中国糖尿病流行特点研究 糖尿病和糖耐量低减患病率调查

为查明我国糖尿病流行情况,采用分层整群抽样方法,根据WHO诊断标准,对我国 11省(市 )居住 5年及 5年以上的社区人群进行了糖尿病患病率流行病学调查。研究对象包括 20至74岁居民共42751人。结果显示,糖尿病(DM)标化患病率为 3.21% (95%CI为 3.05%～ 3.37%),糖耐量低减 (IGT)标化患病率为 4.76% (95%CI为 4.56%～4.96%),DM与IGT之比为 1∶1.5,患病率随年龄增大而上升,40岁以下人群DM患病率为 1.01%、IGT患病率为 2.70 %,50岁年龄组DM和IGT的患病率均达到7%以上,60岁年龄组的DM和IGT患病率均超过11%。     

正常血压人群中糖耐量水平与A型性格的关系

目的研究糖耐量水平与A型性格之间的潜在联系。方法在85例年龄35～76岁正常血压的受试者中实施A型性格的问卷调查及75g口服葡萄糖耐量试验（OGTT）。根据血糖检测结果将受试者分为新诊断糖尿病组、糖耐量受损组及正常糖耐量组。A型性格测试采用1985年由“全国心身医学协作研究组”开发的A型行为问卷（TABQ）。结果新诊断糖尿病组、糖耐量受损组、正常糖耐量组A型性格的构成比分别为50％、36．7％和22．2％,新诊断糖尿病组A型性格的构成比在三组中最高。应用多元线性回归,对年龄、性别及收缩压等潜在混杂因素进行调整后,校正系数1．4,表明具有A型性格的受试者2h餐后血糖较非A型性格受试者显著高1．4mmol／L（P=0．025）。结论A型性格人群有可能具有较高的餐后血糖水平以及较差的糖耐量状况。     

Prevalence of diabetes mellitus and impaired glucose tolerance in the middle-aged population of three areas in Finland.

The prevalence of diabetes mellitus and impaired glucose tolerance (IGT) was determined in a random sample of the population aged 45-64 years in three areas of Finland. The two-hour oral glucose tolerance test was repeated in subjects whose first test suggested abnormal glucose tolerance. In the final classification, based on the results of the two tests, the age-standardized prevalence of diabetes, according to the WHO criteria was 5.7% (95% confidence interval (CI): 4.3-7.1) in men and 4.6% (95% CI: 3.6-5.0) in women. The prevalence of IGT was 3.1% (95% CI: 2.1-4.1) in men and 5.1% (95% CI: 3.9-6.3) in women. Among those aged 55-64 years the prevalence was 6.9% in men and 7.5% in women. The prevalence of diabetes and IGT were not different between the three areas. The age-specific mean values of fasting and two-hour blood concentrations and the 90th percentiles of the blood glucose distributions were also not different between the areas. The prevalence of IGT and diabetes increased with age more steeply among women than men. The median of fasting blood glucose did not change, but the 90th percentile increased with increasing age. The entire distribution of two-hour blood glucose shifted towards higher values with ageing, but the major increase was seen for the 95th percentile. The majority of the diabetic subjects were aware of their condition. The awareness was better among men than women.     

Changes in glucose tolerance during three years'' follow-up in an elderly population

The aim of this study was to describe changes in glucose tolerance over 3 y and to establish the prevalence of diabetes and impaired glucose tolerance in an unselected non-institutionalised elderly population aged 70 y or over at the beginning of the study. Diabetes was assessed on the basis of self-reports and 2 h oral glucose tolerance tests which were classified according to the 1985 WHO criteria.At the end of the follow-up period, 15% (n=14) of the men were diagnosed as having previously diagnosed diabetes, 8% (n=7) as having previously undiagnosed diabetes, 36% (n=33) as having IGT and the remaining 41% (n=38) as having normal glucose tolerance. The corresponding figures for the women were: 22% (n=37), 8% (n=13), 37% (n=61) and 34% (n=56), respectively.More than one third of the people with baseline normal glucose tolerance (NGT) had progressed to impaired glucose tolerance (IGT) or diabetes mellitus (DM) (n=44). Almost one third of those with baseline IGT had reverted to NGT (n=24), half had persisting IGT (n=41) and one fifth had progressed to DM (n=14). Almost one fifth of the subjects with baseline DM had reverted to IGT (n=12), and only one had reverted to NGT.In conclusion, a comparatively high proportion of both previously diagnosed diabetes, previously undiagnosed diabetes and IGT were found in the follow-up examinations of this elderly study population. The rate of deterioration of glucose tolerance during 3 y follow-up was also moderately high among these elderly subjects.     

