空腹血糖受损新标准对台州农村居民糖调节受损检出率的影响

目的分析空腹血糖受损(IFG)的空腹血糖(FPG)诊断标准下调对糖调节受损(IGR)人群检出率的影响,并探讨区分糖调节正常与受损的FPG理想截定点以及诊断糖尿病(DM)的FPG理想切点。方法3219例台州农村人群分层整群随机抽样调查,空腹测毛细血管血糖,若≥5.6mmol/L做OGTT检查。结果空腹血糖受损(IFG)患病率按新诊断切点5.6mmol/L为10.15%,按原切点6.1mmol/L为1.24%;空腹血糖受损合并糖耐量受损(IGT)患病率按新诊断切点5.6mmol/L为6.14%,按原切点6.1mmol/L为3.26%。结论IFG诊断标准下调后,IFG、IFG IGT检出率明显增加;非T2DM人群中诊断IGR的FPG理想截定点为5.7mmol/L,DM的最佳FPG切点为6.6mmol/L。     

空腹血糖受损人群人体成分特点及意义

1997年美国糖尿病协会（ADA）提出空腹血糖受损（Impaired fasting glycaemia,IFG）概念后引起人们的普遍关注。而2003年底,ADA更是将IFG诊断标准下限值由6．1mmoL／L下调到5．6mmol／L,提高了空腹血糖（FPG）预测糖尿病的价值。     

OGTT1h高血糖对糖尿病转归的预报作用研究

1997年，美国ADA发表了新的糖尿病诊断标准。主要是针对空腹血糖的标准做了修改，餐后2h血糖标准不变，并提出空腹血糖受损（IFG）的概念。然而。无论是1985年WHO或1997年美国ADA的糖尿病诊断标准，对OGTT1h血糖均未作出严格规定。另一方面，从OGTT曲线来分析，血糖高峰落在1小时。无论正常人或糖尿病患者均是如此，理论上OGTT1h血糖反映糖耐量受损的状态应更加灵敏，可能适用于糖尿病高危人群的筛查。鉴于此，本研究分析餐后高血糖患者各OGTT血糖指标对5年后糖尿病转归的预报作用，报道如下。     

农村居民糖尿病及糖调节受损特征分析

目的 分析山东省中西部农村25岁～居民糖尿病及糖调节受损的流行特征.方法 采用多阶段分层随机抽样方法,共调查16 388人,开展同卷调查并测量身高、体重、腰围、血压和空腹血糖.空腹血糖在6.1～7.0mmol/L者再进行口服葡萄糖耐量(OGTT)试验.根据WHO 1999年糖尿病诊断标准将调查人群分为正常人、孤立性空腹血糖受损(I-IFG)、空腹血糖受损合并糖耐量受损(IFG/IGT)和糖尿病(DM).结果 该地区农村居民IFG标化患病率为6.85%,DM为3.38%,I-IFG为4.41%,IFG/IGT为0.83%,且患病率均随年龄、腰围、身高、体质指数(BMI)的增加而升高.年龄＞35岁,I-IFG、IFG/IGT和年龄＞45岁DM患病率升高明显.男性腰围≥85 cm、女性腰围≥80 cm.IFG/IGT和DM患病率升高明显.BMI≥24,I-IFG、IFG/IGT和DM患病率升高明显.调查对象的年龄、腰围、BMI、腰臀比、收缩压和舒张压按正常人→I-IFG→IFG/IGT、DM顺序逐渐升高,但IFG/IGT和DM两者问变化无差异.结论 山东省中西部农村居民I-IFG、IFG/IGT和DM的流行特征基本相同.糖尿病及糖调节受损发病较高,应重视和加强宣传和早期预防控制工作.     

某高校教职工体检糖尿病及空腹血糖受损检出情况

目的了解高校教职工人群糖尿病(DM)和空腹血糖受损(IFG)患病情况,探讨其相关危险因素。方法对某高校1 507名教职工体检资料进行流行病学分析。结果该校教职工人群DM和IFG的检出率分别为4.8%和3.0%,男性DM检出率(7.5%)高于女性(2.9%);DM和IFG的检出率随年龄、BMI、TG、LDL、SBP和DBP水平的升高而增高(P值均0.05);低HDL组和中HDL组DM检出率均为5.3%,高于高HDL组0.7%(P=0.023)。多因素logistic回归分析表明,年龄、BMI、HDL和SBP是DM的独立危险因素,IFG的独立危险因素是年龄、BMI、TG、LDL和SBP。结论该高校教职工糖尿病和空腹血糖受损患病率低,年龄、肥胖、血脂紊乱和高血压与糖尿病和空腹血糖受损密切相关。     

