三门峡市企业退休职工主要慢性病患病现状调查

目的了解河南省三门峡市企业退休职工高血压、糖尿病、血脂异常以及超重、肥胖等主要慢性病的流行状况,为制定相应防控策略提供科学依据。方法采用普查的方法对三门峡市30余家企业退休职工进行针对主要慢性病的体格测量和实验室检查。结果调查对象共7 475名,高血压、糖尿病、血脂异常以及超重和肥胖的患病率分别为44.29%、10.03%、33.19%、41.03%和16.48%;经Cochran-Armitage趋势检验,几种主要慢性病的患病率均有随着年龄增长而升高的趋势(P<0.05);女性的血脂异常、肥胖患病率高于男性(P<0.05);建立logistic回归模型,年龄不同,高血压的发生概率不同,肥胖、血脂异常以及糖尿病是影响这一目标人群高血压患病的主要危险因素。结论三门峡市企业退休职工的高血压、糖尿病、血脂异常以及超重、肥胖的患病率水平高。当前应加强慢性病的三级预防,加强社区慢性病综合防治工作。     

Chronic non-communicable diseases in Cameroon - burden, determinants and current policies

ABSTRACT: Cameroon is experiencing an increase in the burden of chronic non-communicable diseases (NCDs), which accounted for 43% of all deaths in 2002. This article reviews the published literature to critically evaluate the evidence on the frequency, determinants and consequences of NCDs in Cameroon, and to identify research, intervention and policy gaps. The rising trends in NCDs have been documented for hypertension and diabetes, with a 2-5 and a 10-fold increase in their respective prevalence between 1994 and 2003. Magnitudes are much higher in urban settings, where increasing prevalence of overweight/obesity (by 54-82%) was observed over the same period. These changes largely result from the adoption of unfavorable eating habits, physical inactivity, and a probable increasing tobacco use. These behavioral changes are driven by the economic development and social mobility, which are part of the epidemiologic transition. There is still a dearth of information on chronic respiratory diseases and cancers, as well as on all NDCs and related risk factors in children and adolescents. More nationally representative data is needed to tract risk factors and consequences of NCDs. These conditions are increasingly been recognized as a priority, mainly through locally generated evidence. Thus, national-level prevention and control programs for chronic diseases (mainly diabetes and hypertension) have been established. However, the monitoring and evaluation of these programs is necessary. Budgetary allocations data by the ministry of health would be helpful, to evaluate the investment in NCDs prevention and control. Establishing more effective national-level tobacco control measures and food policies, as well as campaigns to promote healthy diets, physical activity and tobacco cessation would probably contribute to reducing the burden of NCDs.     

Ten-year comparison of estimates of overweight and obesity, diagnosed diabetes and use of office-based physician services for treatment of diabetes in the United States

OBJECTIVE: To compare trends in the prevalence of overweight and obesity, diagnosed diabetes and numbers of visits to office-based physicians for diabetes care. RESEARCH DESIGN AND METHODS: Data from the Behavioral Risk Factor Surveillance System and the National Ambulatory Medical Care Survey (1995-2004) were used to compare trends among adults aged 18 years and older for overweight, obesity and visits made to office-based physicians where diabetes was the primary diagnosis. Estimates for overweight and obesity and office visits were made for each year. RESULTS: The prevalence of overweight and obesity increased by nearly 24%. The prevalence of diabetes increased by approximately 76%. The numbers of visits to office-based physicians where diabetes was the primary diagnosis have more than doubled. The average age among adults, who were overweight or obese, was 46.9 years compared to 60.1 years for those seeking care for a diabetes-related issue from an office-based physician. CONCLUSIONS: As the prevalence of overweight and obesity increases, the incidence of diabetes will increase along with the demand for treatment of diabetes later in life. It is imperative to promote population-based programs for reducing overweight and obesity at younger ages in order to reduce the morbidity, mortality and economic cost of the disease as the population ages.     

