贵州省苗族人群锰暴露与糖尿病前期及糖尿病的关联分析

目的 探讨贵州省30~79岁苗族人群尿锰水平与糖尿病前期及糖尿病的关联性。方法 采用多阶段、分层整群抽样方法,排除未收集尿液者后,对贵州省30~79岁3 722名苗族人群进行问卷调查、体格检查。利用电感耦合等离子体质谱法检测苗族人群尿液中锰的浓度,采用二元logistic回归分析尿锰水平与糖尿病前期及糖尿病患病风险之间的关联。结果 贵州省30~79岁苗族人群糖尿病前期检出率为38.47%,糖尿病患病率为9.38%。Logistic回归分析结果显示:与第一分位（Q1）相比,尿锰浓度第三分位Q3（OR=1.363,95%CI:1.123~1.656）和第四分位Q4（OR=1.417,95%CI:1.167~1.720）与糖尿病前期患病风险呈正相关,未发现尿锰水平与糖尿病患病风险之间存在关联。亚组分析显示,女性（OR=1.792,95%CI:1.341~2.239）、患高血压（OR=2.132,95%CI:1.363~3.334）人群尿锰浓度越高,糖尿病前期风险越大。结论 贵州省30~79岁苗族人群尿锰浓度升高与糖尿病前期患病风险增加有关,未发现尿锰浓度与糖尿病患病风险存在关联性。     

脂质比值TC/HDL-C、TG/HDL-C和LDL-C/HDL-C与胰岛素抵抗、糖尿病及糖尿病前期的关联性

目的 研究天津市成人脂质比值TC/HDL-C、TG/HDL-C和LDL-C/HDL-C与胰岛素抵抗、糖尿病和糖尿病前期的关联性,以期探索、评估这三项脂质比值在糖尿病的公共卫生预防、临床诊断、病情预测等方面的价值。方法 根据中国成人慢性病与营养监测方案,调查天津市河西区等7个区18岁及以上常住居民,收集其空腹静脉血,检测血脂四项、FPG和胰岛素水平。将TC/HDL-C、TG/HDL-C和LDL-C/HDL-C按照四分位数法进行分组,采用二分类Logistic回归分析模型分析其与胰岛素抵抗、糖尿病和糖尿病前期的OR值及其95%CI。结果 天津市调查人群中糖尿病患病率合并糖尿病前期患病率为46.6%(2 030/4 356)。总人群中,TC/HDL-C和TG/HDL-C升高均能增加胰岛素抵抗风险,但是与LDL-C/HDL-C<1.78组相比,只有≥2.86组胰岛素抵抗患病风险增加(OR=1.78, 95%CI:1.21～2.63);不论是男性还是女性,随着TC/HDL-C和TG/HDL-C的升高,糖尿病、糖尿病前期的患病风险增加,关联性较强,且与LDL-C/HDL-C的关联性低于TC/...     

社区居民糖尿病前期患病率分析

目的调查天津市劝业场社区居民糖尿病及糖尿病前期的患病率。方法选择天津市劝业场社区年龄在20岁以上的重点人群作为调查对象,给予实验室检测和问卷调查,观察糖尿病前期患者的患病率及其与年龄、体质指数（BMI）的关系。结果被调查的1379名居民中,符合糖耐量受损（IcR）诊断标准者175人,患病率为12．7％,其中糖调节受损（IGT）155人,患病率8．33％;空腹血糖受损（[rc）38人,患病率为2．75％;IFGklGT22人,患病率1．59％。符合糖尿病诊断标准112人,患病率为8．12％,其中原有糖尿病78人,新发现糖尿病34人。患病率随着年龄的增高有上升的趋势。IFG患病率、IGT患病率及IFG＼IGT患病率均在40～49岁年龄组最高,分别为2．89％、13．50％、3．53％。不同年龄组患病率与BMI呈正相关。结论糖尿病前期患者的患病率随着年龄、BMI增长而增高,对重点人群进行糖尿病前期筛查,以便及早干预,对社区开展糖尿病综合防治工作具有积极意义。     

