30岁以上医务人员代谢综合征患病情况及策略分析

目的了解洛阳市第一人民医院30岁以上医务人员代谢综合征(MS)发病情况,为指导医务人员积极采取保健措施提供依据。方法选取洛阳市第一人民医院30岁以上医务人员,对其体检情况采用整群随机抽样方法进行研究,对体检人群代谢综合征情况进行分析。结果 MS患病率为23.94%,超重和肥胖在所有异常指标中检出率最高,男性MS、超重或肥胖、高血压、高血糖、血脂异常的患病率均明显高于女性;不同年龄间MS、高血压、高血糖、血脂紊乱和超重指标随着年龄的增长均有明显增加。结论洛阳市第一人民医院30岁以上医务人员具有较高的MS患病率,各组患病率在不同性别、不同年龄段有所不同,超重和肥胖检出率最高,30岁以上医务人员应该高度警惕MS的发生,加强保健意识,定期体检。     

通辽地区脂肪肝患病情况分析

目的加强该地区对脂肪肝的认识,及时预防,并探讨脂肪肝的相关因素。方法对来我院体检中心参加体检的634名通辽地区居民进行健康体检,对其结果进行统计分析。结果脂肪肝患病率50.63%,男性脂肪肝患病率61.84%,女性脂肪肝患病率29.55%,脂肪肝患病率与体重指数、高血脂、高血糖、高血压、饮酒等因素密切相关。结论通辽地区脂肪肝患病率较高,男性高于女性,肥胖、高血脂、高血糖、高血压是该病的危险因素。     

锡林浩特市居民糖尿病患病情况及影响因素分析

目的了解锡林浩特市18岁以上居民糖尿病的患病情况及影响因素,为防治糖尿病提供科学依据。方法采用按比例多阶段随机抽样的方法抽取锡林浩特市住满5年的18岁以上居民2 411人进行面对面的问卷调查和体格检查。结果 2 411人中,糖尿病患者117人,患病率为4.85%,其中男性患病率为4.81%,女性患病率为4.87%,男女患病差异有统计学意义(P0.05)。糖尿病患病率随年龄的增加逐渐上升,随着BMI的增加呈升高趋势。经多因素分析显示,本研究人群糖尿病患病与年龄、家族史、腰围、BMI、吸烟饮酒、食盐摄入、文化程度有关。结论锡林浩特市糖尿病流行形势不容忽视,应继续加强社区糖尿病防治工作,对有家族史、超重肥胖的人群进行重点干预。     

汕头特区糖尿病患病情况的调查分析

目的:调查了解汕头特区糖尿病的患病现状及其流行特点、危险因素,为汕头市制定糖尿病防治和控制规划提供依据。方法:采用分层整群随机抽样方法,抽取汕头特区“广厦街道”3个居委会、市郊区县各1个居委会510户自然人群共2041人,通过问卷调查收集资料和体质测量,根据美国糖尿病协会1997年对未诊断的糖尿病高危人群的筛选标准犤3犦中任何一项符合者检测空腹血糖(fastingplasmaglucose,FPG)和餐后随机血糖(postprandialplasmaglucose,PPG),按美国糖尿病协会1997年提出修改的糖尿病诊断标准,用SPSS10.0软件包建立数据库并进行统计学分析。结果:汕头特区居民糖尿病、空腹血糖受损(impairedfastingglucose,IFG)和糖耐量异常(impairedglucosetolerance,IGT)患病率分别为3.67%,2.16%和3.82%,均随年龄增长而上升,45岁以上女性明显高于男性,新诊断糖尿病占现患患者的69.23%,高血压患病率及超重+肥胖患病率与糖尿病患病率有明显的相关性。结论:汕头特区糖尿病及糖尿病前期患病率较高,患者较多,形势严峻,防治任务相当严重而迫切,不容轻视。     