Noncommunicable Diseases: Current Status of Major Modifiable Risk Factors in Korea

A noncommunicable disease (NCD) is a medical condition or disease that is by definition non-infectious and non-transmissible among people. Currently, NCDs are the leading causes of death and disease burden worldwide. The four main types of NCDs, including cardiovascular disease, cancer, chronic lung disease, and diabetes, result in more than 30 million deaths annually. To reduce the burden of NCDs on global health, current public health actions stress the importance of preventing, detecting, and correcting modifiable risk factors; controlling major modifiable risk factors has been shown to effectively reduce NCD mortality. The World Health Organization''s World Health Report 2002 identified tobacco use, alcohol consumption, overweight, physical inactivity, high blood pressure, and high cholesterol as the most important risk factors for NCDs. Accordingly, the present report set out to review the prevalence and trends of these modifiable risk factors in the Korean population. Over the past few decades, we observed significant risk factor modifications of improved blood pressure control and decreased smoking rate. However, hypertension and cigarette smoking remained the most contributable factors of NCDs in the Korean population. Moreover, other major modifiable risk factors show no improvement or even worsened. The current status and trends in major modifiable risk factors reinforce the importance of prevention, detection, and treatment of risk factors in reducing the burden of NCDs on individuals and society.     

新疆生产建设兵团1998-2008年慢性非传染性疾病的变化趋势分析

目的 了解新疆生产建设兵团(兵团)1998-2008年慢性非传染性疾病(慢病)患病率的变化趋势.方法 采用多阶段分层整群抽样方法 对兵团常住居民进行慢病横断面调查,同时利用1998、2004年两次兵团卫生服务调查慢病相关资料.按1998年调查人口年龄构成进行标化,计算标准化患病率.结果 1998、2004和2008年兵团慢病患病率分别为17.26%、25.61%和24.85%,标准化患病率分别为17.26%、23.54%和20.49%.35～、45～、55～、≥65岁年龄组在1998、2004和2008年的慢病患病率差异均有统计学意义,且呈逐年上升趋势;1998-2008年兵团居民中高血压病、糖尿病、脑血管疾病、冠心病、慢性阻塞性肺部疾病(COPD)的患病率增加较明显;按不同年龄组分析,高血压病在≥35岁组,糖尿病在≥45岁组,冠心病和脑血管疾病在≥55岁组的患病率呈逐年增加趋势.结论 心脑血管疾病、糖尿病是兵团近10年来上升速度较快的慢病,已成为危害兵团居民健康的主要疾病,人口老龄化是主要原因.     

南京市部分社区居民体重和相关慢性病的患病情况

目的通过调查南京市部分社区居民,分析居民超重/肥胖、糖尿病、高血压、血脂异常等慢性病的患病情况,为有关部门采取有效应对措施提供科学依据。方法采用整群抽样方法抽取南京市某区18周岁以上居民812名进行体格和实验室检查,根据体质指数及腰围身高比,计算超重及肥胖率与高血压、糖尿病及血脂异常的关系。结果共调查居民812名,超重率为39.4%,肥胖率为17.6%,中心肥胖率为62.9%,高血压患病率为36.8%,血脂异常患病率为28.3%,糖尿病患病率为13.6%。高年龄组超重肥胖率、中心肥胖率、血脂异常患病率、糖尿病患病率、高血压患病率均高于低年龄组。超重肥胖组(或中心肥胖组)高血压、糖尿病、甘油三酯异常及高密度脂蛋白异常患病率均高于正常体重组,差异有统计学意义(P0.05)。结论调查显示南京市某区超重肥胖率和糖尿病患病率有所增高。     

示范点社区慢病现况及主要危险因素分析

目的 了解示范点社区慢性非传染性疾病（以下简称慢病）流行现况及主要危险因素，为有效地在社区开展慢病预防和控制工作提供参考。方法 采用整群抽样法，示范点社区内6966名居民被抽取为调查对象，分别进行了身高、体重、腰围、血压测量及问卷调查。结果 社区内19种疾病的患病率前五位依次为高血压（31.93％）、慢性胃肠疾病（17．60％）、慢性支气管炎（11．00％）、冠心病（7，97％）、骨质疏松或骨折（5.76％）。超重与肥胖、吸烟、缺乏体育锻炼等是慢病的主要危险因素。结论 示范点社区居民高血压患病率高、超重与肥胖、吸烟、饮酒及缺乏体育锻炼的现状已经对其健康构成威胁。因此，应该采取相应的干预措施，降低危险因素的暴露水平，预防和控制高血压，减少心脑血管疾病的发生。     