城乡社区居民高尿酸患病情况及与糖尿病的关系

目的 探讨城乡社区居民高尿酸(HUA)患病情况及其与糖尿病前期(Pre-DM)、糖尿病(DM)的关系。方法 用分层整群随机抽样方法，2019—2020年抽取福州市1个城市点和1个农村点，用KISH表抽取≥18岁常住居民3 744人开展问卷调查、体格检查和实验室检测。统计分析不同人口学特征的城乡居民尿酸与Pre-DM、DM间的关联。结果 调查人群的Pre-DM、DM及HUA的标化患病率分别为18.1%、13.0%和23.1%;农村地区Pre-DM、HUA患病率均高于城市(χ²=68.66、20.69,P均<0.01);多因素logistic回归分析显示，城市居民尿酸第3四分位数Q₃水平的发生DM风险较高(OR=1.57,P<0.01);农村居民Q₃水平者Pre-DM的发生风险较高(OR=1.42,P<0.05)。按年龄、性别分层分析发现，在城市居民<60岁、农村≥60岁中，Q₃水平与Pre-DM患病风险增加有关，在城市<60岁、城市女性中，Q₃水平与...     

2010—2012年贵州省成年居民2型糖尿病患病状况及相关因素

目的了解2010—2012年贵州省成年居民2型糖尿病患病状况及相关因素。方法采用多阶段分层整群随机抽样方法,抽取2010—2012年"中国居民营养与健康状况监测"中贵州省5个监测地区18岁及以上人群3073人(城市1576人,农村1497人;男性1362人,女性1711人),调查其基本情况、生活方式及行为,并检测体格指标及血压、血糖、总胆固醇(TC)、甘油三酯(TG),计算2型糖尿病患病率,采用非条件Logistic回归模型进行多因素分析。结果贵州省3073名18岁及以上居民中有151人检出患有2型糖尿病,患病率为4. 9%,其中城市居民80人,农村居民71人,患病率分别为5. 1%和4. 7%,城乡差异无统计学意义(χ~2=0. 183,P=0. 669)。年龄与2型糖尿病患病相关,且患病率随年龄增长而升高(χ~2趋势=55. 478,P=0. 001)。多因素Logistic回归分析结果显示,家族史、腹型肥胖、高血压、TC异常、TG异常对2型糖尿病患病率的影响均有统计学意义(OR值分别为2. 377、1. 721、1. 666、1. 619和1. 982,P<0. 05)。结论贵州省18岁及以上居民2型糖尿病的患病率低于全国平均水平,贵州省居民2型糖尿病的预防工作应把中老年人、具有家族史、腹型肥胖者、高血压患者、TC异常者、TG异常者作为重点人群。     

不同握力水平对C-反应蛋白与糖尿病前期人群血糖变化的调节作用

目的 通过队列研究探讨C反应蛋白(C-reactive protein, CRP)与糖尿病前期人群血糖变化的关联性,并探讨研究握力是否可以调节该关联性。方法 基于中国健康与养老追踪调查,选择参加基线调查(2011年)和随访调查(2015年)的中老年人。采用多元logistic回归模型分析CRP与糖尿病前期人群发展为糖尿病或恢复为正常血糖的关联性及握力的调节效应。结果 本研究共纳入2 811名研究对象。随访期间,441(15.7%)人发展为糖尿病,1 762(62.7%)人保持糖尿病前期,608(21.6%)人恢复为正常血糖。调整协变量后,多元logistic回归结果显示：与CRP第一四分位数组(Quartile 1)相比,CRP第三四分位数组(Quartile 3)和第四四分位数组(Quartile 4)均会增加糖尿病发生风险,其OR值和95%CI分别为1.63 (1.18～2.24)、1.67 (1.14～2.17),且Quartile 4组会使恢复为正常血糖的几率降低32%;在低握力组,Quartile 3和Quartile 4组发生糖尿病的风险是Quartile 1组的1.80倍...     