深圳市部分公务员糖代谢异常及相关疾病流行病学研究

目的 了解深圳市部分公务员糖尿病(DM)、空腹血糖异常并葡萄糖耐量减低(IFG IGT)的患病率．探讨其与性别、年龄、血压、血脂、体重等的关系。方法 对2002年6月在本院进行健康体检的2847名公务员进行DM、IFG IGT流行病学调查。结果 1)DM患病率4％．其中男4．9％，女3．0％，IFG IGT患病率为2．4％．其中男3．7％．女1．0％。2)DM、IFG IGT患病率随年龄增加而增长，尤以50岁以后增加显著。3)超重和肥胖、高血压、家族史阳性者DM、IFG IGT患病率较正常人群增高。4)DM、IFG IGT患者高血脂、高尿酸血症、脂肪肝及冠心病患病率较正常血糖组高。结论 深圳市部分公务员DM患病率高于1996年全国普查水平。与人口老龄化、肥胖、高血压以及遗传因素有关，公务员中男性患病率增高．应受到重视。DM、IFG IGT患者易并发高血压、冠心病、脂代谢紊乱及尿酸异常．在防治DM、IFG IGT的同时注意积极治疗并发症及合并症。     

上海市南翔农村地区老年居民糖尿病状况及相关危险因素分析

[目的]调查和了解上海市南翔农村地区老年居民糖代谢异常状况及其相关危险因素. [方法]采用整体筛查方法对4 443名老年人测空腹静脉血糖,对于FBG≥6.0 mmol/L人群行OGTT,并进行问卷调查,调查和了解糖尿病(DM)、血糖调节受损(IGR)的患病率,并对其相关危险因素如高血压、饮食、肥胖、DM家族史、体力活动状况等进行分析. [结果]糖尿病患病率8.39%,空腹血糖受损(IFG)患病率5.49%,糖耐量受损(IGT)患病率5.85%,IGR(IFG IGT)患病率9.27%,高血压及肥胖是糖代谢异常的重要危险因素,其他危险园素有喜甜食、缺乏体力活动、性别、有DM家族史等,而与饮酒和吸烟无显著相关. [结论]上海市南翔农村地区老年人群DM和IGR患病率较高,多种危险因素参与糖代谢异常的发生、发展.     

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。     

机关人员糖尿病流行病学调查

目的　了解机关人员糖尿病患病及有关影响因素。　方法　对 2 2～ 76岁的机关人员 35 39人进行流行病学调查 ,采用己糖激酶法测定血糖 ,按 1997年美国糖尿病协会 (ADA)诊断标准判定。　结果　糖尿病 (DM)患病率为5 .6 2 % ,糖耐量减低 (IGT)患病率为 5 .96 %。DM、IGT患病率随年龄增长呈上升趋势。肥胖、有 DM家族史人群 DM和IGT患病率明显增高 ,DM和 IGT人群多伴有血脂增高。　结论　糖尿病是目前机关人员的主要流行疾病 ,家庭史、高龄、肥胖及高血脂是糖尿病的危险因素。     

上海市泗泾地区>40岁非糖尿病人群3年转归及相关因素分析

目的探讨>40岁非糖尿病人群3年进展为糖尿病的发生率及其影响因素,为糖尿病的筛查及早期防治提供科学依据。方法采用队列研究,以2013年上海市泗泾地区体检中非糖尿病居民为观察对象,将其分为正常糖耐量(NGT)组和糖调节受损(IGT)组,观察其糖代谢异常的自然转归,以是否转归为糖尿病为因变量,年龄、BMI和生化指标为自变量,进行相关分析与logistic回归分析。结果共随访5 212人3年,非糖尿病人群2型糖尿病(T2DM)累积发病率为10.86%,NGT组为5.26%,IGR组为19.83%;3年累积发病率比较:空腹血糖受损(IFG)组、IGT组和IFG+IGT组均高于NGT组,IFG+IGT组高于IFG组和IGT组,差异均有统计学意义(P值均<0.05)。年龄、糖代谢异常、高胆固醇、肥胖、高血压对糖尿病发生、进展均有影响,其中糖代谢异常是最重要的危险因素;胰岛素抵抗人群相关回归分析表明,空腹胰岛素、空腹血糖、BMI水平与胰岛素抵抗指数及分泌指数最为相关。结论泗泾地区>40岁人群3年糖尿病累积发病率为10.86%,糖尿病发病风险与年龄、糖代谢异常、高胆固醇、肥胖、高血压水平显著相关;与胰岛素抵抗与分泌关系最相关的因素是空腹胰岛素、空腹血糖、肥胖及甘油三酯水平。应控制血糖、血脂的水平,提高胰岛素敏感性,延缓胰岛素抵抗的发生。     