汕头特区糖尿病患病情况的调查分析

目的：调查了解汕头特区糖尿病的患病现状及其流行特点、危险因素。为汕头市制定糖尿病防治和控制规划提供依据。方法：采用分层整群随机抽样方法，抽取汕头特区“广厦街道”3个居委会、市郊区县各1个居委会、510户自然人群共2041人，通过问卷调查收集资料和体质测量，根据美国糖尿病协会1997年对未诊断的糖尿病高危人群的筛选标准中任何一项符合者检测空腹血糖(flasting plasma glucose，FIG)和餐后随机血糖(pistprandial plasma glucose,PPG)，按美国糖尿病协会1997年提出修改的糖尿病诊断标准，用SPSS 10．0软件包建立数据库并进行统计学分析。结果：汕头特区居民糖尿病、空腹血糖受损(impsired fasting glucose,IFG)和糖耐量异常(impaired glucose tolerance，IGT)患病率分别为3．67％，2．16％和3．82%，均随年龄增长而上升，45岁以上女性明显高于男性，新诊断糖尿病占现患患者的69．23％，高血压患病率及超重 肥胖患病率与糖尿病患病率有明显的相关性。结论：汕头特区糖尿病及糖尿病前期患病率较高，患者较多，形势严峻，防治任务相当严重而迫切。不容轻视。     

妊娠期糖尿病患病情况及危险因素的调查分析

目的:探讨妊娠期糖尿病(GDM)的患病情况及危险因素。方法:选取2019年1月—2019年10月产科住院分娩的531例产妇作为研究对象,调查收集产妇的基本资料、临床资料及GDM患病情况,通过单因素分析基本资料及临床资料中影响GDM患病率的相关危险因素,将差异有统计学意义的相关危险因素进行多因素Logistic回归分析,找出影响GDM患病率的独立危险因素。结果:本研究531例产妇中妊娠期发生GDM 192例,占36.16%,显示孕产妇GDM的患病率较高。单因素分析结果显示,年龄、文化程度、产检次数、孕前体质指数(BMI)、孕期增重、糖尿病家族史、GDM知识了解程度及生育间隔为影响孕产妇GDM患病率的相关危险因素(P<0.05)。多因素分析结果显示,年龄、产检次数、孕前BMI、孕期增重及生育间隔为孕产妇出现GDM的独立危险因素(OR>1,P<0.05)。结论:孕产妇GDM患病率偏高。多因素分析结果显示,年龄、产检次数、孕前BMI、孕期增重及生育间隔为孕产妇出现GDM的独立危险因素。通过帮助孕产妇控制体重,指导良好的饮食及生活方式,嘱其定时、定量进行正规产检,并指导孕产妇适龄合理安排生育计划是降低GDM患病率的有效方式。     

糖尿病患者血糖达标情况及影响因素分析

目的探究385例糖尿病患者血糖达标情况及影响因素分析,为糖尿病的治疗及健康管理提供数据支撑。方法本研究对象为2014年8月—2016年8月期间于本院就诊的385例Ⅱ型糖尿病患者,所有患者均采用常规胰岛素治疗,通过临床检查统计所有患者用药3月后空腹血糖(FPG)、糖化血红蛋白(HbA1c)、餐后2小时血糖(2hPG)、体重指数(BMI)达标率。随后通过问卷调查以及体检的形式对患者的一般情况进行统计,包括性别、年龄、病程、饮食控制、运动、血糖监测、血糖监测频率、学习糖尿病知识、用药依从性等,将HbA1c达标患者设为达标组,未达标者设为未达标组,探究影响HbA1c达标率的影响因素,并通过logistic分析影响血糖达标率的高危因素。结果 385例2型糖尿病患者BMI、HbA1c、2hPG、FPG达标率分别为46.49%、47.79%、50.65%、52.73%;影响HbA1c达标率的危险因素有病程、饮食控制、运动、血糖监测、血糖监测频率、学习糖尿病知识、用药依从性,以上危险因素均有统计学意义(P0.05);影响HbA1c达标率的高危因素有饮食不规律或未控制(OR=1.543,95%CI为1.245～1.913)、运动无计划或不规律(OR=1.432,95%CI为1.212～1.691)、无血糖检测(OR=1.536,95%CI为1.156～2.024)、从不服或偶尔服药(OR=1.445,95%CI为1.087～1.920)。结论 385例糖尿病患者BMI达标率较差,达标率最高为FPG,总体情况并不乐观,需要通过对饮食、运动、血糖检测、服药依从性等血糖达标率的影响因素的改善达到控制血糖的目的。     