宁海县不同地域人群糖尿病及相关危险因素分布特征研究

目的了解宁海县不同地域人群糖尿病患病情况及相关危险因素分布特征,为宁海县糖尿病防治工作提供依据。方法于2016年1月采用多阶段整群随机抽样法抽取3 210例宁海县常住居民为研究对象,其中城关居民715人、沿海居民1 413人、山区居民1 082人。开展问卷调查、体格检查和生化指标检测,比较宁海县不同地域人群糖尿病患病率及危险因素分布差异,采用芬兰糖尿病风险评分法进行风险评分。用SPSS 24.0软件进行χ2检验、趋势χ2检验、t检验和方差分析。结果宁海县城关、沿海和山区居民糖尿病患病率分别为13.99%、7.29%和7.84%,糖尿病风险评分分别为(5.10±3.63)、(5.41±3.66)和(5.98±3.43)分。城关地区居民糖尿病患病率、平均每日静态行为时间高于沿海和山区居民,谷薯类饮食频率低于沿海和山区居民,差异均有统计学意义(P0.017)。沿海地区男性有害饮酒率高于城关和山区,牛奶摄入频率低于城关和山区,女性中心性肥胖率高于城关居民,差异均有统计学意义(P0.017)。山区居民糖尿病患病风险、男性吸烟率高于城关和沿海,平均每日身体活动时间、新鲜绿色蔬菜摄入频率低于城关和沿海居民,差异均有统计学意义(P0.05)。结论城关居民糖尿病患病率最高,山区居民糖尿病患病风险最高,要重点关注与干预,应针对高危人群开展监测和体检,针对不同地域危险因素特征做好精准化预防。     

社区居民糖尿病患病率、知晓率和控制率现况调查

目的了解社区居民糖尿病患病率、知晓率和控制率现状。方法随机整群抽取保定市3个社区,应用横断面研究方法调查45岁以上居民2型糖尿病患病、知晓和控制情况。结果糖尿病标化患病率20.1%,糖尿病前期标化患病率为7.8%;糖尿病知晓率为68.5%,糖尿病前期知晓率为0;达标率仅为17.91%。结论社区居民糖尿病患病率较高,知晓率和控制率较低,解决人群防治的关键是提高知晓率。     

江苏省成年居民不同膳食模式对糖尿病前期患病影响

目的了解江苏省成年居民不同膳食模式对糖尿病前期患病影响,为采用合理膳食模式干预糖尿病患病提供参考依据。方法采用多阶段整群随机抽样方法于2014年5月—2015年12月在江苏省抽取1 865名成年非糖尿病居民进行问卷调查、体格检查和实验室检测;采用因子分析法建立膳食模式,并应用logistic回归模型分析不同膳食模式对糖尿病前期患病的影响。结果江苏省1 865名成年非糖尿病居民中,患糖尿病前期者315例,糖尿病前期患病率为16.9%;因子分析得到动物型膳食、健康型膳食、传统型膳食和淀粉类植物型膳食4种膳食模式,累积方差贡献率为54.000%;多因素logistic回归分析结果显示,在调整了性别、年龄、居住地、吸烟情况、饮酒情况、父母是否患糖尿病、体质指数、是否高血压、是否血脂异常等混杂因素后,健康型膳食是江苏省成年居民糖尿病前期患病的保护因素,因子得分处于T3水平居民糖尿病前期患病风险为因子得分处于T1水平居民的0.689倍(OR=0.689,95%CI=0.481~0.986,P=0.042),因子得分处于T4水平居民糖尿病前期患病风险为因子得分处于T1水平居民的0.518倍(OR=0.518,95%CI=0.356~0.756,P=0.001)。结论健康型膳食模式可降低江苏省成年居民糖尿病前期患病风险。     

