上海市某社区成人2型糖尿病及其合并肾功能不全流行现况及相关因素

  目的  了解上海市某社区2型糖尿病（type 2 diabetes mellitus，T2DM）及其合并肾功能不全的流行情况，探讨其相关的因素。  方法  采用随机整群抽样的方法抽取上海市某社区20~75岁的常住居民9 257名，进行T2DM、肾功能不全等患病情况及相关因素的问卷调查、体格检查及血尿常规和相关生化指标的检查，应用SPSS 19.0软件进行统计分析。  结果  9 257名调查对象中，资料完整的共8 207名，女性占58.9%；45岁以上占75.8%。T2DM患病率为12.7%（95%CI:12.0%~13.4%），T2DM中合并肾功能不全的患病率15.4%（95%CI:12.3%~18.4%），其中早期（1~2期）肾功能不全患者占65.8%。T2DM患者中，肥胖者合并肾功能不全的患病率高于正常体重指数（body mass index，BMI）者；高龄（OR=1.35，95%CI:1.09~1.68）、中心性肥胖（OR=1.50，95%CI:1.05~2.15）、高尿酸血症（OR=2.51，95%CI:1.63~3.86）为T2DM合并肾功能不全主要相关因素。  结论  上海市某社区T2DM患者中合并肾功能不全的患病率较高，已成为该社区重要的公共卫生问题之一，需对高龄、肥胖、高尿酸血症的T2DM患者重点关注。

Epidemiology investigation of type 2 diabetes mellitus and its associated renal insufficiency in a community-based population in Shanghai

  Objective  To investigate the prevalence and related factors of type 2 diabetes mellitus(T2DM) and its associated renal insufficiency in adult residents of a community in Shanghai.  Methods  A total of 9 257 residents aged 20-75 years old in a community of Shanghai were selected by random cluster sampling. All participants were interviewed to complete questionnaires, physical examination, examination of blood, urine and common biochemical indicators for T2DM, renal insufficiency and other related factors. Then the SPSS 19.0 software was used for analysis.  Results  Of the 9 257 respondents, eligible data of 8 207 subjects were enrolled in the study. The prevalence of T2DM was 12.7% (95% CI: 12.0%-13.4%), and the prevalence of its associated renal insufficiency was 15.4% (95% CI: 12.3%-18.4%), and majority of patients (65.8%) were in the early stage. Among the T2DM patients in this survey, the prevalence of renal insufficiency in obese patients was higher than that in patient with the normal body mass index. Logistic regression analysis showed that elder (OR=1.35), central obesity (OR=1.50), hyperuricemia (OR=2.51) were independent risk factors related with renal insufficiency in T2DM patients.  Conclusions  Renal insufficiency has become one of the important public health problems in T2DM patients. It shows a more urgent need for early prevention and control of CKD to prevent the incidence of end-stage renal disease and related complications in T2DM patients with advanced age, obesity, and hyperuricemia.