糖尿病及空腹血糖受损者血脂水平分析

目的探讨糖尿病(DM)患者及空腹血糖受损(IFG)患者的血糖、血脂水平。方法对在本院DM患者190例和IFG患者179例,分别测定其血糖(BG)、胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),并与同期正常对照者的血脂水平进行比较。结果与正常对照相比,DM、IFG患者的BG、TC、TG、LDL-C、HDL-C水平均存在统计学意义差异(P<0.05);DM与IFG患者之间,各项血脂水平不存在统计学意义差异(P>0.05)。结论在DM前期即IFG期,患者即出现血脂代谢紊乱。     

宁波某地区脂肪肝患病情况及相关因素分析

目的探讨宁波某地区脂肪肝患病情况及相关因素。方法宁波某地区城镇居民,包括机关干部、职员、教师、学生（10岁以上）、离退休人员、部分农民共27073人,调查其年龄、身高、体重、血清学指标、饮食、行为习惯等,经B超检查后,对其结果进行统计分析。结果脂肪肝患病率为14.33%,男性脂肪肝患病率为16.98%,女性脂肪肝患病率为12.12%,其中以51-60岁组男性患病率最高,为29.25%,女性随年龄增长患病率增高,以61-70岁患病率最高,71岁以上男女患病率均下降,脂肪肝的患病与体重指数、高脂血症、高血压、糖尿病、胆结石、饮酒等因素具有密切相关性。结论宁波某地区脂肪肝患病率较高,男性高于女性,男性以51-60岁组患病率最高,肥胖、高脂血症、高血压、糖尿病、胆结石、饮酒是脂肪肝患病的危险因素。     

近郊糖尿病患者血糖控制情况分析

糖尿病是一种慢性、复杂的代谢性疾病，系胰岛素相对或绝对不足引起。糖尿病的临床特征是血糖浓度持续升高，甚至出现糖尿。长期患有糖尿病常伴有脂类、蛋白质代谢紊乱，水、电解质紊乱及酸碱平衡失调，甚至出现一系列并发症，如眼、肾的微血管病变及神经病变，重者可致死亡［1］。现对本镇2011年1月1日至2013年12月31日管理在册的1005例糖尿病患者血糖值检测结果进行回顾性分析。     

烟台地区体检人群糖尿病及空腹血糖受损患病率调查分析

目的分析烟台海滨地区人群糖尿病和空腹血糖受损患病情况及特征。方法对2008—2009年在济南军区烟台疗养院体检中心进行健康体检的3740例18～69岁人群进行调查分析。结果糖尿病患病率为5.78%(标化率为4.82%),空腹血糖受损患病率为9.41%(标化率为8.24%),且随年龄增长患病率逐渐增高。超重、肥胖者糖尿病和空腹血糖受损患病率明显高于体重指数正常者。男女之间无显著差异。结论烟台地区糖尿病和空腹血糖受损患病率与1996年及2002年全国流行病学调查结果相比明显升高。     

Normal fasting plasma glucose and risk of type 2 diabetes

OBJECTIVE

To investigate the association of normal fasting plasma glucose (FPG) and the risk for type 2 diabetes.

RESEARCH DESIGN AND METHODS

Data concerning 13,845 subjects, aged 40–69 years, who had their FPG measured at least three times between 1992 and 2008 were extracted from a database. Three FPG groups were defined (51–82, 83–90, and 91–99 mg/dL). A Cox proportional hazards analysis was applied to estimate the risk of incident diabetes adjusted for other risk factors.

