捕获-再捕获方法在恶性肿瘤死亡登记报告中的应用

目的 应用捕获再捕获方法估计恶性肿瘤死亡人数,评价癌症登记处收集恶性肿瘤死亡资料的完整性.方法 收集林州市癌症登记处、民政和公安3个来源2004至2005年的恶性肿瘤死亡登记资料.用居住地址、姓名、性别、身份证编码、死亡时间、死亡原因等变量对不同来源数据进行匹配.利用3个数据来源的对数线性泊松模型估计林州市2004至2005年实际的恶性肿瘤死亡人数.结果 捕获-再捕获法估计林州市2004至2005年恶性肿瘤死亡数为3140例(95%CI:3124～3.161),比合并样本多71例;对数线性模型中的交互项显示来源间存在的相依性为正,表明在使用两样本的情况下,会造成缺失病人的低估;用捕获-再捕获得到的校正值作分母,癌症登记处的漏报率为6.6%.结论 运用捕获一再捕获法对恶性肿瘤死亡登记进行估计,可以校正因漏报而造成的数值误差,获得较准确的恶性肿瘤死亡人数.     

地特胰岛素与瑞格列奈治疗老年2型糖尿病的体会

目的:探讨地特胰岛素+瑞格列奈在老年2型糖尿病中的应用价值.方法:选择老年2型糖尿病病患74例,采用数字抽签的方式将之随机等分成A、B两组.其中,A组联合应用地特胰岛素与瑞格列奈,B组应用预混胰岛素.观察两组用药后相关血糖指标的变化情况,比较低血糖发生率等指标.结果:A组治疗后的2hBG、MACE、FBG与HbAlc指标水平均明显优于B组(P<0.05).A组的低血糖发生率(2.7％)比B组(21.62％)更低(P<0.05).结论:积极对老年2型糖尿病病患施以地特胰岛素+瑞格列奈治疗,有助于促进其血糖水平的降低,提高用药安全性.     

Socioeconomic inequalities in the incidence and prevalence of type 2 diabetes mellitus in Europe

Objective

The aim of this study was to analyze socioeconomic position (SEP) inequalities in the prevalence and incidence of type 2 diabetes mellitus (T2DM) in people aged 50 years and over in Europe and to describe the contribution of body mass index (BMI) and other possible mediators.

Methods

This was a cross-sectional and longitudinal study including men and women ≥50 years old in 11 European countries in 2004 and 2006 (n = 21,323). The prevalence and cumulative incidence of T2DM were calculated with self-reported T2DM or when the individual took drugs for diabetes. Prevalence ratio (PR) and relative risk (RR) of prevalent and incident T2DM were calculated according to educational level and adjusted by BMI and other possible mediators.

Results

The age-adjusted and country-adjusted prevalence of T2DM in 2004 was 10.2% in men and 8.5% in women. Compared to those with higher education, men and women with lower education had a PR [95% CI] of T2DM of 1.29 [1.12–1.50] and 1.61 [1.39–1.86], respectively. SEP-related inequalities in incidence (RR [95%CI]) were 1.88 [1.35–2.62] in women and 1.04 [0.78–1.40] in men. Adjusting for potential mediators reduced inequalities in the prevalence and incidence of T2DM among women by 26.2% and 21.6%, respectively, and inequalities in prevalence among men by 44.8%.

Conclusions

We observed significant inequalities in the prevalence and incidence (women only) of T2DM as a function of socioeconomic position. These inequalities were mediated by BMI.     

2型糖尿病患者脂肪肝的患病率及相关危险因素分析

目的了解2型糖尿病患者脂肪肝的患病率,观察其与2型糖尿病非脂肪肝患者的性别、病程、糖化血红蛋白、C肽、血脂、血糖、体重指数等因素的关系。方法对436例2型糖尿病患者进行肝脏B超检查及血糖、糖化血红蛋白、C肽、血脂、体重指数的检测。结果2型糖尿病患者脂肪肝患病率为52.29%,该组患者的体重指数、血甘油三酯与非脂肪肝组比较,差异有统计学意义(P<0.01)。结论2型糖尿病患者脂肪肝患病率明显高于正常人群,体重指数、血甘油三酯为其重要危险因素。     

Estimating the prevalence of multiple sclerosis in the United Kingdom by using capture-recapture methodology.