肥胖及高血压与中老年人糖尿病患病率的关系

「目的」探讨肥胖、高血压与中、老年人糖尿病患病率的关系。「方法」采用问卷和体检的方法对遵义市４０岁及以上年龄的２２３４名居民进行流行病学调查。「结果」超重和肥胖组的糖尿病和糖耐量低减患病率高于正常体重和低体重组;肥胖体型组ＤＭ和ＩＧＴ患病率分别为８．８６％和９．３６％,均高于正常体型组;糖尿病和糖耐量低减患者的收缩压和舒张压也明显高于对照组（Ｐ均〈０．００１）。「结论」肥胖（尤其腹部型肥胖）、高血压对中、老年人糖尿病和糖耐量低减患者病率有影响。     

老年人群糖尿病和IGT患病率及其影响因素

目的：了解重庆市老年人群糖尿病（DM）和糖耐量低减（IGT）的患病情况及其主要患病风险因素，为城市社区人群制定适宜的预防和干预措施提供科学依据。方法：采用整群分层抽样方法，对60岁以上1791例自然人群进行了横断面调查。结果：DM患病率14．45％，IGT患病率21．70％，随着年龄增加，DM和IGT患病率亦逐渐升高。超重者（BMI≥25）DM和IGT患病率为17．51％和28．02％，肥胖者（BMI≥30）DM和IGT患病率为21．43％和37．14％，按腰臀比（WHR）划分，向心性肥胖者DM和IGT患病率为17．45％和25．09％。影响DM患病风险的因素主要有：DM家族史、BMI、wHR、高收缩压、高甘油三酯。结论：在社区人群中，倡导健康合理的膳食习惯、控制血压、体重是降低糖尿病发生的重要措施，老年人是DM防治工作的主要对象。     

不同年龄和体重的多囊卵巢综合征患者糖耐量异常的研究

目的:研究不同年龄阶段和不同体重指数的PCOS患者糖耐量异常的发生率,探讨糖代谢异常与年龄、体重的关系。方法:495例PCOS患者,口服75 g葡萄糖,行糖耐量及胰岛素释放实验。用卡方检验及偏相关分析方法比较不同年龄与体重的PCOS患者糖耐量的差异。结果:495例患者中糖尿病发生率为4.0%(20例),糖耐量低减的发生率为16.6%(82例);根据胰岛素敏感性指数分析,胰岛素敏感性高者275例,占55.6%,胰岛素敏感性低者220例,占44.4%;偏相关分析发现,不同年龄段的PCOS患者糖尿病和糖耐量低减的发生率不同,两者呈正相关,r=0.172,有统计学差异(P=0.000),不同年龄患者的胰岛素敏感性相比,无显著性差异;不同体重指数的PCOS患者糖尿病发生率和糖耐量低减的发生率不同,两者呈正相关,r=0.318,有统计学差异(P=0.000),胰岛素敏感性相比,两者呈负相关,r=-0.434,有显著性差异(P=0.000)。结论:PCOS患者随着年龄和体重的增加,糖耐量异常的发生率增加;肥胖患者的胰岛素抵抗更严重。     