RESULTS

During 108,061 person-years of follow-up (8,110 women and 5,735 men), 307 incident cases of type 2 diabetes were found. The final model demonstrated a hazard ratio of 2.03 (95% CI 1.18–3.50) for 91–99 mg/dL and 1.42 (0.42–4.74) for 83–90 mg/dL.

CONCLUSIONS

Our data suggest that FPG between 91 and 99 mg/dL is a strong independent predictor of type 2 diabetes and should be used to identify people to be further investigated and aided with preventive measures.The prevalence of type 2 diabetes is increasing worldwide (1,2). Prediction methods are a matter of discussion (3–5). A recent study (6) showed an alteration of normal linear trajectories for fasting and postload plasma glucose concentrations and insulin sensitivity and secretion 3–6 years before diagnosis. Other studies (7,8) showed an increased risk of developing type 2 diabetes among normoglycemic subjects, particularly in those with a fasting plasma glucose (FPG) range of 91–99 mg/dL. Clear information regarding Mediterranean populations is lacking. We investigated whether the higher tertiles of within-normal-range FPG concentrations in a northern Italian population can help identify people at increased risk.     

南通地区健康人群空腹血糖水平参考区间的建立

目的 建立南通地区健康人群空腹血糖(FBG)参考区间.方法 从南通大学附属医院体检中心2017年2月至2020年3月的健康体检者中选取8300例健康个体,剔除溶血、乳糜、黄疸标本后,纳入研究对象共7473例.根据研究对象的不同性别和年龄进行分组统计分析,建立相应的参考区间.结果 受检者结果呈偏态分布,且男性血清FBG水...     

Explaining the increase of diabetes prevalence and plasma glucose in Mauritius

OBJECTIVE

Secular trends in the epidemiology of diabetes are best described by studying the same population over time, but few such studies exist. Using surveys from Mauritius in 1987 and 2009, we examined 1) the change in the prevalence of diabetes, 2) the extent to which changes in traditional diabetes risk factors explained the increase, and 3) the change in the distribution of plasma glucose levels over time.

RESEARCH DESIGN AND METHODS

Independent population-based surveys were undertaken in Mauritius in 1987 and 2009 using similar methodology in adults aged 20–74 years. Physical measurements and fasting blood samples were taken, and an oral glucose tolerance test was performed at both surveys.

RESULTS

The age-standardized prevalence of diabetes in 2009 was 22.3% (95% CI 20.0–24.6) among men and 20.2% (18.3–22.3) among women, representing an increase since 1987 of 64 and 62% among men and women, respectively. Concurrent changes in the distribution of age, ethnicity, waist circumference, BMI, physical activity, smoking, family history of diabetes, and hypertension explained more of the increase in the prevalence of diabetes in men than in women. Increases in plasma glucose (especially fasting glucose) were seen across the population but were greater at the upper levels.

CONCLUSIONS

In Mauritius, there has been a marked increase in diabetes prevalence over 22 years. This mainly results from changes in traditional risk factors, leading to population-wide increases in plasma glucose levels. Interventions to control this escalation of diabetes should focus on population-wide strategies.There are 285 million people with diabetes, and this is predicted to increase to 439 million by 2030, with larger increases in the developing than in the developed world (1). The reasons driving these increases include aging of populations, changes in physical activity levels, and patterns of dietary intake. Available data on the increasing prevalence of diabetes come from comparing studies of different designs in different populations, while most information on risk factors comes from cohort studies. Few publications to date have examined population-wide change in prevalence and in risk factors over time using consistent methodology at different time points.Also unclear is to what extent the rise in the prevalence of diabetes is a result of a uniform increase across the whole spectrum of plasma glucose; the rise might be restricted to increases at the upper end of the glucose distribution. Data from the U.S. have shown that increases in the prevalence of diabetes have been accompanied by an increase in right skew of the fasting glucose distributions (2). There has been no detailed analysis of trends in the continuous distribution of glucose using 2-h postload glucose (2hrPG). Understanding the nature of the change in plasma glucose distribution is essential for determining the extent to which interventions should be directed at the whole population or just at those already at high risk.Using national health surveys from Mauritius in 1987 and 2009, we sought to examine 1) the magnitude of the change in diabetes prevalence, 2) the extent to which changes in traditional diabetes risk factors can explain the increase in diabetes prevalence, and 3) whether increases in blood glucose levels were uniform across the population or were confined to those already at the upper end of the plasma glucose distribution.     