The geographic distribution of multiple sclerosis is nonrandom, as the disease is more prevalent in temperate than in tropical regions. Surveys conducted between 1970 and 1996 suggest that multiple sclerosis is more prevalent in the northern part of the United Kingdom than in the southern part. This north-south gradient ("the latitudinal gradient") might be a methodological artifact, because high prevalence figures from serial surveys of the northern part of the United Kingdom might have been the result of better ascertainment. By using capture-recapture methods, the authors found that case ascertainment was similar in the northern and southern parts of the United Kingdom. When prevalence figures for multiple sclerosis in the southern United Kingdom were increased to account for the number of unobserved cases, the difference persisted: The prevalence of multiple sclerosis in the northern part of the United Kingdom appeared to be at least 180 cases per 100,000 persons, whereas the maximum prevalence in the southern part of the United Kingdom was less than 160 cases per 100,000 persons. The distribution of multiple sclerosis in the United Kingdom is not uniform and is consistent with the hypothesis that populations with a high prevalence of multiple sclerosis may be genetically predisposed to the disease.     

Hidden diabetes in the UK: use of capture-recapture methods to estimate total prevalence of diabetes mellitus in an urban population

An early requirement of the UK's Diabetes National Service Framework is enumeration of the total affected population. Existing estimates tend to be based on incomplete lists. In a study conducted over one year in North Liverpool, we compared crude prevalence rates for type 1 and type 2 diabetes with estimates obtained by capture-recapture (CR) analysis of multiple incomplete patient lists, to assess the extent of unascertained but diagnosed cases. Patient databases were constructed from six sources-a hospital diabetes centre; general practitioner registers; hospital admissions with a diagnosis of diabetes; a hospital diabetic retinal clinic; a research list of patients with diabetes admitted with stroke; and a local children's hospital. Log linear modelling was used to estimate missing cases, hence total prevalence. The crude prevalence of diabetes was 1.5% (95% confidence interval [CI] 1.41, 1.52), compared with a CR-adjusted rate of 3.1% (CI 3.03, 3.19). Age-banded CR-adjusted prevalence was always higher in males than in females and the difference became more pronounced with increasing age. Among males, CR-adjusted prevalence rose from 0.4% at age 10-19 years to 18.3% at 80+ years; in females the corresponding figures were 0.4% and 9.3%. The gap between crude and CR-estimated prevalence points to a rate of 'hidden diabetes' that has substantial implications for future diabetes care.     

The prevalence of type 2 diabetes and gestational diabetes mellitus in an inner city multi-ethnic population

'Zeeburg', a multiethnic town borough in the Amsterdam-East region, has one of the city's highest rates of immigrants. In the total population of 19,825 Surinam (mainly Creole), Turkish, Moroccan, and Dutch adults the prevalence of known type 2 diabetes in 1994 and of gestational diabetes mellitus (GDM) between January 1992 and January 1997 was investigated. Based on World Health Organization (WHO) criteria of 1985, the age-standardized prevalence of type 2 diabetes was similar in men (6.4%; 95% confidence interval [CI]: 5.6–7.2) and women (6.4%; 95% CI: 5.8–7.0) for all ethnic groups combined. However, the age- and sex-standardized prevalence of type 2 diabetes was significantly greater in the non-Dutch inhabitants than in the Dutch inhabitants (17.3% [95% CI: 12.9–21.6] in Surinam inhabitants, 10.9% [95% CI: 9.7–12.2] in Turkish inhabitants, 12.4% [95% CI: 9.7–15.0] in Moroccan inhabitants, and 3.6% [95% CI: 3.2–3.9] in Dutch inhabitants. The odds ratios for type 2 diabetes for the separate immigrant groups relative to the Dutch group were 5.88 (95% CI: 4.54–7.69) for Surinam inhabitants, 4.00 (95% CI: 2.86–5.55) for Turkish inhabitants, and 4.17 (95% CI: 3.03–5.55) for Moroccan inhabitants. GDM was present in 2.59% of women of non-Dutch origin compared with 0.62% of women of Dutch origin. A significant positive association was found between the non-Dutch origin and the occurrence of GDM (²=6.7; p < 0.01). The study highlights a high prevalence of known type 2 diabetes and GDM in the immigrant inhabitants and emphasizes that appropriate interventions are necessarily with implications for health targets and capitation based budgets.     