贵州省黔南州农村少数民族18～79 岁居民糖尿病及糖尿病前期流行病学调查

目的 了解黔南州农村少数民族18～79 岁居民糖尿病及糖尿病前期的流行情况,为开展糖尿病防治提供依据。方法 于2017年10月—2019年9月,对49 787名贵州省黔南州农村少数民族18～79岁居民,采用自行编制《贵州省黔南州糖尿病流行病学调查表》进行问卷调查,依据《WHO糖尿病诊断标准（1999）》进行诊断。结果 49 787名黔南州农村少数民族20～79岁居民中,糖尿病及糖尿病前期现患3 496例和4 117例,患病率分别为7.02%（95%CI = 6.672%～10.732%,男性7.72%,女性6.04%）和8.27%（95%CI = 5.987%～9.324%,男性9.17%,女性7.01%）。男性糖尿病及糖尿病前期患病率高于女性（χ2值为52.35、74.755,P＜0.01)。糖尿病及糖尿病前期患病率随年龄增大逐渐升高（χ2趋势值为86.972、105.745,P＜0.01）。布依族、苗族、水族、毛南族、瑶族糖尿病及糖尿病前期患病率分别为9.25%、8.79%、5.94%、5.34%、4.27%和12.21%、9.66%、6.62%、6.17%、4.58%。不同民族间糖尿病及糖尿病前期患病率比较差异有统计学意义（P＜0.01）。黔南州12县（市）中糖尿病及糖尿病前期患病率排前3位分别是惠水县（9.68%、10.95%）、都匀市（8.73%、9.65%）、独山县（8.60%、9.46%）。结论 黔南州农村少数民族18～79岁居民糖尿病及糖尿病前期的患病率低于全国平均水平,但面对该地区潜在糖尿病负担,需对高危人群进行有效干预,降低糖尿病发病风险。     

Newborn infant urinary cotinine and birth outcomes in the Jerusalem Environment Mother and Child Cohort Study

BackgroundEnvironmental tobacco smoke (ETS) exposure during pregnancy can cause preterm delivery and childhood cancer. The aim of this study was to measure ETS exposure in pregnant women and in newborn infants in Israel using urinary cotinine measurements, to assess predictors of ETS exposure in these vulnerable groups, and to assess associations with birth effects (birth weight, birth length, head circumference) in newborn infants.MethodsWe analyzed urinary cotinine and creatinine in 265 non-smoking pregnant women and 97 newborns, and analyzed associations with self-reported exposure to ETS, paternal smoking, sociodemographic variables and with birth outcomes (birth weight, birth length, head circumference).Results37.7% of pregnant women and 29.0% of infants had urinary cotinine concentrations above the level of quantification (LOQ) of 1 μg/L, whereas 63.8% and 50.5%, respectively, had urinary cotinine concentrations above the level of detection (LOD) of 0.5 μg/L. Median unadjusted and creatinine adjusted urinary concentrations of cotinine in pregnant women were 0.7 μg/L, and 0.9 μg/g creatinine, respectively, and in newborn infants were 0.5 μg/L, and 1.3 μg/g creatinine, respectively. We did not find an association between maternal and infant urinary cotinine level. Maternal (but not infant) urinary cotinine was significantly associated with paternal smoking (p < 0.05). Infant (but not maternal) cotinine above the LOQ was negatively associated with birth weight (p < 0.05).ConclusionsIn this high socioeconomic cohort, almost a third of newborn infants born to non-smoking mothers had quantifiable levels of urinary cotinine. This is the first study showing that newborns with quantifiable urinary cotinine levels have lower birth weight.     

Urinary cadmium levels in the U S working population, 1988-1994

Few studies have estimated the prevalence and mean urinary cadmium levels in U.S. workers and the factors associated with high cadmium exposure. In this study, urinary cadmium measurements were obtained on 11228 U.S. workers aged 18 to 64 years who participated in the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994). Urinary cadmium levels ranged from 0.01 to 15.57 microg/L, with a geometric mean of 0.30 microg/L (0.28 microg/g creatinine) for all U.S. workers. The prevalence of urinary cadmium levels >or=5 microg/L was 0.42% (551000) for U.S. workers aged 18 to 64 years. Among U.S. workers in the metal industry (two-digit Standard Industrial Classification or SIC codes 33 and 34), the geometric mean urinary cadmium level was 0.48 microg/L (0.39 microg/g creatinine), and 0.45% of these workers had urinary cadmium levels >or=10 microg/L. The prevalence of urinary cadmium levels >or=15 microg/L was 0.0028% (3907). The agriculture industry (two-digit SIC codes 01, 02, and 07-09) was associated with low urinary cadmium levels, compared with repair services industries (two-digit SIC codes 75 and 76). Results from ordinary least squares regression analyses indicated that smokers had significantly higher urinary cadmium levels than nonsmokers (p 相似文献   

Peer Reviewed: Prevalence of Self-Reported Prediabetes Among Adults Participating in a Community-Based Health Awareness Program,New York State

Introduction

The purpose of this study was to assess crude, age-adjusted, and risk-factor–specific prevalences of self-reported prediabetes and to identify factors associated with self-reported prediabetes in an adult population.

