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1.
目的 探讨中国中老年人群和高个成年人的适宜腰围界值点及其对糖尿病患病危险的预测价值.方法 利用2002年中国居民营养与健康状况调查数据,分析≥45岁人群和身高在全人群第85百分位数(P85)以上成年人的腰围分布特征,分析不同的腰同界值点与体重指数(BMI:kg/m2)≥24的诊断一致性,采用多元logistic回归分析不同腰围水平的调查对象患糖尿病和空腹血糖受损的相对风险,并以ROC曲线最短距离确定上述人群的适宜腰围界值点.结果 中国中老年人腰围男性均值为80.8 cm,女性均值为79.4 cm;高个男性腰围均值为84.1 cm,女性为77.9 cm.中老年人腰围以男性85 cm、女性80 cm作为界值点,与BMI≥24的诊断一致性最好,预测糖尿病的ROC曲线距离最短.与腰围<85 cm组相比,85 cm~组、90 cm~组和95 cm~组的中老年男性患糖尿病[OR值分别为2.1(95%CI:1.6~2.8)、3.0(95%CI:2.3~4.0)和4.5(95%CI:3.4~5.8)]和空腹血糖受损[OR值分别为1.6(95%CI:1.2~2.2)、2.6(95%CI:1.9~3.5)和3.5(95%CI:2.6~4.6)]的相对风险明显增加.与腰围<80 cm组相比,80 cm~组、85 cm~组和90 cm~组中老年女性患糖尿病[OR值分别为1.9(95% CI:1.4-2.6)、3.2(95%CI:2.4~4.3)和4.8(95%CI:3.7~6.1)]和空腹血糖受损[OR值分别为2.5(95%CI:1.8~3.4)、3.2(95%CI:2.4~4.4)和4.2(95%CI:3.2~5.6)]的相对风险明显增高.高个成年人腰围以男性90 cm、女性85 cm作为界值点,预测糖尿病患病的ROC曲线距离最短.与腰围<85 cm组相比,95cm~组高个男性患糖尿病和空腹血糖受损的相对风险明显增高[OR值分别为3.6(95%CI:2.1~6.4)和5.5(95%CI:3.0~10.1)].与腰围<80cm组相比,85 cm~、90 cm~组高个女性患糖尿病的相对风险明显升高[OR值分别为5.0(95%CI:2.7~9.4)和8.0(95%CI:4.6~14.1)],90 cm~组患空腹血糖受损的相对风险OR=3.7(95%CI:2.0~6.9).结论 男性85 cm和女性80 cm是中老年人群的适宜腰围界值点;对于高个成年人,此腰围界值点对于空腹血糖受损有预测价值;人群中心型肥胖预防指标建议使用男性85 cm和女性80 cm作为腰围界值点.  相似文献   

2.
无锡市社区人群代谢综合征现况调查及特点分析   总被引:5,自引:0,他引:5  
目的了解无锡市社区人群代谢综合征(MS)的患病水平及影响MS患病的相关因素与后果。方法采用整群抽样方法调查无锡市社区20岁以上人群10833人,按照国际糖尿病联盟(IDF)标准分析MS及其各组分代谢紊乱的患病情况和代谢综合征人群的空腹血糖受损及糖尿病患病率;logistic多因素分析MS患病危险因素以及MS人群发生空腹血糖受损和糖尿病的危险因素。结果无锡市社区人群MS标化患病率为18.8%。随年龄的增加MS患病率逐步增高,女性MS标化患病率高于男性。无论男性还是女性,中心性肥胖伴高血压、高血脂是MS患者的主要代谢紊乱表现。MS人群中空腹血糖受损的患病率为6.01%,糖尿病患病率为21.14%。logistic多因素分析结果显示,女性、年龄大、高血压家族史、饮食偏咸和常吃烟熏食物是MS患病的危险因素,糖尿病家族史是MS患者发生空腹血糖受损和糖尿病的危险因素,文化程度高是保护因素。结论无锡市社区人群中MS患者代谢紊乱状态以中心性肥胖伴高血压、高血脂为特点,MS人群中发生空腹血糖受损及糖尿病者高于一般人群,年龄大以及伴有糖尿病家族史的代谢综合征患者更易发生空腹血糖受损和糖尿病。  相似文献   