Prevalence of type 2 diabetes and obesity in rural Mapuche population from Chile

The aim of this study was to estimate the prevalence of Type 2 diabetes, impaired glucose tolerance (IGT), and obesity in the Mapuche natives from rural areas in Chile. This cross-sectional study involved men (n = 95) and women (n = 224) older than 20 y from an aboriginal ethnic group (Mapuches), residing in rural communities from the south of Chile. Prevalence of Type 2 diabetes and IGT was calculated according to the World Health Organization criteria. Data on age, degree of ancestral purity, obesity, and hypertension were also obtained. The prevalence of Type 2 diabetes in rural Mapuche natives was estimated as 3.2% (95% CI: 0.7--9.0) in men and 4.5% (95% CI: 2.2--8.1) in women. The overall prevalence of obesity was 56.1% (95% CI: 50.5--61.6): 40.0% (95% CI: 30.1--40.8) in men and 62.9% (95% CI: 56.3--69.3) in women (P value < 0.001). These data suggest that the prevalence of obesity and Type 2 diabetes has been increasing during recent years in the Mapuche communities. The prevalence estimated in this study is higher than that reported 15 y ago. This suggests an important role of lifestyle changes as a possible explanation for epidemiologic transition.     

上海市金山区35岁以上居民糖调节受损 和糖尿病流行现状

摘要:目的　初步了解金山区35岁以上居民糖调节受损和糖尿病流行特点,为评估金山区糖尿病流行趋势并采取积极的防治措施提供依据。方法　采用多阶段随机整群抽样的方法,对金山区35岁以上居民进行横断面的调查。结果　35岁以上居民糖尿病（DM）、糖调节受损（IGR）、糖耐量减低（IGT）和空腹血糖受损（IFG）患病率分别为17.84%（512/2870）、21.57%（619/2870）、16.34%（469/2870）和5.23%（150/2870）（标化率16.69%、21.25%、16.29%和4.96%）。高血压人群中DM患病率为27.58%（275/997）,IGR患病率为24.67%（246/997）,明显高于血压正常人群［分别为12.65%（237/1873）和19.91%（373/1873）］。男性DM和IGR患病率分别为20.42%（255/1249）和20.34%（254/1249）,女性DM和IGR患病率分别为15.85%（257/1621）和22.52%（365/1621）,DM患病率男性高于女性,差异有统计学意义（P＜0.01）,IGR患病率男女之间差异无统计学意义（P＝0.159）。新诊断DM比例为56.45%。结论　金山区糖尿病患病率处在较高水平,仅不到一半的糖尿病患者知道自己患病,有效的预防和及时发现糖尿病患者应作为今后糖尿病防治工作的重要内容。     

泸天化(集团)公司员工糖尿病的现况调查

目的：了解化工行业人群糖尿病的患病率及其分布特征。方法：采用WHO（1985）诊断标准和美国糖尿病协会1997年公布的糖尿病诊断标准，对泸天化（公司20岁以上的全体人员6387人，进行问卷调查、体格检查及血液生化指标测定，计算患病率并进行统计分析。结果：糖尿病（DM）、糖耐量减低（IGT）、空腹血糖不良（IFG）的患病率分别为3．33％、3．91％、0．31％，标化患病率分别为3．39％、3．74％、0．25％（用1990年全国人口统计数据标化）。DM、IGT的标化患病率女性高于男性；DM、IGT、IFG患病率随年龄的增大、文化程度的降低而升高；餐饮服务人员、行政干部的DM、IGT和IFG患病率与职业有关；DM、IGT和IFG人群的血压、体重指数、腰臀围比值等均值都显著高于正常人群。结论：泸天化（集团）公司员工DM的患病率高于全国平均水平。     