Type 2 diabetes and impaired fasting glucose in American Indians aged 5-40 years: the Cherokee diabetes study

PURPOSE: To estimate the prevalence of type 2 diabetes and impaired fasting glucose (IFG) and to study several potential risk factors for type 2 diabetes among Oklahoma Cherokees aged 5 to 40 years. METHODS: A random sample of 2205 members of the Cherokee Nation of Oklahoma aged 5 to 40 years was recruited. Demographic, clinical, and laboratory data were collected. Type 2 diabetes and IFG were determined using the 1997 American Diabetes Association (ADA) criteria. Relationships between type 2 diabetes and potential risk factors were examined by univariate and multivariate regression methods. RESULTS: According to ADA criteria, the age-adjusted prevalence proportions of type 2 diabetes were 4.3% in females and 4.8% in males. Among the 89 individuals who had type 2 diabetes, 31 were newly diagnosed. Thirty-two (1.5%, 18 females and 14 males) were found to have IFG. The prevalence of type 2 diabetes and IFG increased with age, number of parents with diabetes, obesity, degree of Indian heritage, high triglyceride value, and low HDL cholesterol. CONCLUSIONS: The increasing prevalence of type 2 diabetes in young American Indians is alarming. The findings must be disseminated to the Indian communities and their health care providers. Preventive measures and early detection programs must be designed and implemented for children and adolescents in this population.     

Prevalence and clinical implications of American Diabetes Association-defined diabetes and other categories of glucose dysregulation in older adults: the health, aging and body composition study

Using data on history of diabetes, fasting glucose (FG) and the oral glucose tolerance test (OGTT), the authors contrasted cardiovascular disease (CVD) risk factors (body mass index, blood pressure, lipids and glycated hemoglobin) in 3052 African-American and White adults aged 70-79 in mutually exclusive categories of diagnosed diabetes, undiagnosed diabetes defined by the American Diabetes Association (ADA), isolated post-challenge hyperglycemia (IPH; FG < 126 mg/dL and 2 h post-OGTT > or = 200 mg/dL), impaired fasting glucose (IFG; FG > or = 110 but < 126 mg/dL), and individuals who were non-diabetic by both ADA and World Health Organization (WHO) criteria (FG < 126 mg/dL and 2 h post-challenge glucose < 200 mg/dL). The prevalence of diagnosed diabetes, undiagnosed ADA diabetes and IPH were 15.2, 3.8 and 4.7%, respectively, with more diagnosed and undiagnosed ADA diabetes in African-Americans than Whites. Compared to mean glycated hemoglobin (HbA(1c)) among ADA/WHO non-diabetic individuals (6.0%), HbA(1c) was substantially higher in the diagnosed diabetes and undiagnosed ADA diabetes groups (8.0% and 7.7%), but not in the IPH group (6.3%). The diagnosed and undiagnosed ADA diabetic groups had worse CVD risk factor profiles than the ADA/WHO non-diabetic group. IPH subjects had elevated levels of some CVD risk factors, but differences were more modest than those for the diabetic groups. Among people with IPH, those who also had IFG had worse CVD profiles than those with IPH alone. Although the OGTT may identify additional adults with more CVD risk factors than normals, these differences appear to be clustered among those who also have IFG.     