3.
目的 探讨不同诊断标准诊断代谢综合征(MS)的一致性.方法 运用美国国家胆固醇教育计划成人治疗方案第三次报告[NCEP-ATPⅢ(修订)]、国际糖尿病联盟[CDS(2004)]和中华医学会糖尿病分会[IDF(2005)]诊断标准对石港镇18~74岁人群进行MS患病率调查.结果 石港镇人群MS的患病粗率分别为15.8%(IDF),8.5%(CDS)和15.8%(ATPⅢ),女性MS患病率高于男性;ATPⅢ和IDF诊断标准在该人群中应用的一致性较好,Kappa值为0.923,男、女性分别为0.917和0.924;CDS与ATPⅢ、IDF诊断标准的Kappa值分别为0.644,0.671;男性腰围切点为85 cm,女性为80 cm时,预测危险因素聚集的ROC面积分别为0.74和0.68,其在所选择的切点中ROC距离最短.结论 3种MS诊断标准中,A11PⅢ标准诊断MS的患病率及检出危险因素聚集的比例最高;适宜通州石港人群最佳腰围切点为男性85 cm、女性80 cm.  相似文献   

4.
目的评价男性腰围90cm与85cm两种切点对人群中代谢综合征(MS)的患病率的影响。方法整群抽取柳州市社区常住居民7660人,其中男性3894人,女性3766人,平均年龄(40.5±12.2)岁。进行身高、体质量、腰围、血压、空腹血脂及血糖等指标检测,分别按国际糖尿病联盟(IDF)提出的MS定义及修正其中男性腰围切点(85cm)诊断MS并进行统计分析。结果按IDF定义,3894例男性中检出MS402例,粗患病率为10.3%;按修正了男性WC切点的定义,在同一男性人群检出MS769例,粗患病率为19.7%;男性MS粗患病率从35岁以下组的10.5%增高至65岁以上组的27.7%。降低男性WC切点后,使两性MS总患病率从8.1%增高至12.9%。结论IDF提出的MS定义中,我国男性WC切点偏大,会低估MS的患病率,不能检出很多将来发生心血管病危险的男性个体,宜从90cm修正为85cm。  相似文献   

5.
目的探讨体质指数、腰围及腰臀比对高血压、高血糖的预测作用。方法采用分层整群抽样法调查20岁以上,在深圳居住5年及以上8 207名常住社区居民高血压、糖尿病患病与肥胖相关数据,进行偏相关分析、交互作用分析,并在体质指数、腰围及腰臀比各切点上进行相对危险度、归因危险比、人群归因危险比分析。结果按性别分层,控制年龄进行相关分析显示血压、血糖与BMI、WC、臀围、WHR呈正相关(P(0.0001)。交互作用分析提示,BMI与WC、BMI与WHR 对高血压、高血糖、二者聚集有交互作用。BMI、WC取不同切点,各自对高血压、高血糖及二者聚集的人群危险度及归因比分析提示,BMI切点在25及以上者约占23%,控制此切点,可改善总人群 34%的高血压,23%的高血糖,44%的危险因素聚集。而男性WC切点在85cm及以上,女性WC切点在 80cm及以上者占总人群的29%,控制此因素可改善总人群45%的高血压,33%的高血糖,59%的危险因素聚集。结论结合分析偏相关系数,高血压、糖尿病的危险度,及人群预防的公共卫生意义,筛选深圳市该类疾病高危人群适当的界点是:高血压取BMI≥25cm,高血糖取男性WC≥85cm, 女性WC≥80c...  相似文献   

