拉萨市区藏族中老年人群高血压患病率调查

目的 了解拉萨市区藏族中老年人群高血压患病情况及影响因素。方法 采用在居民集中区普查的方法对4853例藏族中老年人群进行血压、血糖及体重指数等检查。结果 拉萨市区藏族中老年人群高血压患病率为40．68％，并且发现年龄与高血压患病率呈正相关；60岁以上老年人单纯收缩期高血压患病率明显增加，超重肥胖发生率及血糖异常率，高血压组明显高于正常血压组。高血压知晓率39．56％，治疗率29．64％，控制率9．68％。结论 西藏拉萨市区藏族中老年人高血压患病率高，与其特殊的地理环境、生活方式、过多脂肪和钠盐的摄入、运动量较少、低文化程度等有关。高血压知晓率、治疗率、控制率较低，必须采取干预措施。     

中老年人288例脂肪肝患者的临床研究

目的 掌握中老年人脂肪肝患病状况。方法 对2229名中老年人进行体格检查，通过询问病史，测量身高、体重、血压、血脂、血糖及B超等检查，研究脂肪肝的患病状况。结果 脂肪肝患病率为12．9％，性别、年龄对脂肪肝患病率无明显影响。仅15．6％脂肪肝患者有消化道症状，肝功能异常者占25．3％。脂肪肝患者多合并有高甘油三酯、高胆固醇、高血压、糖尿病及糖耐量异常、高尿酸血症。肥胖、高甘油三酯、高胆固醇、高血压、糖尿病及糖耐量异常、高尿酸血症均为脂肪肝的危险因素。结论 中老年人脂肪肝患病率高，必须加强脂肪肝的监测与防治，降低其患病率。     

1994年中国糖尿病患病率及其危险因素

为调查全国糖尿病及糖耐量低减（ＩＧＴ）的患病率及糖尿病危险因素，对全国１９省市年龄≥２５岁的２２４２５１人群进行横向普查，根据１９８５年ＷＨＯ标准，年龄在２５～６４岁的２１３５１５人群中，糖尿病患病率为２．５１％，糖耐量低减患病率为３．２０％（按１９９０年全国人口年龄标化后患病率）；新诊断糖尿病的比例（７０．３３％）明显高于已确诊的糖尿病者。现患病率是１０年前的３．０倍左右，其中农村患病率的增长高于城市。经多因素ｌｏｇｉｓｔｉｃ逐步回归分析显示，年龄、体重指数或腰臀围比、糖尿病家族史、高血压、低体力活动、高收入为非胰岛素依赖型糖尿病（ＮＩＤＤＭ）的独立危险因素，而且在高收入人群中，低文化程度也为ＮＩＤＤＭ的独立危险因素。     

云南昆明安宁城乡地区45岁以上人群糖尿病患病率调查

采用人群普查的方法,对昆明安宁城乡地区45岁以上常住人群45163人进行空腹血糖检查,血糖大于6．0mmol／L而小于7．0mmol／L者,择日进行口服82．5g葡萄糖耐量试验,并行问卷调查,体格检查。结果：糖尿病的患病率3．43％,空腹血糖受损患病率1．90％,葡萄糖耐量减低患病率为1．58％,城镇糖尿病患病率高于农村,I类农村地区糖尿病患病率高于Ⅱ类农村地区,糖尿病患病率随年龄的增加而逐渐增加,2型糖尿病的主要危险因素有年龄、糖尿病家族史、高血压、中心肥胖,城乡地区糖尿病知晓率和控制率较低。结论：昆明安宁城乡地区中老年人群糖尿病患病率低于全国,多种危险因素参与糖代谢异常的发展。     

济南地区中老年人群低密度脂蛋白胆固醇水平升高的影响因素

目的探讨济南地区中老年人群低密度脂蛋白胆固醇(LDL-C)升高的影响因素。方法采用分层多阶段随机抽样方法,对济南地区6个区县45岁以上中老年3 000人进行调查研究,全自动生化分析仪检测LDL-C水平,并分析相关有效因素。结果济南地区中老年人群LDL-C升高的患病率1.97%(59/3 000)。45~69岁人群随年龄增大,LDL-C升高患病增加,70岁以上老年人患病率下降。年龄和糖尿病是男性LDL-C升高的危险因素,肥胖和糖尿病是女性LDL-C升高的危险因素,适度饮酒和体力锻炼为中老年LDL-C升高的保护因素。结论济南地区动脉粥样硬化的低发可能与人群LDL-C的低患病率有关,防治糖尿病、适度饮酒和体力锻炼对预防LDL-C升高具有重要意义。     