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。     

Hyperglycemia as a risk factor of mortality in a middle-aged Finnish population

In 1990-1992, a population-based study was carried out in the city of Oulu in northern Finland, to assess the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in a middle-aged population. We report the mortality of the study population until 31 December 1998. Altogether 831 subjects (82%) (369 men) participated in the baseline examinations, in which the prognostic risk factors were determined. Special attention was given to the effect of hyperglycemia on mortality. The WHO 1985, ADA 1997 and WHO 1999 criteria for diabetes, IGT and impaired fasting glucose (IFG) were used. Forty-one subjects (32 men) died during the average follow-up of 6.7 years, and the mortality rate was hence 7.7/1000 person-years. The results suggest that both fasting and post-load hyperglycemia are important predictors of mortality. Estimated by the Cox proportional hazards regression, the unadjusted hazard ratio (HR) for death was 2.5 (95% CI 0.9-6.6) in the subjects classified as diabetic according to the WHO 1999 criteria compared to normoglycemic subjects. The corresponding HR of the subjects with IFG was 2.5 (95% CI 0.7-8.8) and that of the subjects with IGT 1.5 (0.6-3.7). In addition, a high mortality was predicted by smoking (HR 4.2, 95% CI 2.0-8.8), male gender (HR 3.5, 95% CI 1.6-7.9) and hypertension (HR 2.3, 95% CI 1.1-5.1).     

The association between adherence to the Mediterranean diet and fasting indices of glucose homoeostasis: the ATTICA Study

OBJECTIVE: We investigated the association between adherence to Mediterranean diet and fasting indices of glucose homoeostasis, in a Greek adult population. METHODS: During 2001-2002 we randomly enrolled 1514 men and 1528 women (18-89 years old) without history of CVD, from the Attica area. Diabetes mellitus (type 2) and impaired fasting glucose (IFG) were defined according to the established ADA criteria. Insulin resistance was evaluated by HOMA-IR. Dietary habits were assessed through a validated food frequency questionnaire and a diet score (range 0-55) was developed (higher values means greater adherence to the Mediterranean diet). RESULTS: The overall prevalence of diabetes type 2 was 7.9% in men and 6.0% in women (P = 0.05). Mean diet score was 26.3 +/- 6.8 in normoglycemic, 25.7 +/- 6.4 in IFG and 22.2 +/- 5.8 in diabetic subjects (p < 0.001). In normoglycemic subjects who were in the upper tertile of the diet score we observed 7% lower glucose (p < 0.05), 5% lower insulin (p < 0.05) and 15% lower HOMA-IR (p < 0.01) levels compared to subjects in the lower tertile of the diet score. Additionally, in diabetic/IFG participants who where in the upper tertile of the diet score we observed 15% lower glucose (p < 0.05), 15% lower insulin (p < 0.05) and 27% lower HOMA-IR (p < 0.01) levels compared to those in the lower tertile. However, multiple regression analysis, adjusted for age, sex, BMI, waist-to-hip ratio, physical activity, smoking status, and presence of hypertension and hypercholesterolemia, confirmed the previous associations in normoglycemic, but not in diabetic/IFG people. CONCLUSION: An inverse association was observed between adherence to Mediterranean diet and indices of glucose homeostasis, only in normoglycemic people.     

Peer Reviewed: Prevalence of Diabetes and Impaired Fasting Glucose in Chinese Adults,China National Nutrition and Health Survey, 2002

Introduction

As a result of rapid economic development in China, the lifestyles and dietary habits of its people have been changing, and the rates of obesity, diabetes, and other chronic conditions have increased substantially. We report the prevalence of type 2 diabetes and impaired fasting glucose (IFG) and the association between diabetes and overweight and obesity in Chinese adults. We also compare the results with those from the US National Health and Nutrition Examination Survey, 1999-2002.

Methods

Data were from adults aged 20 years or older who participated in the China National Nutrition and Health Survey, 2002 (n = 47,729). Diabetes and IFG were defined by the American Diabetes Association 2009 criteria. We assessed the prevalence of diabetes, IFG, and overweight and obesity by sex, age, region of residence, and ethnicity.

Results

The prevalence of diabetes and IFG in Chinese adults was 2.7% and 4.9%, respectively. The prevalence of diabetes increased with age and body mass index. Men and women had a similar prevalence of diabetes, but men had a significantly higher prevalence of IFG. The prevalence of diabetes among Chinese who lived in urban areas was 2 to 3 times higher than the prevalence among those who lived in rural areas (3.9% for urban areas and 6.1% for large cities vs 1.9% for rural areas), and the prevalence of IFG was 1.5 to 2 times higher (6.1% and 8.1% vs 4.2%, respectively). The prevalence of diabetes among Chinese women and young (20-39 y) and middle-aged (40-59 y) adults who lived in large cities was similar to the prevalence of diabetes in the US population.

