Objective To investigate the economic burden caused by diabetes and attributable to obesity in rural residents of Dayao County of Yunnan Province. Methods Using multi _ stage sampling method,we divided the 12 villages and towns of Dayao County into two groups according to their economic level,and selected one village from each group. Using proportion probability sampling method,we selected three administrative villages from each village,and randomly selected 420 rural residents from each administrative village,and a total of 2 520 residents were selected. In January 2015,we conducted surveys by a self _ designed questionnaire,and the survey content included the basic information of these rural residents and medical expense for diabetes. A total of 2 520 were distributed,and 2 479 effective questionnaires were collected,with an effective rate of 98. 4%. Investigators who had received strict training measured height,body weight,waistline and blood glucose of these rural residents,and their BMI was calculated. Two _ step model and human capital approach were used to calculate the economic burden caused by diabetes in combination with disability _ adjusted life year( DALY),and the economic burden caused by diabetic diseases attributable to obesity was calculated in combination with population attributable risk(PAR). Results Among 2 479 rural residents,there were 115(4. 6% )residents with systemic obesity,and there were 988 (39. 9% ) residents with central obesity. Among 2 479 rural residents,there were 150(6. 1% )diabetic patients;residents with different genders and ages were significantly different in the prevalence of diabetes( P < 0. 05). For the 150 diabetic patients,YLL, YLD and DALY were 1. 4 / 1 000 people,2. 0 / 1 000 people and 3. 4 / 1 000 people respectively. Logistic regression analysis showed that systemic obesity and central obesity were influencing factors for diabetes(P < 0. 05). The risk of diabetes in people with systemic obesity was 3. 54 times that of people without systemic obesity;the risk of diabetes in people with central obesity was 2. 44 times that of people without central obesity. PAR of systemic obesity and central obesity for diabetes was 10. 3% and 35. 8% respectively. The total economic burden caused by diabetes in Dayao County of Yunnan Province was 108. 5 million,and the economic burden caused by diseases attributable to systemic obesity and central obesity was 11. 2 million and 38. 8 million respectively. Conclusion The economic burden caused by diabetes is heavy,and obesity has marked influence on the economic burden caused by diabetes,thus corresponding measures should be taken to reduce the economic burden.%目的：了解云南省大姚县农村居民糖尿病及归因于肥胖的疾病经济负担。方法采用多阶段抽样方法，根据经济发展水平将云南省大姚县12个乡镇分为好和差两类，每类随机抽取1个乡；采用按比例概率抽样方法从每个乡中各抽取3个行政村；在每个行政村中各随机抽取420例农村居民，共抽取2520例。于2015年1月，采用自行设计的调查问卷进行调查，调查内容包括农村居民的基本情况、因糖尿病的医疗支出。发放问卷2520份，回收有效问卷2479份，有效回收率为98.4%。由经过严格培训的调查人员对农村居民进行身高、体质量、腰围、血糖的测量，并计算出体质指数（BMI）。采用二步模型法和人力资本法结合伤残调整生命年（DALY）估算糖尿病的疾病经济负担，并与归因危险度（PAR）相结合测算归因于肥胖的糖尿病疾病经济负担。结果2479例农村居民中，全身性肥胖者115例，患病率为4.6%；中心性肥胖者988例，患病率为39.9%。2479例农村居民中，糖尿病患者150例，患病率为6.1%；不同性别、年龄的农村居民的糖尿病患病率比较，差异均有统计学意义（P <0.05）。150例糖尿病患者的早死所致生命损失年（YLL）为1.4人年/1000人，伤残所致生命损失年（YLD）为2.0人年/1000人，DALY 为3.4人年/1000人。Logistic 回归分析结果显示，全身性肥胖、中心性肥胖是糖尿病患病的影响因素（P <0.05），全身性肥胖者患糖尿病的风险是非全身性肥胖者的3.54倍，中心性肥胖者患糖尿病的风险是非中心性肥胖者的2.44倍，全身性肥胖、中心性肥胖的糖尿病 PAR 分别为10.3%、35.8%。云南省大姚县糖尿病的总疾病经济负担为108.5百万元，其中归因于全身性肥胖、中心性肥胖的疾病经济负担分别为11.2百万元、38.8百万元。结论云南省大姚县农村居民的糖尿病疾病经济负担较重，肥胖对当地糖尿病的疾病经济负担造成了显著的影响，应采取相应措施降低其导致的疾病经济负担。
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