糖耐量试验中空腹血糖和2小时血糖关系的研究

探讨口服葡萄糖耐量试验（ＯＧＴＴ）中空腹血糖（ＦＰＧ）和２小时血糖（２ｈＰＧ）的关系，以寻找最佳的ＦＰＧ值作为筛选糖尿病（ＤＭ）的指标。方法对８１５例无ＤＭ病史者进行ＯＧＴＴ测试，分析ＦＰＧ和２ｈＰＧ之间的关系。结果和结论ＯＧＴＴ中，ＦＰＧ和２ｈＰＧ水平呈显著相关，一致性检验表明，卡帕值为０．４２，有中度一致性。以ＷＨＯＤＭ诊断标准中，２ｈＰＧ≥１１．１ｍｍｏｌ／Ｌ（２００ｍｇ／ｄｌ）作为黄金标准，ＦＰＧ≥７．８ｍｍｏｌ／Ｌ具有１００％的特异度，故可用于明确诊断；当ＦＰＧ介于６．６７ｍｍｏｌ／Ｌ（１２０ｍｇ／ｄｌ）和７．０ｍｍｏｌ／Ｌ（１２６ｍｇ／ｄｌ）之间时，它们的假阳性和假阴性之和均较小，且它们之间的差异也较小，其中以７．０ｍｍｏｌ／Ｌ的特异性最高，故可作为诊断指标；依据ＲＯＣ，ＦＰＧ６．３９ｍｍｏｌ／Ｌ（１１５ｍｇ／ｄｌ）为最佳临界值，可作为ＤＭ筛选的标准。     

Risk of progression to type 2 diabetes based on relationship between postload plasma glucose and fasting plasma glucose

OBJECTIVE: We sought to assess the risk of progression to type 2 diabetes in normal glucose tolerance (NGT) subjects based on the relationship between the plasma glucose concentration during oral glucose tolerance tests (OGTTs) and the fasting plasma glucose (FPG) concentration. RESEARCH DESIGN AND METHODS: Subjects with NGT (n = 1,282) from the San Antonio Heart Study received an OGTT with measurement of the plasma glucose concentration at 0, 30, 60, and 120 min at baseline and after 7-8 years of follow-up. Subjects were divided into four groups based on the relationship between the plasma glucose concentration during the OGTT and the FPG concentration on the same day as the OGTT. Insulin resistance was calculated by the homeostasis model assessment of insulin resistance (HOMA-IR) and Matsuda index. Early-phase insulin secretion was calculated as the ratio between the incremental plasma insulin and glucose concentrations during the first 30 min of the OGTT (DeltaI(0-30)/DeltaG(0-30)). Total insulin secretion was calculated as the ratio between the incremental areas under the insulin and glucose curves during the OGTT [DeltaG(AUC)/DeltaI(AUC)]. RESULTS: In 23 subjects (group I), the plasma glucose concentration during the OGTT returned to levels below the FPG concentration at 30 min; in 111 subjects (group II) and in 313 subjects (group III), the plasma glucose concentration during the OGTT returned to levels below the FPG concentration at 60 and 120 min, respectively. In the remaining 835 subjects (group IV), the plasma glucose concentration during the OGTT never fell below the FPG concentration. Insulin resistance, measured by HOMA-IR and the Matsuda index, increased progressively from group I through group IV, while insulin secretion measured by DeltaI(0-30)/DeltaG(0-30) and DeltaG(AUC)/DeltaI(AUC) decreased progressively from group I through group IV. The incidence of type 2 diabetes was 0% in group I and progressively increased to 0.9% in group II, 3.2% in group III, and 6.4% in group IV. CONCLUSIONS: Subjects whose postload plasma glucose concentration returned to baseline (i.e., FPG level) more quickly had greater insulin sensitivity, a higher insulinogenic index, and a lower risk of developing type 2 diabetes after 8 years of follow-up compared with subjects whose postload glucose concentration returned to baseline more slowly.     

