山东地区20岁及以上人群2008年糖尿病及糖尿病前期患病率调查

目的了解山东地区成人糖尿病及糖尿病前期的流行病学特点。方法2008年5月到7月采用多级多层整体抽样方法，选取山东省济南、淄博、济宁、德州4个地区常住居民3011人为调查对象，其中男1328人，女1683人，年龄20～76岁，平均（51±12）岁。隔夜空腹行口服葡萄糖耐量试验（OGTr），检测空腹血糖及餐后2h血糖诊断受试者中糖尿病及糖尿病前期患者。根据性别、年龄（10年为一间隔）分层分组对各组糖脂代谢状态进行比较分析。组间均数的比较采用单因素方差分析，率的比较采用X2检验。结果糖尿病及糖尿病前期粗患病率分别为12．6％（378／3011）男性12．9％（171／1328），女性12．3％（207／1683）]和8．8％（266／3011）男性8．6％（114／1328），女性9．0％（152／1683）]，标化后分别为9．9％（男性10．9％，女性8．8％）和7．3％（男性7．6％，女性6．9％）。糖尿病及糖尿病前期患病率的性别差异均无统计学意义（x。=0．225，0．184，均P〉0．05）。男女糖尿病患病率均随年龄增长而升高（）（。=57．296、109．882，均P〈0．05）。新诊断糖尿病患者156例，占总糖尿病患者的41．3％。糖尿病前期患者中单纯糖耐量受损明显多于单纯空腹血糖受损（分别为74．1％和16．9％）。城市居民糖尿病患病率高于农村居民（13．5％比10．9％，x2=4．25，P〈0．05）。多因素logistic回归分析显示增龄、家族史、腹型肥胖、收缩压升高、心率增快、甘油三酯升高、低密度脂蛋白胆固醇升高为发生糖代谢异常的危险因素（OR=1．623、2．150、1．758、1．132、1．214、1．130、1．171，均P〈0．05）；HDL—C是发生糖代谢异常的保护因素（OR=0．617，P〈0．05）。结论山东地区糖尿病患病率为9．9％，糖尿病前期患病率7．3％，须采取更加有效的措施预防、及早诊断和治疗糖代谢异常。

Investigation of the prevalence of diabetes and prediabetic state among the adults in Shandong province in 2008

Objective To investigate the prevalence and epidemiologic characteristics of diabetes mellitus and prediabetic state among the adults in Shandong province. Methods It was a cross-sectional and cluster sampling investigation. From May to July in 2008, a total of 3011 residents （ 1328 males and 1683 females）, aged 20 years and above（20 -76 yrs,mean （51 ＋ 12） yrs）, from 4 regions in Shandong province were enrolled in this study. After an overnight fast, participants underwent an oral glucose-tolerance test. The fasting and 2-hour plasma glucose levels were measured to identify undiagnosed diabetes and prediabetes. Prevalence of diabetes and prediabetes and fat metabolism were compared by subgroups according to sex, age （ 10 years for an interval）. One-way ANOVA was applied to compare differences of continuous variables between subgroups. Rates were compared by using the Chi-Square test. Results The crude prevalence estimates of diabetes and prediabetes in this survey was 12. 6% （378/3011） and 8.8% （266/3011）, respectively. When adjusted for age and sex, the prevalence was 9. 9% （ 10. 9% for men and 8.8% for women） for diabetes and 7.3% for prediabetes （7.6% for men and 6. 9% for women）. There was no significant differences in prevalence of diabetes and prediabetes between males and females （ x2 = 0. 225, 0. 184, both P 〉0. 05）. The prevalence of diabetes increased with age in men and women （x2 = 57. 296, 109. 882, both P 〈 0. 05）. The newly-diagnosed diabetes （n = 276） accounted for 41.3% of the total diabetes. The prevalence of isolated impaired glucose tolerance was higher than that of isolated impaired fasting glucose（74. 1% vs 16. 9% ）. The prevalence of diabetes was higher in urban residents than that in rural residents （ 13.5% vs 10. 9% , X2 = 4. 25, P 〈 0. 05 ）. The muhivariable analysis showed that age, family history of diabetes, central obesity, systolic blood pressure, heart rate, triglyceride and low density lipoprotein cholesterol were the risk factors for development of glucose metabolism disorder （ OR = 1. 623, 2. 150, 1. 758, 1. 132, 1. 214, 1. 130, 1. 171, respectively, all P 〈 0. 05）, and high density lipoprotein cholesterol was the protective factor （ OR = 0. 617, P 〈 0.05 ）. Conclusions The prevalence of diabetes and prediabetes is 9. 9% and 7.3 respectively in Shandong. More effective measures should be taken for the prevention, early diagnosis and treatment of diabetes and prediabetes.