Conclusion

The prevalence of diabetes and IFG was much higher in urban than rural areas, particularly in the large cities of China. Prevention must be emphasized among adults to reduce the future social and economic burden of diabetes in China.     

Prevalence of metabolic syndrome (MetS) in Chinese subjects gradually increased with impaired glucose homeostasis: a multicenter, clinical based, cross-sectional study

ABSTRACT: BACKGROUND: Metabolic Syndrome (MetS) is a high risk factor for Cardiovascular Diseases (CVD). We estimated to investigate how MetS prevalence by glucose homeostasis varies across different age and gender groups. METHODS: We studied 9257 Chinese subjects over the age of 15 years in two cross-sectional surveys in 2006. With oral glucose tolerance test (OGTT) test, 2341 subjects were normal glucose tolerance (NGT), and 5448 were diagnosed as having type 2 diabetes (T2D). All other 1468 subjects were considered to be impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) subjects. Diabetes was diagnosis by WHO99 criteria. We used modified NCEP-III criteria for the diagnosis of MetS. RESULTS: The prevalences of MetS in the male NGT, IFG/IGT and T2D groups were 25.9% (404/1559), 65.6% (769/1172), and 73.5% (2483/3376), respectively. The prevalences of MetS in the female NGT, IFG/IGT and T2D groups were 13.4% (105/782), 51.0% (151/296), and 75.4% (1563/2072), respectively. The prevalence of MetS in the male IFG/IGT group gradually decreased from 73.26% to 41.08% in subjects over the age of 30 years. The prevalence of MetS in the female IFG/IGT group gradually increased from 30% to 75% with aging. CONCLUSIONS: The prevalence of MetS in subjects with different glucose tolerances in China was high and gradually increased with impaired glucose homeostasis both in males and females.     

藏族居民2型糖尿病及空腹血糖受损情况调查

目的 了解西藏自治区拉萨市城镇藏族居民2型糖尿病和空腹血糖受损情况.方法 随机抽样调查30～70岁藏族居民370人.采用世界卫生组织诊断标准,判定2型糖尿病和空腹血糖受损情况,同时进行问卷调查及血糖、血脂的测量,计算体质指数和腰臀比.结果 拉萨市30～70岁城镇居民糖尿病患者率为7.6%.其中,男性为2.2%,女性为10.3%,差异有统计学意义,P=0.009.空腹血糖受损的患病率为13.5%.其中男性为11.0%,女性为15.0%,P=0.405.30～69岁人群年龄结构与世界人口年龄进行标化后,糖尿病的患病率为7.2%,其中男性为2.1%.女性为8.9%.结论 藏族居民2型糖尿病患病率与2002年的调查结果相比,有逐年增高趋势;女性糖尿病的患病率高于男性.空腹血糖受损人群患病率较高.     

中国儿童青少年血糖分布情况

了解中国儿童青少年空腹血糖水平的分布情况及其随年龄和性别变化趋势,为儿童青少年糖尿病的早期防控提供科学依据.方法 采用分层随机整群抽样方法,抽取7 个省市(湖南省、宁夏回族自治区、天津市、重庆市、辽宁省、上海市、广东省) 6~ 18 岁儿童青少年共16 745 名,进行空腹静脉血血糖测定.结果 中国7 省市6 ~ 18 岁儿童青少年空腹血糖平均值为(4.66±0.65) mmol /L,其中男生和女生的空腹血糖平均值分别为(4.73±0.66) 和(4.60±0.64) mmol /L,男生高于女生,差异有统计学意义(t = 12.88,P< 0.05); 儿童青少年空腹血糖异常检出率为1.71%(年龄标化检出率为 1.83%),男、女生空腹血糖异常检出率分别为2.40%和1.00%(年龄标化检出率分别为2.60%和1.00%),男生高于女生,差异有统计学意义(χ2 = 41.98,P<0.05).男生空腹血糖值和血糖异常检出率均高于同年龄段的女生.男、女生空腹血糖水平和空腹血糖异常检出率的变化趋势基本一致,均随年龄呈双峰或"M"态势.结论 中国儿童青少年空腹血糖水平和空腹血糖异常检出率在性别和年龄之间有差别,血糖异常检出率较高,需要引起进一步关注.