成都地区社区居民高血压前期与糖脂代谢的关系

目的探讨成都地区社区居民高血压前期和糖脂代谢紊乱之间的关系。方法2008年4月至11月应用分层整群抽样方法，选取成都市3个社区的40岁及以上居民，进行问卷调查和体格检查，给予口服葡萄糖耐量试验，并检测血糖、血脂等生化指标。在5123名40岁及以上中老年人群中，正常血压者1486名，平均年龄（52±10）岁；高血压前期者1636名，平均年龄（55±10）岁。比较两组人群的糖脂代谢情况，并进一步分析高血压前期与相关因素的关系。计量资料以均数±标准差表示，两组间比较采用t检验，计数资料比较采用）（。检验，相关因素分析采用logistic回归分析。结果成都地区中老年人群高血压前期总体患病率为31．93％，标化患病率为32．70％，其中男性为35．56％，女性为29．69％。高血压前期组／正常血压组在单纯空腹血糖受损、单纯糖耐量异常、空腹血糖受损合并糖耐量异常以及糖尿病的患病率分别为3．42％／2．22％、18．46％／14．47％、2．69％／1．55％和15．71％／8．41％，两组间比较差异均有统计学意义（X^2=4．064、8．978、4．833、38．613，均P〈0．05）。高血压前期组／正常血压组在高胆固醇血症、高甘油三酯血症、高低密度脂蛋白胆固醇（LDL．C）和低高密度脂蛋白胆固醇（HDL-C）的患病率分别为5．38％／3．30％、17．1l％／9．62％、2．69％／1．68％和11．74％／6．93％，两组问比较差异均有统计学意义（X^2=8．041、37．313、4．219、21．009，均P〈0．05）。logistic回归分析显示，年龄、性别、BMI、腰臀比、餐后血糖、总胆固醇、甘油三酯和HDL-C均与高血压前期相关（OR=1．03、0．60、1．10、6．92、1．04、1．19、1．10、0．68，均P〈0．05），其中女性和HDL-C升高是高血压前期的保护因素，年龄和性别是不可控因素。结论成都地区社区中老年人群高血压前期的患病率高，中老年高血压前期人群更易合并糖尿病和血脂紊乱，高血压前期与糖脂代谢关系密切。     

成都地区中老年人群LDLC升高的流行状况及影响因素

目的探讨成都城乡地区中老年人群LDLC升高的流行状况及影响因素,为今后本地区脂代谢异常防治奠定基础。方法样本的获取采用分层整群抽样的方法,以社区(村)为单位,抽取城乡社区40~79岁有代表性人群5 230人进行LDLC及相关因素的调查。结果成都地区中老年人群LDLC升高的患病率2.18%。标化患病率为2.03%。40~74岁人群随年龄增大LDLC升高的患病率逐渐增高;75岁以后患病率略有下降。男女两性及城乡患病率差异均无显著性(P均0.05)。成都地区中老年男性人群LDLC升高的危险因素为年龄、糖尿病,适度饮酒为保护因素;中老年女性人群LDLC升高的危险因素为分娩巨大儿、腹型肥胖、糖尿病,保护因素为适度饮酒、体力锻炼。结论成都地区中老年人群LDLC升高的患病率较低,明显低于全国水平。成都乃至四川地区冠心病的相对低发可能与人群高LDLC血症的低患病率有关。防治糖尿病、适度饮酒、合理体力锻炼对预防LDLC升高可能有积极意义。     

浅谈老年糖尿病的营养问题

随着我国老龄人口的增加、膳食结构的改变和体力活动的减少，糖尿病发病率迅速上升，糖尿病已经成为威胁我国居民健康的疾病，据统计60岁以上老年人群中，糖尿病和糖耐量减低患病率均超过11％，成为威胁老年人健康的主要疾病之一。     

