised 202 T2DM patients as cases from unselected series patients in clinic and hospitalization of both Shenyang No.202 Military Hospital and Shenyang Red Cross Hospital between September 2006 and September 2007; 204 non-DM people as control group were selected from many different communities in Shenyang city with the similar sex and age distribution in the same time. The investigation was performed face to face by examiners using a home-made questionnaire. The examiners were trained before the investigation in order to make a unify methods and standards. Content investigated included general condition, past history, family history, statural, living habit, etc. We established database of SPSS13.0 software with clinic and epidemiological investigation data.χ2 Test and t Test were used to analyze the equilibrium of sex and age respectively in 2 groups. The univariate Logistic regression analysis was used, and if there were positive factors, a multiple Logistic regression analysis was used additionally. The prevalence in the first degree relatives was tested withχ2 Test in 2 groups. The degree of heritability was calculated with Falconer method.ResultsThe study comprised 202 patients, 93 male with a mean age of (60.70±8.90 )years and 109 female with a mean age of (61.66±8.86) years. The control group comprised 204 people, 98 male with a mean age of (62.99±6.81) years and 106 female with a mean age of (61.62±9.33) years. There was no statistical significance between sex distributions in 2 groups withχ2 Test (x2 =0.163,p>0.05). The mean age of 2 groups was tested with t Test (t =1.074 p> 0.05)and fell short of statistical significance. There were statistical significances in 14 factors analyzed with univariate no conditional Logistic regression analysis and the 14 factors were also analyzed with multiple no conditional Logistic regression analysis. There were the results: family history of DM (OR=10.387), excessive sweet food (OR=4.499), excessive fat intake (OR=3.365), high waist-to-hip ratio(OR=2.174), high body mass index(OR=4.242),hypertension (OR=3.556), they were all risk factors for increasing incidence of T2DM;however, more physical exercises (OR=0.307) and more vegetable intake (OR=0.410)could reduce the risk of T2DM incidence significantly .The risk of incidence for T2DM in the first degree relatives(parents, sib, children) of a T2DM patient was higher than that of control group(OR=5.32),the degree of heritability calculated with Falconer method was(56.88±8.34)%.DiscussionThere was significant association between T2DM and family history of T2DM, OR values were 10.906 and 10.387 analyzed with univariate Logistic regression analysis and multiple Logistic regression analysis respectively, which were higher than other reports from case control studies based on different population in their own regions in china(5.341 and 2.085), moreover, the risk of incidence for T2DM in the first degree relatives of a T2DM patient was higher than that of control group(OR=5.32),the degree of T2DM heritability wa(s56.88±8.34)% in Shenyang, it was higher than 36.2% reported by ShenHongbing, etc. Therefore, family history of T2DM was a very important risk factor for T2DM in Shenyang city.Obesity was an important risk factor for T2DM, we studied the association between T2DM and obesity by 2 indexes (waist-to-hip ratio and body mass index),which display: the OR values of BMI were 11.584 and 7.536 analyzed with univariate Logistic regression analysis and multiple Logistic regression analysis respectively, and that of WHR were 4.242 and 2.174, which indicated that BMI and WHR were significantly associated with T2DM incidence, therefore ,obesity was a risk factor for T2DM in Shenyang city.Hypertension was considered as another important risk factor for T2DM, the prevalence of hypertension in DM patients was higher than that of no DM population by 1.5-2.0 times. Our findings demonstrated: there was significant association between T2DM and hypertension, OR were 4.226 and 3.556 analyzed with univariate Logistic regression analysis and multiple Logistic regression analysis respectively, which indicated hypertension was a risk factor for T2DM in Shenyang city.Our findings also demonstrated: excessive sweet food and fat intake had significant association with T2DM incidence in Shenyang, the OR values of excessive sweet food intake were 5.634 and 11.702 analyzed with univariate Logistic regression analysis and multiple Logistic regression analysis respectively, while that of excessive fat were 4.499 and 3.365, which indicated that both of them were risk factors for T2DM in Shenyang city.There was significant association between vegetables and T2DM, the OR values were 0.261 and 0.410 analyzed with univariate Logistic regression analysis and multiple Logistic regression analysis respectively, which indicated that it was a protective factor.Exercises regularly could energetically promote the metabolism of blood sugar and plasma lipids of T2DM patients. Exercises could also lighten hyperinsulinemia, heighten blood HDL– C level and have other beneficial effects. Our finding discovered that the frequency of physical exercises associated with T2DM significantly by univariate Logistic regression analysis and multiple Logistic regression analysis, OR value was 0.149 and 0.307 separately, it was a protective factor for T2DM.Conclusions1. Risk factors for T2DM in Shenyang city residents were: DM family history, more sweet food and fat intake, obesity, hypertension. Protection factors were: physical exercises and vegetables intake.2. The Risk of T2DM was significantly increased in people who belonged to the first degree relatives of T2DM patients in Shenyang city residents, the degree of heritability in first degree relatives of T2DM patients was (56.88%±8.34)%.3.We suggest take intervention study in Shenyang city to prevent T2DM. The interfered in factors were hypertension, obesity, unhealthful eating habits, physical exercises and vegetables intake, the population with DM family history should be placed emphasis on.
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