机关工作人员高血压、糖尿病及高脂血症患病情况分析

目的了解机关工作人员高血压、糖尿病和高脂血症现患情况。方法对1462名体检人员的一般资料及血压、血糖和血脂等资料进行分析。结果①高血压现患率为21.8%,新诊断者占31.6%,过去确诊的高血压患者63.4%血压控制不达标;②糖尿病现患率为9.4%,空腹血糖受损和/或糖耐量减低现患率为12.5%,48.9%的糖尿病患者为首次确诊,过去确诊的糖尿病患者78.6%血糖控制不满意;③高脂血症现患率为41.5%,单纯高甘油三酯血症和单纯高胆固醇血症分别是16.6%和12.9%。高血压、糖尿病和高脂血症现患率基本上呈随龄递增趋势;体重指数(BMI)愈大,高血压、糖尿病和高脂血症患病率愈高。结论高血压、糖尿病和高脂血症是影响本组人群健康的常见病,年龄增大和体重增加是高血压、糖尿病和高脂血症的重要危险因素。     

Persistent impaired glucose tolerance, insulin resistance, and beta-cell dysfunction were independent predictors of type 2 diabetes

BACKGROUND AND OBJECTIVE: To compare clinical profiles and risk of diabetes between subjects with transient (trIGT) and persistent (pIGT) impaired glucose tolerance in Taiwan. STUDY DESIGN AND SETTING: In the pIGT group, IGT was diagnosed in two consecutive periods (1992-1994 and 1995-1996); in the trIGT group, the diagnosis was IGT at the baseline but normal glucose tolerance in the second period. The normal group was defined by fasting plasma glucose < 6.1 mmol/L and 2-hour post-load plasma glucose < 7.8 mmol/L in both periods. All three groups were considered eligible subjects for further follow up (1998-1999). RESULTS: Among 298 nondiabetic subjects at baseline, there were 29 new cases of diabetes diagnosed according to 1999 WHO criteria in 1,614.3 person-years of follow-up (1.79%/year; 95% CI = 1.14-2.44%/year). Among subjects with normal, trIGT, or pIGT, the incidence rates were 0.73%/year (8/1,093.0; 95% CI = 0.22-1.24%/year), 2.57%/year (7/272.2; 95% CI = 0.67-4.47%/year), and 5.62%/year (14/249.1; 95% CI = 2.68-8.56%/year), respectively. CONCLUSION: The group with trIGT had abnormal glucose tolerance and beta-cell dysfunction, which may represent an earlier stage than the group with pIGT in development of type 2 diabetes. Moreover, pIGT, insulin resistance, and beta-cell dysfunction played independent roles in the deterioration from IGT to diabetes.     

Energetic determinants of glucose tolerance status in Jamaican adults

As type 2 diabetes mellitus (DM2), obesity and sedentary lifestyles are increasing in developing countries, this observational study investigated the role of physical activity on DM2 in Jamaica. Anthropometry, body composition (by bioelectrical impedance analysis) and glucose tolerance status was assessed in 722 adults in 1993 and 1997. Energy expenditure was estimated in a subset using measured resting energy expenditure in combination with self-reported activity recalls. The rates of impaired glucose tolerance (IGT) were 23.7 and 27.3%, and DM2 were 16.3 and 23.7% among men and women, respectively. After adjusting for body composition, a one-unit increase in physical activity significantly reduced the odds of having diabetes (OR = 0.05; 95% CI: 0.004, 0.66), but not IGT. Hence, decreased physical activity is a significant independent contributor to the high rates of glucose intolerance in Jamaica. Efforts must be directed at minimizing obesity and increasing physical activity in developing countries.     

包头地区电力系统职工糖尿病流行病学调查

为了解包头地区电力系统糖尿病患病情况，按照ＷＨＯ规定的标准，于１９９６年８月至１９９７年８月对包头市电力系统１０８６７名职工进行了糖尿病的流行病学调查，结果发现糖尿病（ＤＭ）和糖耐量低减（ＩＧＴ）标化患病率分别为３．１５％和２．８３％；ＤＭ和ＩＧＴ患病率均随年龄和标准体重百分比的增加而增高（Ｐ均〈０．０１），ＤＭ和ＩＧＴ组的收缩压、舒张压及血浆总胆固醇明显高于对照组（Ｐ均〈０．０１），这种情况可能     