克拉玛依和舟山地区2型糖尿病与生活方式关系的调查

目的研究生活方式和２型糖尿病的关系。方法研究对象为１９９４年全国糖尿病普查中经济收入较高而患病率不同的克拉玛依和舟山两地区人群（各１２０例，年龄２５～６４岁），采用问卷形式调查其饮食结构和体力活动状况。结果克拉玛依人群饱和脂肪酸摄入明显高于舟山人群，单不饱和脂肪酸摄入和饮食中多不饱和脂肪酸／饱和脂肪酸比例（Ｐ／Ｓ比例）明显低于后者（Ｐ均＜０．０１）。可能与两地区人群饮食中肉食结构不同有关。体力活动调查显示克拉玛依人群体重指数（ＢＭＩ）明显高于舟山人群（分别为２５．６和２２．４），运动单位明显低于后者（分别为８．６Ｕ／ｄ和１２．５Ｕ／ｄ）（Ｐ均＜０．０１）。Ｌｏｇｉｓｔｉｃ逐步回归分析显示：ＢＭＩ和饱和脂肪酸与糖尿病患病率显著正相关，运动和Ｐ／Ｓ比例与糖尿病患病率显著负相关（Ｐ均＜０．００１）。结论肥胖、低体力活动、饮食中高饱和脂肪酸摄入和低Ｐ／Ｓ比例可能是克拉玛依人群２型糖尿病患病率高的危险因素；与此相反的生活方式可能是舟山人群２型糖尿病患病率低的保护因素。提示保持合理生活方式对预防２型糖尿病是十分重要的     

呼伦贝尔市鄂温克族糖尿病的流行病学研究

对内蒙古呼伦贝尔市鄂温克旗鄂温克民族434人进行了糖尿病（DM）及糖耐量低减（IGT）的流行病学调查。结果糖尿病（DM）16人、患病率3．68％,糖耐量减低（IGT）23人、患病率为5．29％。结论鄂温克族糖尿病发病率较低。     

四川巴中地区老年人糖尿病及糖调节受损患病率的调查

目的了解四川巴中地区老年人糖尿病（DM）及糖调节受损的发病现状。方法采用多级抽样的方法,抽取2414名巴中地区60岁及以上人群进行问卷调查、体检、血糖检查和糖耐量试验。结果2414名对象中,有252例患DM,患病率为10．4％;女性DM患病率高于男性,城镇高于农村,大专及以上文化程度的发病率最低,从事脑力劳动的高于体力劳动的,随经济收入的增高,DM患病率增高。单纯IFG患病率为6．6％,单纯的IGT患病率为22．8％,IFG合并IGT的患病率为1．9％。结论巴中地区老年人糖尿病及糖调节受损的患病形势严峻,应重视和加强防治工作。     

藏族人群高血糖症与颈动脉粥样硬化的关系

目的:探讨藏族人群高血糖症与颈动脉粥样硬化的关系。方法:以拉萨市藏族人群为研究对象,进行临床调查、生化检查和颈动脉检查。检查并分析449例藏族人的糖耐量,糖基化血红蛋白、血压、血脂、空腹胰岛素含量和颈总动脉内中膜厚度。结果:根据糖耐量试验的结果,将研究对象分为3组:正常糖耐量组(NGT)352例,糖耐量低减组(IGT)62例,糖尿病组(DM)35例。患者糖耐量异常的程度越高,患者年龄越大(P<0.01),高血压发病率越高(P<0.05),胰岛素抵抗指数(HOMA-IR)越大(P<0.001),糖基化血红蛋白值越高(P<0.01),血糖(P<0.001)、甘油三酯浓度(P<0.05)越高,高密度脂蛋白-胆固醇水平越低(P<0.05)。IGT和DM组的颈动脉粥样硬化程度远比NGT组严重(P<0.001)。多元回归分析表明,增龄、胆固醇、甘油三酯、低密度脂蛋白、糖基化血红蛋白和胰岛素抵抗指数的自然对数ln(HOMA-IR)是颈动脉粥样硬化的独立危险因素(P<0.05)。结论:高糖血症的藏族人群动脉粥样硬化程度严重。糖基化血红蛋白、增龄、血脂异常、胰岛素抵抗是颈动脉粥样硬化的重要因素。     