Methods

Data were collected through questionnaires completed by a racially diverse sample of diabetes-free adult participants in the statewide community-based wellness and diabetes awareness program in New York State during 2006 (N = 2,572). Prediabetes was determined by the affirmative answer to the question, "Have you ever been told by a doctor that you have prediabetes?"

Results

The overall crude prevalence of self-reported prediabetes was 9.1%, and the age-adjusted prevalence was 7.6%. The age-adjusted prevalence of prediabetes was significantly lower among non-Hispanic blacks (4.2%) and significantly higher among American Indians (22.4%), compared with the prevalence among non-Hispanic whites (7.3%). The prevalence of self-reported prediabetes was uniformly higher among older (aged ≥45 years) adults than younger (aged <45 years) adults, overall and in each racial/ethnic group. In all age and racial/ethnic groups, the prevalence significantly increased with the number of additional risk factors. The best fit multivariate logistic regression model identified that self-reported prediabetes was associated with family history of diabetes (odds ratio [OR], 3.65), body mass index 25.0 kg/m² or higher (OR, 2.79), age 45 years or older (OR, 2.77), and having health insurance (OR, 2.38).

Conclusion

This study found that adults who were at high risk for diabetes and had health insurance were more likely to report having prediabetes. Community-based diabetes prevention needs to consider strategies to increase detection of prediabetes in high-risk uninsured people and to raise general awareness of prediabetes.     

Benefits and risks from the national strategy for improvement of iodine nutrition: A community-based epidemiologic survey in Chinese schoolchildren

ObjectiveMild to severe iodine deficiency has been documented in China since 1960. To eliminate this persisting iodine deficiency, legislation on universal salt iodization was introduced in 1995 as a long-term public health intervention strategy. We examined the urinary iodine excretion and the iodine content of drinking water and salt samples to assess the benefits and risks of this national strategy.MethodsWe examined the urinary iodine excretion of 1594 schoolchildren 8 to 10 y old from the 16 counties of China. The iodine content of 1097 drinking water and 4501 table salt samples also was assessed in these counties. The study was conducted from April 2009 through October 2010. Urinary iodine excretion and iodine levels in drinking water and table salt samples were measured based on the Sandell–Kolthoff reaction. Data were interpreted according to World Health Organization criteria.ResultsThe median urinary iodine levels of the schoolchildren were 198.2, 277.2, 336.2, and 494.8 μg/L in areas with iodine levels lower than 10, 10 to 150, 150 to 300, and higher than 300 μg/L in the drinking water, respectively. The mean iodine level in the table salt specimens was 30.4 mg/kg, the coverage rate was 98.6%, and the qualified rate was 96.7%. The goiter prevalence was 8.0% in the areas with an iodine level higher than 150 μg/L in the drinking water.ConclusionIn each area, the median urinary iodine of schoolchildren was nearly or above 200 μg/L, which confirmed the effectiveness of the iodization strategy. However, in areas with an iodine content higher than 150 μg/L in the drinking water, the schoolchildren had more than adequate or excessive iodine intake, which was associated with the prevalence of goiter. Therefore, it is important to adjust the strategy of universal salt iodization control in China.     

江苏省部分地区婴幼儿碘营养状况及影响因素分析

【目的】 调查江苏省婴幼儿碘营养状况及影响因素,为本地区婴幼儿合理的碘摄取提供参考意见。 【方法】 采用分层随机抽样的方法,收集2 329名婴幼儿,检测尿碘浓度,询问并填写调查表,体格测量,分析尿碘水平及影响因素。 【结果】 1)江苏省5地区婴幼儿尿碘浓度四分位数间距(Q75~Q25)为250~100μg/L,尿碘中位数(MUI)为200 μg/L;尿碘浓度(UIC)＜100μg/L的比例为12.2%,UIC＞300 μg/L者占5.2%。2)不同月龄尿碘分布情况存在差异(χ²=19.870,P<0.05),不同地区尿碘分布情况存在差异(χ²=60.355,P<0.001)。3)Logistic回归分析显示:尿碘值可能与儿童月龄、居住地区及添加食盐有关,与父母文化程度无关。 【结论】 江苏省五地区婴幼儿平均碘营养状况处于适宜水平,仍存在碘缺乏和碘过量的现象;不同地区尿碘分布情况不同,城市尤以南京市婴幼儿碘缺乏和碘过量比例较高。     