郑州市中老年糖尿病和糖耐量减低的流行病学调查

郑州市中老年糖尿病流行病学抽样调查结果显示：糖尿病（ＤＭ）和糖耐量减低（ＩＧＴ）患病率分别为６２８％和１３０８％,而且随年龄增大而升高;女性ＤＭ和ＩＧＴ患病率均高于男性;肥胖、体力劳动减少、高血压均与ＤＭ和ＩＧＴ患病率增高密切相关;ＤＭ家族史是ＤＭ的重要危险因素;婚姻状况亦对ＤＭ和ＩＧＴ患病率有影响。     

Mortality among individuals diagnosed with glucose intolerance by the 75 g oral glucose tolerance test in rural Japanese communities

OBJECTIVE: To examine mortality among individuals confirmed to have glucose intolerance by the 75 g oral glucose tolerance test (OGTT) in rural communities. METHODS: Subjects were 1,639 residents of seven rural communities in Japan (total population size = 54,000) who underwent an OGTT as a secondary screening test for diabetes during 1987-95 and had received no medication for diabetes at baseline. OGTT results were classified as diabetes (n = 471), impaired glucose tolerance (IGT) (n = 408), or normal glucose tolerance (NGT) (n = 760), according to the recommendations of the American Diabetes Association. Indirect age-adjusted mortality rates and standardized mortality ratios (SMRs) for diabetes and IGT groups were calculated using age-stratified mortality rates for people aged 40-89 in the communities as the standard population. Relative risks of death and 95% confidence intervals (CI) for diabetes and IGT were calculated using Cox's proportional models, adjusted for age and baseline factors such as body mass index (BMI), total cholesterol, hypertension, smoking, alcohol drinking, history of diabetes, and family history of diabetes. RESULTS: During 9.4 years of follow-up, we recorded 70 deaths for the NGT, 46 for the IGT, and 71 for the diabetes group. The SMRs for IGT and diabetic men and women were not significantly increased in comparison with the standard population values. However, when analyzed in our cohort, age-adjusted relative risks of death for IGT and diabetes versus NGT men were 1.10 (9.5% CI: 0.72-1.67) and 1.54 (95% CI: 1.05-2.24), respectively, whereas, the risks among women did not significantly vary. Finally, multivariate analysis, further adjusted for the baseline factors, indicated the relative risk of mortality with diabetes in men to be significantly increased (relative risk = 1.74, 95% CI: 1.11-2.75). CONCLUSION: During follow-up, mortality rates among screened IGT and diabetes were not significantly higher than those in general. Nonetheless, we found that diabetes elevated the risk of death in our cohort, primarily in men.     

蚌埠市社区绿地暴露与成年居民糖尿病患病率的关系: BMI的中介作用

  目的  了解蚌埠市龙子湖区社区绿地暴露与糖尿病(diabetes mellitus, DM)患病率的相关性,并探讨BMI在社区绿地暴露与DM之间的中介效应。  方法  2015年8月,采用分层随机抽样,调查蚌埠市龙子湖区成年居民3 354人。居民基本信息以问卷形式收集,社区绿地暴露用归一化植被指数(normalized difference vegetation index,NDVI)和土壤调整植被指数(soil adjusted vegetation index,SAVI)1 000 m缓冲区的值表示。用二分类Logistic回归分析探究社区绿地暴露与DM的相关性,并评估BMI的中介效应。  结果  NDVI-1 000 m (χ2=36.39, P < 0.001)与SAVI-1 000 m(χ2=20.14, P < 0.001)不同组之间患病率均存在统计学差异。调整模型下,NDVI-1 000 m和SAVI-1 000 m Q3组患病率分别是Q1组的0.538倍(OR=0.538,95% CI: 0.388~0.745)和0.605倍(OR=0.605,95% CI: 0.440~0.833)。BMI在NDVI-1 000 m和SAVI-1 000 m与DM的关联分别存在6.42%(95% CI: 1.83%~16.00%)和7.43%(95% CI: 2.36%~19.00%)的中介效应。  结论  社区绿地暴露越高,DM患病率越低。BMI在社区绿地暴露与DM之间有中介效应。     

Metabolic syndrome among Caribbean-born persons living in the U.S. Virgin Islands.