空腹血糖受损、糖耐量受损人群3年自然转归及其影响因素的研究

目的 探讨空腹血糖受损(IFG)、糖耐量受损(IGT)人群发生糖尿病的危险性及其影响因素. 方法对2003年4～6月朝阳市市区居民1 062人糖尿病普查中IFG、IGT患者79人于2006年4～6月进行随访调查.测量身高、体重、腰围、血压,做过夜空腹75g葡萄糖耐量试验,同时测定血总胆固醇(TC),甘油三酯(TG),高密度脂蛋白胆固醇(HDL-C).结果 随访的65人中22人发生糖尿病.其中孤立性IFG(I-IFG)糖尿病转变率为10.8%,孤立性IGT(I-IGT)为9.2%, IFG/IGT为10.4%.在不同的年龄组,随着年龄增长糖代谢异常、高血压、肥胖、脂代谢异常有增加趋势,在40岁以上人群糖代谢异常的患病率有明显增加趋势.进行单因素相关分析结果发现血糖升高可能与增龄、糖尿病(DM)家族史、劳动强度、腰围指数(WC)增加、收缩压(SBP)增加、血脂异常等相关.进行Logistic回归分析,高龄、血压升高、中心性肥胖、体力活动强度减弱均为糖尿病危险因素.结论 I-IGT、IGT/IFG人群糖尿病累计发病率明显高于I-IFG人群.增龄、向心性肥胖、高血压、体力活动减少是糖代谢异常的重要危险因素,因此控制血压、体重,增加体力活动,对糖尿病预防具有重要意义.     

A population-based study of the prevalence and associated factors of diabetes mellitus in southern Taiwan

Diabetes mellitus is one of the major health care problems in Taiwan, since the mortality rate has increased from 7.91 per 100 000 in 1980 to 35.1 per 100 000 in 1996. To determine the prevalence of diabetes in southern Taiwan and to investigate possible associated factors, a stratified systematic cluster sampling of 1638 subjects (780 men and 858 women) aged ≥20 years living in Tainan city was investigated with a standard 75-g oral glucose tolerance test. The crude prevalence of diabetes in Tainan was 9.0 % (10.3 % men and 7.9 % women) and the age-adjusted prevalence was 9.2 % (10.4 % men and 8.1 % women). The crude prevalence of IGT was 14.0 % (13.8 % men and 14.1 % women), and the age-adjusted prevalence was 15.5 % (15.0 % men and 15.9 % women). The prevalence of diabetes by using the revised new diagnostic criteria was 7.5%. The prevalence of diabetes and IGT increased significantly with age for both genders, although the rises in prevalence of IGT in women was less consistent. Diabetic and IGT subjects were older and had higher levels of BMI, triglyceride, systolic and diastolic blood pressure, and higher prevalence of obesity, hypertension, and dyslipidemia but indulged in less physical activity than non-diabetic subjects. The significant factors associated with the newly diagnosed diabetes were age, family history of DM, BMI, systolic blood pressure, physical activity, and serum triglyceride levels. © 1998 John Wiley & Sons, Ltd.     

Subscapular skinfold thickness distinguishes between transient and persistent impaired glucose tolerance: Study on Lifestyle-Intervention and Impaired Glucose Tolerance Maastricht (SLIM).

AIMS: To assess whether adding anthropometric measurements to an oral glucose tolerance test (OGTT) can help to distinguish between transient and persistent impaired glucose tolerance (IGT). METHODS: From the SLIM project (Study on Lifestyle-Intervention and IGT Maastricht), a study designed to evaluate whether diet and physical activity intervention can improve glucose tolerance in subjects at risk for diabetes, 108 subjects with IGT underwent a repeated OGTT 2-4 months after the initial OGTT. Following the second test, subjects were classified as transient IGT, or persistent IGT. Anthropometric measurements, including body mass index, waist and hip circumference, sagittal and transverse abdominal diameters and skinfold thickness measurements, were done during the second OGTT. RESULTS: Persistent IGT was diagnosed in 47 subjects (44%), transient IGT in 40 (37%), impaired fasting glucose in eight subjects (7%), and diabetes in 13 cases (12%). Two-hour blood glucose levels at the initial OGTT and subscapular skinfold thickness were significantly higher in subjects with persistent IGT (2-h blood glucose 9.8+/-0.1 mmol/l vs. 10.2+/-0.1 mmol/l for transient IGT and persistent IGT, respectively; subscapular skinfold thickness 25.4+/-1.4 mm vs. 29.8+/-1.2 mm for transient IGT and persistent IGT, respectively). After adjustment for age, sex and family history of diabetes mellitus, logistic regression indicated that 2-h blood glucose level during the initial OGTT represented the strongest predictor of persistent IGT (P<0.02), followed by subscapular skinfold thickness (P<0.05). After adjustment for 2-h blood glucose levels during the first OGTT, subscapular skinfold thickness remained significantly associated with persistent IGT (odds ratio 1.84; P<0.05). CONCLUSIONS: In addition to the 2-h blood glucose level, subscapular skinfold thickness was the best predictor of persistent IGT, suggesting that adding simple anthropometric measures to oral glucose tolerance testing may improve the distinction between persistent and transient glucose intolerance.     

