北京市郊区某镇农村居民糖调节受损患病率及口服葡萄糖耐量试验筛查的必要性

目的对北京市顺义区南法信镇35～74岁自然人群进行2型糖尿病(type 2 diabetes mellitus,2DM)筛查,分析不进行口服葡萄糖耐量试验(OGTT)仅进行空腹血糖筛查可能造成的漏诊及误诊情况。方法在北京市顺义区南法信镇自然人群进行体检。35～74岁居民均纳入研究对象,对空腹血糖≥5.6mmol/L者作OGTT筛查。结果体检结果显示,2DM患病率为15.1%,其中新诊断2DM者为45.8%,明显高于2002年全国营养调查大城市糖尿病患病率。糖调节受损(IGR)163例,患病率为4.9%。若不进行OGTT试验将有12.6%新诊断的2DM、42%空腹血糖受损(IFG)、25.8%糖耐量异常(IGT)、41.3%IFG合并IGT漏诊,36.4%新诊断2DM误诊为IFG。结论2DM患病率在我国处于不断上升阶段,大城市郊区农民患病率明显上升,对其进行糖代谢检查十分必要,进行OGTT试验可明显减少漏诊及误诊情况。

Prevalence of Impaired Glucose Regulation in Beijing Rural Population and the Necessity to Carrying out Oral Glucose Tolerance Test

Objective To practice type 2 diabetes mellitus(2DM) screening in Beijing rural general population at age between 35 to 74 years and to analyze missed diagnosis and misdiagnosis of 2DM without oral glucose tolerance test(OGTT). Methods The study was conducted in the community of Nanfaxin, a rural suburb of Beijing, all of the inhabitants who were 35 to 74 years-old in the towns were included in the study. OGTT was performed in the subjects with fasting blood glucose(FBG)≥ 5.6 mmol/L. Results Prevalence rate of 2DM was 15.1%, in which newly diagnosed 2DM was 45.8%,which is significantly higher than the diabetes prevalence rate of major cities in 2002 national nutrition survey. Prevalence rate of impaired glucose regulation (IGR)(163 cases) was 4.9%. If not screening glucose homeostasis with OGTT 12.6% newly diagnosed 2DM, 42% impaired fasting glucose(IFG), 25.8% impaired glucose tolerance(IGT), 41.3% IFG combined IGT would be missed from diagnosis, 36.4% of newly diagnosed 2DM would be misdiagnosed as IFG. Conclusion Prevalence of 2DM in China is in a rising phase, especially in the outskirts of large cities. It is necessary to test glucose homeostasis in adult residents. Using OGTT can significantly reduce the cases of missed diagnosis and misdiagnosis.