肥胖与糖尿病,高血压关系的流行病学研究

目的：了解肥胖在自然人群中的流行特点及其与糖尿病和高血压发生的关系。方法：对江苏常州市城乡社区３２２２名对象进行流行病学研究。结果：该市２０岁以上居民超重和肥胖的患病率分别为２７．９３％、３．４０％,标化率为２４．２６％、２．７２％。肥胖和超重的患病率与年龄呈正相关。女性肥胖有患病率显著高于男性;城镇人群的患病率高于乡村。女性肥胖与糖尿病发病的关系较男性更为密切,无论男性和女性,高血压的患病率均随ＢＭＩ的升高而显著增高。结论：肥胖已成为常州城乡人群的一个重要公共卫生问题,预防肥胖的发生应成为糖尿病和心血管疾病综合防治的重要措施。     

2005年北京市顺义区高血压患病率及相关危险因素分析

目的了解成人高血压患病率及相关危险因素在顺义区的现况,分析相关危险因素对高血压的影响。方法采用等比例多阶段整群随机抽样的方法,3个乡镇、9个调查点被抽中,共计调查18岁及以上常住居民738人。结果调查显示该区18岁及以上人群中高血压患病率为39.84%,年龄、吸烟、过量饮酒、超重和肥胖等因素均对血压患病率有显著影响;高血糖和血脂异常人群的高血压患病率明显高于正常人群。结论该区居民的高血压患病率较高,吸烟、超重、肥胖、高血糖和血脂异常等危险因素与高血压关系密切,亟需采取多种措施加以控制,以此减少高血压对居民健康的危害。     

超重、肥胖和腹型肥胖与心血管代谢性疾病的关联研究

目的 了解超重、肥胖和腹型肥胖对心血管代谢性疾病的影响。方法 采用整群抽样方法,选取河南省开封市通许县673名15岁以上居民为调查对象进行横断面调查,并对研究对象进行问卷调查和体格检查,留取空腹和餐后2h静脉血进行血糖检测。结果 开封地区居民标化超重患病率为35.52%;标化肥胖患病率为14.18%;标化腹型肥胖患病率为42.62%。单因素logistic回归分析显示,超重、肥胖和腹型肥胖是高血压、2型糖尿病、高血脂的危险因素;腹型肥胖是冠心病和脑卒中的危险因素(P<0.05)。腹型肥胖的人群归因危险度(PAR)在高血压、2型糖尿病、高血脂和心脑血管疾病中均高于70%。结论 在对高危人群进行筛查时,腰围比体质指数更为重要。减少腹型肥胖人群比例对预防心血管代谢性疾病的意义更为重大。     

National,regional, and global trends in adult overweight and obesity prevalences

Background

Overweight and obesity prevalence are commonly used for public and policy communication of the extent of the obesity epidemic, yet comparable estimates of trends in overweight and obesity prevalence by country are not available.

Methods

We estimated trends between 1980 and 2008 in overweight and obesity prevalence and their uncertainty for adults 20 years of age and older in 199 countries and territories. Data were from a previous study, which used a Bayesian hierarchical model to estimate mean body mass index (BMI) based on published and unpublished health examination surveys and epidemiologic studies. Here, we used the estimated mean BMIs in a regression model to predict overweight and obesity prevalence by age, country, year, and sex. The uncertainty of the estimates included both those of the Bayesian hierarchical model and the uncertainty due to cross-walking from mean BMI to overweight and obesity prevalence.

Results

The global age-standardized prevalence of obesity nearly doubled from 6.4% (95% uncertainty interval 5.7-7.2%) in 1980 to 12.0% (11.5-12.5%) in 2008. Half of this rise occurred in the 20 years between 1980 and 2000, and half occurred in the 8 years between 2000 and 2008. The age-standardized prevalence of overweight increased from 24.6% (22.7-26.7%) to 34.4% (33.2-35.5%) during the same 28-year period. In 2008, female obesity prevalence ranged from 1.4% (0.7-2.2%) in Bangladesh and 1.5% (0.9-2.4%) in Madagascar to 70.4% (61.9-78.9%) in Tonga and 74.8% (66.7-82.1%) in Nauru. Male obesity was below 1% in Bangladesh, Democratic Republic of the Congo, and Ethiopia, and was highest in Cook Islands (60.1%, 52.6-67.6%) and Nauru (67.9%, 60.5-75.0%).