Increased visceral fat and impaired glucose tolerance predict the increased risk of metabolic syndrome in Japanese middle-aged men.

BACKGROUND: Impaired glucose tolerance (IGT) represents a stage of pre-diabetes and is a risk factor for future cardiovascular disease (CVD) which is a major cause of death in type 2 diabetes. The metabolic risk factors such as elevated blood pressure (elevated BP), abdominal obesity, dyslipidemia (elevated levels of total triglycerides [TG] and low levels of HDL cholesterol), and hyperglycemia precede the onset of the metabolic syndrome that increases the risk for CVD. This clustering is commonly associated with pre-diabetic hyperinsulinemia and it reflects peripheral insulin resistance. The present study documented that a visceral fat area (VFA) >/= 100 cm (2) can replace waist-to-hip ratios (WHR) associated with IGT or IFG/IGT as a critical risk for the development of the metabolic syndrome in Japanese middle-aged men. MATERIALS AND METHODS: A total of 575 middle-aged Japanese men with fasting plasma glucose levels of 6.1 - 6.9 mmol/l (impaired fasting glucose; IFG) were enrolled in the study. After a 75-g oral glucose tolerance test (OGTT), blood samples were collected 0 - 2 h later for determination of plasma glucose, insulin concentrations and other variables. Based on the results of an OGTT, the subjects were subgrouped into categories of glucose tolerance for further study. RESULTS: Subjects with IGT or IFG/IGT had significantly higher levels of metabolic abnormalities such as high BMI, increased AUC glucose, elevated HbA1c, high VFA, elevated BP, and increased TG levels when compared to NGT (normal glucose tolerance) (p < 0.001). Compensatory hyper-secretion of insulin was seen in all pre-diabetic subjects, and was higher in IFG/IGT subjects (681 +/- 33 pmol . h/l) than NGT (480 +/- 22 pmol . h/l) (p < 0.01). The metabolic clustering including abnormal VFA, TG, HDL-C, and BP was strongly associated with the development of metabolic syndrome. Interestingly, VFA >/= 100 cm (2) adjusted for the Japanese correlates strongly with the development of the metabolic syndrome in preclinical IGT or IFG/IGT subjects, with odds ratios of 2.7 and higher. CONCLUSION: VFA >/= 100 cm (2) strongly correlates with prediabetic IGT or IFG/IGT which is possibly associated with underlying insulin resistance, and is a critical risk factor linked to the development of metabolic syndrome in Japanese middle-aged subjects with IGT or IFG/IGT.     

432例糖耐量减低患者二年的演变

对1986年诊断的432例糖耐量减低(IGT)者,于1988年进行复查,IGT每年约7.7％发展为糖尿病(DM)。原空腹及服糖后1、2小时血糖较高的IGT者易发展为DM,可能为长期胰岛素抵抗,胰岛对持续高血糖刺激分泌胰岛素的功能失代偿所致。原血糖较低及控制体重的IGT者易恢复正常,并显示胰岛素抵抗减轻及胰岛素分泌功能改善。IGT者转为DM及正常组后血压降低,可能与血浆胰岛素水平降低有关。     