空腹血糖与糖化血红蛋白联合检测对糖尿病筛查的价值

目的：探讨空腹血糖（FPG）与糖化血红蛋白（HbA1C）联合检测筛查糖尿病的临床价值。方法选取糖尿病高危人群8634例,抽取空腹静脉血,使用全自动生化仪对FPG和HbA1C水平进行检测。结果 FPG阳性率为8．61％,HbA1C阳性率为7．20％,2项分别进行筛查阳性率差异无统计学意义（P＞0．05）。 FPG 联合HbA1C进行筛查,其中一项及以上为阳性者共941例,占10．90％,明显高于 FPG 阳性、HbA1C阳性或阴性及FPG阳性或阴性、HbA1C阳性两种情况者,差异有统计学意义（P＜0．05）。分别有319例（3．69％）和198例（2．29％）患者仅FPG或HbA1C阳性,明显少于FPG阳性或HbA1C阳性。按照体检人群FPG水平将其分为在年龄和体质量方面有可比性的3组。与FPG＜6．1 mmol/L相比,FPG为6．1～6．9 mmol/L组FPG和 HbA1C水平均有明显升高,且差异有统计学意义（P＜0．05）;FPG＞6．9 mmol/L组FPG和 HbA1C平均水平明显高于 FPG＜6．1 mmol/L、FPG为6．1～6．9 mmol/L两组,差异有统计学意义（P＜0．05）。2项指标呈正相关。结论采用FPG与HbA1C筛查糖尿病具有一定的漏诊率,将2项联合检测,可以降低漏诊率,提高检出率,有重要的临床意义。     

糖尿病的两种空腹血糖诊断标准对比分析

目的探讨糖尿病(DM)新诊断标准中以空腹血糖(FPG)≥7.0 mmol/L(≥1.26 g/L)取代FPG≥7.8mmol/L(≥1.40 g/L)这一变动是否符合本地区临床应用。方法对我院内分泌门诊438例检查血糖的患者用口服75 g葡萄糖耐量试验(OGTT)确诊后,利用2种不同的诊断标准进行对比分析。结果共检出DM患者159例,其中男83例,女76例,利用受试者工作特征(ROC)曲线对FPG≥7.8 mmol/L和FPG≥7.0 mmol/L诊断的特异性和敏感性进行分析,FPG≥7.8 mmol/L的敏感性和特异性分别为56%和99%;而FPG≥7.0 mmol/L的敏感性和特异性分别为68%和97%。结论FPG≥7.0 mmol/L因其特异性达97%,而敏感性又高于FPG≥7.8mmol/L,适合于本地区临床应用。     

糖尿病的两种空腹血糖诊断标准对比分析

目的 探讨糖尿病（DM）新诊断标准中以空腹血糖（FPG）≥7．0mmol／L（≥1．26g/L）取代FPG≥7．8mmol／L（≥1．40g／L）这一变动是否符合本地区临床应用。方法 对我院内分泌门诊438例检查血糖的患者用口服75g葡萄糖耐量试验（OGTT）确诊后,利用2种不同的诊断标准进行对比分析。结果 共检出DM患者159例,其中男83例,女76例,利用受试者工作特征（ROC）曲线对FPG≥7．8mmol／L和FPG≥7．0mmol／L诊断的特异性和敏感性进行分析,FPG≥7．8mmol／L的敏感性和特异性分别为56％和99％;而FPG≥7．0mmol／L的敏感性和特异性分别为68％和卵％。结论 FPG≥7．0mmol／L因其特异性达97％,而敏感性又高于FPG≥7．8mmol／L,适合于本地区临床应用。