6.
广西城乡居民体质指数和腰围与糖尿病关系的研究   总被引:1,自引:2,他引:1  
目的分析广西城乡居民成人体质指数(BMI)、腰围(WC)与糖尿病(DM)及空腹血糖受损(IFG)的关系。方法根据“2002年中国居民营养与健康状况调查”所确定的多阶段随机整群抽样方法,对广西4个城市和4个县18岁及以上3041名城乡居民进行了身高、体重、腰围测量以及空腹血糖测定,建立数据库,进行统计分析。结果城市居民糖尿病(DM)、空腹血糖受损(IFG)患病率分别为4.2%、1.6%,显著高于农村(0.8%、0.8%)(P<0.01)。BMI为<18.5,18.5~23.9,24~27.9及≥28者DM患病率分别为0.7%、1.4%、5.9%、9.8%,差异显著(P<0.01)。男性WC为<85cm,85~89cm及≥90cmDM患病率分别为1.4%、8.4%、6.0%;女性WC为<75cm,75~79cm,≥80cm者DM患病率分别为0.6%、1.3%、10.6%,均有显著差异(P<0.01)。除18~29岁外其他各年龄组随着BMI增大DM患病率不断上升;男性WC除18~29岁外、女性WC除30~45岁组外,各年龄组均呈现出随着WC增大DM患病率也明显上升趋势;男性30岁以上WC85~89cm的DM患病率达10.0%,是同年龄组WC<85cm的4.95倍,女性组WC≥80cm、18~29岁的DM患病率达11.1%,是同年龄组WC≤75cm组的17.5倍;还发现双重肥胖者(BMI≥28,同时男WC≥90cm或女性WC≥80cm)DM患病率高达10.9%。结论BMI和WC水平与DM/IFG有良好的相关性,尤其是BMI≥28或男性WC≥85cm30岁以上人群或女性WC≥80cm各年龄组以及双重肥胖者均是DM患病高危人群。因此保持或控制BMI≤24和/或WC<85cm(男)、WC<80cm(女)对防范DM、IFG发生至关重要。  相似文献   

7.
目的 比较不同类型肥胖与心血管疾病(CVD)危险因素的关联,为预防和控制心血管疾病提供科学依据.方法 利用"2002年中国居民营养与健康状况调查"资料,按照<中国成人超重和肥胖症预防控制指南>中判定肥胖的界值点[体重指数(BMI):24kg/m2和28 kg/m2;腰围:男性85 cm和95 cm,女性80 cm和90 cm]判定肥胖类型,比较不同类型肥胖人群与罹患CVD危险因素的关联;用logistic回归和多元线性回归分析BMI和腰围与CVD危险因素的关系.结果 与体重和腰围均在正常范围的人群(OR=1)相比,正常体重并高腰围Ⅰ(男性85~95 cm,女性80~90 cm)的人群、超重但腰围正常的人群罹患CVD危险因素的风险为1~2倍,超重并高腰围Ⅰ、肥胖但腰围正常的人群为2~3倍,超重并高腰围Ⅱ(男性≥95 cm,女性≥90 cm)、肥胖并高腰围Ⅰ或Ⅱ(男性≥85 cm,女性≥80 cm)的人群为≥3倍;同一腰围组中,随着BMI增加罹患CVD危险因素的风险也呈逐渐增加趋势;BMI和腰围同时解释CVD危险因素变异的1.7%~9.4%,大于BMI或腰围单独解释的比例(1.5%~9.0%);BMI对于收缩压的标化回归系数为0.129,略大于腰围(0.123),腰围对甘油三酯、总胆固醇和高密度脂蛋白胆同醇标化回归系数的绝对值大于BMI.结论 BMI和腰围与CVD危险因素独立相关,建议评估疾病危险时同时使用BMI和腰围两项指标.  相似文献   