Relationship Between Blood Lead Levels and Hematological Indices in Pregnant Women

Several studies have revealed a negative association between blood lead levels and hematological impairment. In this cross-sectional study, we examined the relationship between blood lead levels and hematological indices in 292 pregnant women from Durango, Mexico. Apparently healthy pregnant women, aged 14–41 years and at 3–41 weeks of gestation, were recruited between June 2007 and May 2008. Blood lead and hematological indices were measured. The mean blood lead was 2.79 ± 2.16 μg/dL, and lead levels ≥5 μg/dL were detected in 25 women (8.6%). Hemoglobin, hematocrit, and red blood cells count were significantly higher in pregnant women with a blood lead concentration of ≥5 μg/dL than the group with lower blood lead levels (p < .05). Mean corpuscular volume and mean corpuscular hemoglobin were not significantly related to lead levels. Hemoglobin and hematocrit showed a non-significant positive correlation with blood lead, but the correlation between red blood cell count and blood lead levels was statistically significant (r = 0.185, p = .002). The findings suggest that a positive association between blood lead and some hematological indices may occur at relatively low blood lead concentration (mean < 5 μg/dL).     

铅接触者职业健康监护血锌原卟啉筛选指标值的探讨

目的探讨铅接触者职业健康监护中血锌原卟啉作为筛选指标的可行性。方法以某蓄电池制造企业2000-2001年极板、装配、化成3个车间各工段的作业场所空气铅烟（尘）监测数据456个及上述3个车间198名职工近2年体检结果为资料进行统计分析。结果各浓度组血锌原卟啉、尿铅值均有随接触浓度增高而增大的趋势；浓度与血锌原卟咻、浓度与尿铅及血锌原卟啉与尿铅之间均呈高度正相关（P〈0．01）。从而提示血锌原卟啉值的变化可间接地反映尿铅值的变化，建立血锌原卟啉与尿铅值的数学模型为Pi^=0．1612×Zi0.7354。若将漏诊率控制在1％左右，经模型推算出血锌原卟啉的值为1．7μmol／L（1062．5μg／L），若血红蛋白值取170g／L（本资料平均值）时，血锌原卟啉值约为6μg／g Hb（1062．5／170）。结论建议血锌原卟啉可以作为筛选指标，其下限值应为6μg／g Hb。     

Binational arsenic exposure survey: methodology and estimated arsenic intake from drinking water and urinary arsenic concentrations

The Binational Arsenic Exposure Survey (BAsES) was designed to evaluate probable arsenic exposures in selected areas of southern Arizona and northern Mexico, two regions with known elevated levels of arsenic in groundwater reserves. This paper describes the methodology of BAsES and the relationship between estimated arsenic intake from beverages and arsenic output in urine. Households from eight communities were selected for their varying groundwater arsenic concentrations in Arizona, USA and Sonora, Mexico. Adults responded to questionnaires and provided dietary information. A first morning urine void and water from all household drinking sources were collected. Associations between urinary arsenic concentration (total, organic, inorganic) and estimated level of arsenic consumed from water and other beverages were evaluated through crude associations and by random effects models. Median estimated total arsenic intake from beverages among participants from Arizona communities ranged from 1.7 to 14.1 μg/day compared to 0.6 to 3.4 μg/day among those from Mexico communities. In contrast, median urinary inorganic arsenic concentrations were greatest among participants from Hermosillo, Mexico (6.2 μg/L) whereas a high of 2.0 μg/L was found among participants from Ajo, Arizona. Estimated arsenic intake from drinking water was associated with urinary total arsenic concentration (p < 0.001), urinary inorganic arsenic concentration (p < 0.001), and urinary sum of species (p < 0.001). Urinary arsenic concentrations increased between 7% and 12% for each one percent increase in arsenic consumed from drinking water. Variability in arsenic intake from beverages and urinary arsenic output yielded counter intuitive results. Estimated intake of arsenic from all beverages was greatest among Arizonans yet participants in Mexico had higher urinary total and inorganic arsenic concentrations. Other contributors to urinary arsenic concentrations should be evaluated.