OBJECTIVES: To determine the frequency of the metabolic syndrome (MS) among four subpopulations in the United States Virgin Islands and to estimate the risk for the MS that is associated with waist circumference cutpoints among overweight and obese individuals. METHODS: In a study undertaken from 1995 to 1999, data on demographic characteristics, anthropometric measurements, blood pressure measurements, and a blood sample were obtained from a population-based cohort of 893 Caribbean-born persons from four population subgroups who were living on Saint Croix (the largest island of the U.S. Virgin Islands) and who did not have a history of diagnosed diabetes. The four subpopulations were: (1) Hispanic white, (2) Hispanic black, (3) non-Hispanic black born in the U.S. Virgin Islands, and (4) non-Hispanic black born elsewhere in the Caribbean. Fasting blood samples were analyzed for glucose, insulin, triglycerides, and high-density lipoprotein cholesterol (HDL-C). National Cholesterol Education Program Adult Treatment Panel III guidelines were used to identify the MS. Insulin resistance was estimated by the homeostasis model assessment (HOMA-IR) method. RESULTS: The overall prevalence of the MS in the sample was 20.5% (95% confidence interval (CI) = 15.3%-25.7%). Persons who had classified themselves as both Hispanic and black had the highest frequency (27.8% (95% CI = 16.3%-39.3%)) of the MS and the highest HOMA-IR scores. After controlling for lifestyle factors and HOMA-IR, Hispanic ethnicity was independently associated with an increased risk of having the MS (odds ratio (OR) = 1.82, (95% CI = 1.07-3.07)), high triglycerides (OR = 3.66 (95% CI = 2.18-6.15)), and low HDL-C (OR = 1.60 (95% CI = 1.04-2.45)). A waist circumference of > 88 cm was associated with an increased risk of metabolic abnormalities among overweight and obese women. CONCLUSIONS: The frequency of the MS among Caribbean-born persons in the U. S. Virgin Islands is comparable to the frequency of the MS among the general population on the mainland of the United States. Among Caribbean-born persons living in the U.S. Virgin Islands, those who are Hispanic blacks may have a greater risk of cardiovascular disease than do other groups.     

江苏省社区人群糖尿病流行特征的研究

采用分层整群抽样在江苏省抽取城乡８层样本进行调查。结果显示,江苏省２０岁以上社区人群糖尿病（ＤＭ）、糖耐量低减（ＩＧＴ）患病率为５８２％、５８７％,按１９８２年全国人口年龄构成标化患病率为４６３％、５０７％,并随年龄、体质指数增大而增高,随体力活动强度增加而降低,ＤＭ家族史阳性者高于阴性者,城镇高于乡村,女性高于男性。     

包头钢铁公司职工糖尿病流行病学调查

目的 了解包头钢铁公司(包钢)职工糖尿病(DM)的患病率及其影响因素并进行有效的干预。方法 调查时间：1999年7月至2000年2月。调查对象为包钢主体单位20岁以上的工人和干部,受检人数占各单位20岁以上人数的90％。诊断标准采用美国糖尿病协会制定的标准(1997年)。结果 20221人中共检出DM600例,糖耐量低减(IGT)635例,空腹血糖受损(IFG)425例,标化后的患病率分别为3．22％、3．48％和2．09％,且随年龄、体重指数和腰臀比的增加而增高。新诊断的糖尿病病例占56．30％。肥胖、糖尿病家族史、女性有巨大胎儿史、脑力劳动及低文化程度者糖尿病的患病率明显增高。高温作业者与非高温作业者DM、IGT及IFG的患病率未见明显差异。结论 增龄、肥胖、糖尿病家族史、女性有巨大胎儿史、脑力劳动及低文化程度是易患糖尿病的高危因素,高温作业对糖尿病的患病率未见明显影响。