8.
目的 探讨利用腰围筛检糖尿病的价值及最佳腰围切割点.方法 按多阶段随机抽样原则,对16 341人测量身高、体重、腰围及空腹血糖,空腹血糖在6.1~7.0 mmol/L间复做口服葡萄糖耐量试验;糖尿病诊断采用WHO 1999年糖尿病诊断标准.采用受试者工作特征(ROC)曲线计算曲线下面积(AUC)和不同切割点下筛检糖尿病的灵敏度、特异度及约登指数,以约登指数最大的点为最佳切割点.结果山东省中西部地区农村居民男、女性糖尿病患病率随腰围增加而升高(趋势检验x2=72.01、122.65,P<0.01),特别是男性腰围≥85 cm、女性腰围≥80 cm,糖尿病患病率升高明显.男、女性AUC分别为0.639和0.655,差异均有统计学意义(t=7.22、11.07,P<0.01).男女性间AUC大小差异无统计学意义(t=0.70,P>0.05).男性腰围以85 cm、女性以80 cm为切割点时筛检糖尿病的约登指数最大,分别为24.90%和24.39%;男性筛检的灵敏度和特异度分别为58.04%和66.86%,女性筛检的灵敏度和特异度分别为67.08%和57.31%.结论腰围对糖尿病具有较好的筛检价值,男性腰围85 cm、女性腰围80 cm可作为山东省中西部农村居民筛检糖尿病和确定高危人群的切割点.  相似文献   

9.
[目的] 探寻上海市35-74 岁人群中代谢综合征(metabolic syndrome,MS)相关肥胖程度的腰围切点。 [方法]采用多阶段随机抽样方法,在上海市35~74 岁居民中进行横断面调查,共调查7 414 名个体。分析男性和女性不同腰围水平与MS 其他因素的关系,以获得检出2 个及以上危险因素敏感性和特异性均较好的腰围切点。 [结果] 随腰围增大,MS 危险因素聚集的比值比(OR)也随之升高,检出2 个及以上MS 危险因素的特异度和阳性预测值逐渐增高,而敏感度和阴性预测值逐渐下降。当男性腰围≥ 85 cm、女性腰围≥ 80 cm,检出2 个及以上MS 危险因素的敏感度为68.33%(男性)、70.17%(女性),特异度为58.48%(男性)、58.36%(女性),受试者工作特征曲线(ROC)距离最短,分别为男性0.522 1、女性0.512 2。 [结论] 当男性腰围≥ 85 cm、女性腰围≥ 80 cm时,能较好反映MS 危险因素的聚集,为本研究人群代谢综合征肥胖的腰围切点。  相似文献   

10.
目的 研究中国成年人BMI和腰围与各项代谢危险因素之间的相关性,确定超重肥胖的适宜BMI和腰围切点。方法 中国慢性病前瞻性研究于2004-2008年进行基线调查,并于2013-2014年随机抽取了5%的研究对象进行第2次重复调查。本研究剔除体格指标或代谢危险因素变量缺失或极端值、自报患有恶性肿瘤者,基线纳入501 201人,第2次重复调查纳入19 201人。比较不同BMI和腰围下代谢危险因素异常率,通过受试者工作特征(ROC)曲线分析,确定预测高血压、糖尿病、血脂异常和危险因素聚集的适宜BMI和腰围切点。结果 随BMI或腰围的增加,高血压、糖尿病、血脂异常和危险因素聚集患病率均呈现上升的趋势。依据正确指数最大的原则选取BMI超重切点和腰围切点,男性和女性BMI超重切点均接近24.0 kg/m2,男性腰围切点接近85 cm,女性腰围切点约为80~85 cm。男性和女性中,检出各项代谢危险因素特异度达到90%的BMI切点范围为27.0~28.9 kg/m2,多数接近28.0 kg/m2,以28.0 kg/m2作为肥胖切点。结论 本研究在更新开展的大样本调查中进一步验证了中国肥胖问题工作组2002年推荐的超重和肥胖标准,超重和肥胖的BMI切点分别为24.0和28.0 kg/m2;中心性肥胖的腰围适宜切点男性为85 cm,女性为80~85 cm。  相似文献   

11.
Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.  相似文献   

12.
This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.  相似文献   

13.
深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.  相似文献   

14.
Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO2) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO2. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO2 at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO2 gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO2 also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO2.  相似文献   

15.
Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L?1 to a maximum of 79?mg·L?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.  相似文献   

16.
The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.  相似文献   

17.
Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).  相似文献   

18.

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.  相似文献   

19.
20.
Occupational health hazards in mining: an overview   总被引:1,自引:0,他引:1  
This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.  相似文献   

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