Conclusions

Globally, the prevalence of overweight and obesity has increased since 1980, and the increase has accelerated. Although obesity increased in most countries, levels and trends varied substantially. These data on trends in overweight and obesity may be used to set targets for obesity prevalence as requested at the United Nations high-level meeting on Prevention and Control of NCDs.

     

昆明市成人超重肥胖流行现状及与血压血糖水平的关系

目的了解昆明市20岁及以上成人超重、肥胖的流行特征,分析超重、肥胖与血压、血糖水平和高血压、糖尿病间的关系。方法采用分层多阶段抽样方法,于2008年1—4月随机抽取昆明市20岁及以上常住居民5195人,进行面对面询问调查和体格检查。结果昆明市20岁及以上城乡居民超重率为25.73%,肥胖率为8.09%。随着体质指数的增加,居民的平均血压和血糖水平均逐渐升高(P0.05),同时,高血压、空腹血糖受损、糖尿病患病率也迅速增高(P0.05),正常体重人群的高血压、空腹血糖受损、糖尿病患病率分别为19.08%,5.35%和4.15%,而超重者高血压、空腹血糖受损和糖尿病患病率分别为30.38%,6.70%和8.23%,肥胖者高血压、空腹血糖受损和糖尿病患病率分别为41.10%,6.36%和14.56%,超重人群的高血压、空腹血糖受损、糖尿病患病率分别是正常体重人群的1.59倍、1.25倍和1.98倍,肥胖人群的高血压、空腹血糖受损、糖尿病患病率分别是正常体重人群的2.15倍、1.19倍和3.51倍。结论超重、肥胖已成为影响昆明市居民健康的重要公共卫生问题,是高血压、糖尿病等慢性病的重要危险因素,应加强对超重、肥胖的干预和控制。     

桂林市社区老年人高血压、糖尿病及相关危险因素调查分析

目的了解桂林市社区老年人高血压、糖尿病及其危险因素流行情况。方法采用多阶段分层整群抽样方法,对桂林市城区15个居委会中≥60岁1 348名老年居民进行问卷调查和体格检查,了解其高血压、糖尿病患病情况,采用非条件logistic回归分析其相关危险因素。结果桂林市社区老年人高血压及2型糖尿病患病率分别为55.12%和12.61%,老年人超重、肥胖、向心性肥胖、吸烟、饮酒、缺乏锻炼等比率分别为32.27%、8.46%、59.79%、16.42%、18.38%和21.21%。Logistic回归分析,老年人高血压的主要影响因素有年龄、中心性肥胖、超重肥胖、离婚、身体锻炼和水果摄入等;糖尿病的主要影响因素有超重肥胖、吸烟、缺少锻炼等。结论桂林市社区老年人高血压、糖尿病患病率处于较高水平,超重和肥胖是主要危险因素。开展社区老年人慢性病综合干预和健康管理,对改善老年人健康水平、提高生活质量具有重要意义。     

超重及肥胖的现况调查

[目的]了解超重及肥胖的现况,并分析其与慢性疾病的关系。[方法]随机抽取2886人进行健康状况问卷调查和医学体检。分析超重及肥胖与冠心病、脑血管病、糖尿病、高血压、血脂异常相对危险度的关系。[结果]天津市居民冠心病、脑血管病、糖尿病、高血压、超重及肥胖、血脂异常的标化患病率分别为9.24%、4.33%、6.74%、34.05%、42.62%、19.98%。BMI≥24、中心性肥胖与高血压、糖尿病、血脂异常、冠心病、脑血管病密切相关。[结论]天津调查对象的超重及肥胖情况与多种慢性疾病有联系,对于BMI达到超重或肥胖标准及腹型肥胖者应加强合理膳食、适当运动,减少静坐时间的行为干预,预防和控制慢性疾病。     

The prevalence and risk factor control associated with noncommunicable diseases in China,Japan, and Korea

Background

Noncommunicable disease (NCD) has become the leading cause of mortality and disease burden worldwide.