Ten-year mortality and glucose tolerance status in an elderly Finnish population

The aim of this study was to determine the 10-year mortality rate of an elderly population aged 70 years or over (n=379) with reference to glucose tolerance status, taking into account other determinants of excess mortality. The baseline examination during 1991-1992 included a postal questionnaire, a physical examination and a 2h OGTT, which was classified according to both the 1985 WHO criteria and the 1999 WHO criteria. Follow-up was continued until death or until 31 December 2001. 66% of men and 51% of women died within 10 years. In men, the cumulative mortalities were 84% for previously diagnosed diabetes, 67% for undiagnosed diabetes, 67% for impaired glucose tolerance (IGT) and 60% for normal glucose tolerance (NGT). The corresponding percentages for women were 76, 52, 49, and 40%. Male gender, poor self-rated health and previously diagnosed diabetes were the most powerful predictors of mortality. When adjustments were made for age, gender, BMI, cardiovascular disease, hypertension, physical exercise and self-rated health, the estimated relative mortality rate was 2.0 (95% CI 1.5-2.7) among previously diagnosed diabetic subjects, 1.3 (CI 0.8-2.2) among undiagnosed diabetic subjects and 1.1 (0.8-1.5) among IGT subjects compared to NGT subjects. These relative mortalities were higher in women than in men. When abnormal glucose tolerance was pooled into one category, the OR for excess mortality was 1.4 (95% CI 1.1-1.9).     

Glucose tolerance and insulin response in parents of patients with insulin-dependent and juvenile-onset non-insulin-dependent diabetes mellitus.

Glucose tolerance and insulin response were examined using a 100 g oral glucose tolerance test (OGTT) in 108 parents of 23 patients with insulin-dependent (IDDM) and 31 patients with non-insulin-dependent diabetes mellitus (NIDDM), whose age of onset of diabetes was less than 35 years. Thirty-two age-matched healthy volunteers without a family history of diabetes were also examined as a control group. Diabetes and impaired glucose tolerance (IGT) were significantly more frequent in parents of NIDDM (diabetes 34%, IGT 27%) than in parents of IDDM (diabetes 7%, IGT 13%) (P less than 0.001). At least one parent had diabetes or IGT in 30% of IDDM and 84% of NIDDM patients (P less than 0.001), and both parents had diabetes or IGT in 9% of IDDM and 39% of NIDDM patients (P less than 0.02). Even in cases with 'normal' glucose tolerance, the mean plasma glucose was higher in parents of NIDDM than in control subjects, suggesting a high prevalence of abnormal glucose tolerance including the marginal degree of abnormality in the families of NIDDM. The early phase insulin response was decreased more among parents of NIDDM with the greater impairment of glucose tolerance. However, among those with 'normal' glucose tolerance, early phase insulin response did not differ between parents of IDDM and NIDDM, and control subjects. The results confirmed a stronger familial background in NIDDM patients of younger onset than in IDDM. The different patterns of glucose tolerance among two parents of young-onset NIDDM patients suggest heterogeneity of the mode of inheritance of NIDDM among families.     

Screening for Diabetes: Does Measurement of Serum Fructosamine Help?

The diagnostic sensitivity and specificity for diabetes of serum fructosamine levels and fasting venous blood glucose concentrations were compared in 613 subjects during a diabetes community screening programme of 1049 adult Muslim Asians in Dar es Salaam, Tanzania. Using WHO (1985) criteria 228 had impaired glucose tolerance (IGT), 41 had previously been diagnosed as having diabetes while 32 had newly recognized diabetes. The mean (+/- SD) serum fructosamine levels were 20.9 +/- 3.2, 21.6 +/- 3.2, 23.9 +/- 4.9, and 30.1 +/- 7.9 (mumol g-1 albumin) in subjects with normal glucose tolerance, IGT, newly diagnosed diabetes, and previously diagnosed diabetes, respectively (p less than 0.001 for differences between groups). The specificity of values above the mean +2SD normal was 99% for abnormal glucose tolerance with a sensitivity of only 22% for diabetes. The predictive values were 44% and 97% for positive and negative results, respectively. Very little difference from normal was found for IGT subjects. Expressing fructosamine values in absolute terms or per gram albumin made little difference to sensitivity and specificity. The sensitivity was only 32% for fasting blood glucose greater than or equal to 6.7 mmol l-1, 73% for values greater than or equal to 5.5 mmol l-1, and 100% for fasting blood glucose greater than or equal to 4.5 mmol l-1. It is concluded that both serum fructosamine and fasting blood glucose are poor screening and diagnostic tests for diabetes and for IGT, and that glucose loading is required.