秦皇岛市北戴河区社区居民高血压、糖尿病与肥胖关系的调查

目的了解成人高血压、糖尿病与肥胖的关系,为心脑血管疾病的防治提供依据。方法参照1995年全国糖尿病流行病学调查操作指南,随机抽取城市社区的20～92岁居民进行面对面调查。结果 2010年8—10月对北戴河区3 572人进行调查,其中有效资料为3 569份,有效率99.92%。高血压患病率为15.19%(男21.26%,女9.16%%)。超重、全身性肥胖和腹型肥胖总患病率分别为19.73%、30.38%和16.63%;不同体重指数(BMI)的高血压患病率差异有统计学意义(χ2=178.61,P0.01)。随着BMI的增大,高血压患病率有逐渐上升的趋势。按照BMI标准,超重、肥胖和腹型肥胖人群血糖异常的患病率分别为19.50%、25.74%和16.01%,不同BMI糖尿病患病率差异有统计学意义(χ2=143.98,P0.01),均显著高于体重正常人群。结论肥胖与高血压、糖尿病往往共存,是心脑血管疾病的危险因素。控制体重对高血压、糖尿病、心脑血管病的防治有着极其重要的意义。     

广东省40岁及以上居民血压及超重/肥胖对糖尿病的影响

  目的  探讨高血压、超重/肥胖及二者相加交互作用对糖尿病的影响,为预防糖尿病提供依据。  方法  采用多阶段整群随机抽样方法,于2015年9-11月对8 991名居民进行问卷调查、医学体检及采集静脉血。基于复杂抽样构建Logistic回归分析模型及线性回归模型对数据进行统计分析,应用相加模型分析高血压及超重/肥胖对糖尿病患病的交互作用。  结果  Logistic回归分析模型结果显示高血压和超重/肥胖是40岁及以上居民糖尿病的危险因素。相加模型结果显示,高血压和超重/肥胖对糖尿病存在协同作用,OR值为4.45(95% CI: 2.75~7.20)。交互作用对FPG及糖化血红蛋白的影响也大于单独高血压或超重/肥胖人群。  结论  高血压、超重/肥胖是广东省40岁及以上人群糖尿病的独立危险因素,高血压伴有超重/肥胖对糖尿病患病存在相加交互作用。     

A global view on the development of non communicable diseases

For a long time non communicable diseases (NCDs) were discussed as burden of the developed world. Recent alarming data show a reverse trend and a dramatic increase of NCDs in the developing world, in particular in highly populated transition countries. This is true for the main mortality triggering diseases such as CVD, cancer or diabetes. Almost 4 out of 5 NCD based deaths happen in low- and middle income countries. This development is multi-factorial and is based on some main trends such as globalization, supermarket growth, rapid urbanization and increasingly sedentary lifestyles. The latter leads to overweight or obesity, which again promotes NCDs similar as high blood pressure, high cholesterol and elevated blood glucose.A high quality diet including functional food or functional ingredients, accompanied by physical activity and a non-smoking policy, is one of the most promising factors in primary and secondary prevention of NCDs.     

江苏淮安市老年2型糖尿病人群血脂异常的患病情况及其影响因素

目的了解淮安市老年2型糖尿病(以下简称"糖尿病")人群血脂异常患病情况及其影响因素,为社区老年糖尿病人群血脂异常的防治提供依据。方法采用随机整群抽样方法,纳入5 914名社区老年糖尿病患者,采用统一问卷询问其基本情况、饮食结构、生活方式和疾病史等,测量其身高、体重、腰围和血压,并检测其血糖和血脂,采用多因素logistic回归分析老年糖尿病人群血脂异常的影响因素。结果淮安市老年糖尿病人群血脂异常患病率为52.18%。多因素非条件Logistic回归分析显示,年龄增加、城市居住、血脂异常家族史、超重肥胖、中心性肥胖、高血压和血糖未控制是患血脂异常的危险因素,而大专及以上是患血脂异常的保护因素。结论淮安市老年糖尿病人群血脂异常患病率偏高,避免超重肥胖(中心性肥胖)、控制血压和血糖水平均有助于降低血脂异常的患病率,进而降低心血管并发症的发病风险。