The prevalence of late complications of type II diabetes mellitus

Prevalence of late complications determined in a representative group of 137 patients with type II diabetes mellitus and a control group of 128 persons without diabetes from the same population. Retinopathy was not rare in type II diabetes mellitus (prevalence 35%), but only 50% of diabetic patients had proper ophthalmological care. Microalbuminuria was found in 42% of the patients with diabetes mellitus, although serious renal dysfunction was seldom found. The ratio of serious diabetic foot problems was 5%. Neuropathy and macrovascular problems occurred more frequently in the diabetic group, but above 70 years of age there was a remarkable reduction in difference between diabetics and non-diabetics with regard to these complications. In microalbuminuria the same tendency was observed. The cause of this reduction in difference at an older age is discussed.     

Prevention of diabetes mellitus type 2

Diabetes mellitus type II is a major clinical and public health problem and is therefore a candidate for several primary and secondary preventive strategies. Further research on the effects and side effects of both types of prevention is required before it is possible to accurately determine which prevention strategy is most suitable. Research into primary prevention should not only focus on the effect of the strategy on diabetes itself, but also on its complications. With respect to diabetic screening, it is advisable to investigate the cost-effectiveness of several screening strategies. As opportunistic screening is becoming the predominant current practice, a cost-effectiveness study of screening strategies should be started in the short term due to increasing difficulties in selecting a control group.     

常山县2015年2型糖尿病患病及其危险因素现况研究

目的了解常山县18岁以上居民糖尿病的患病现状及其相关危险因素,为有关部门制定糖尿病的预防控制策略提供理论支撑。方法运用多阶段抽样的方法,抽取14个乡镇常住成年居民为调查对象,共对2 064人进行问卷调查、体格检查及实验室检测,应用SPSS22.0软件进行统计分析。结果常山县18岁以上居民的糖尿病粗患病率为6.98%,标化患病率为6.17%,糖尿病患病率伴随着年龄增高呈现上升趋势(χ■=323.54,P<0.05)。高龄、糖尿病家庭遗传史、超重肥胖、高血压以及高血脂是导致糖尿病的危险因素,其OR值及95%CI分别为1.025(1.007～1.043)、3.322(1.183～9.330)、3.002(1.529～5.894)、1.724(1.183～9.330)和2.089(1.443～3.025)。结论常山县18岁以上人群糖尿病的患病率较高,需重点针对糖尿病危险因素,在全社会开展健康教育和健康促进,干预和纠正人们的不良行为生活方式,以遏制农村糖尿病流行的快速增长趋势。     

High prevalence of lactose absorbers in Northern Sardinian patients with type 1 and type 2 diabetes mellitus

BACKGROUND: Increased intestinal lactase activity has been shown to occur in alloxan and streptozotocin diabetic rats. OBJECTIVE: The objective of this study was to determine whether increased intestinal lactase activity is present in humans with diabetes mellitus. DESIGN: We assessed the capacity to digest lactose by measuring breath-hydrogen production after oral administration of lactose in 50 patients with type 1 diabetes, 50 patients with type 2 diabetes, and 50 healthy control subjects from Sassari, Sardinia, Italy, a population characterized by a low prevalence of lactase persistence (lactose absorbers). RESULTS: Fourteen percent of control subjects were lactose absorbers, compared with 48% of patients with type 1 diabetes and 52% of patients with type 2 diabetes (P < 0.005). The odds ratio of lactase persistence in patients with type 1 diabetes was 5.3 (95% CI: 2.0, 14.0) and in patients with type 2 diabetes was 5.5 (95% CI: 2.1, 14.5). CONCLUSIONS: Diabetes is associated with increased intestinal lactase activity in humans. Consequently, there is a greater exposure to glucose and galactose in diabetic patients with high lactose consumption. This may explain the association between diabetes and the risk of cataract.     

Diabetes prevalence and socioeconomic status: a population based study showing increased prevalence of type 2 diabetes mellitus in deprived areas

OBJECTIVE: To establish the relation between socioeconomic status and the age-sex specific prevalence of type 1 and type 2 diabetes mellitus. The hypothesis was that prevalence of type 2 diabetes would be inversely related to socioeconomic status but there would be no association with the prevalence of type 1 diabetes and socioeconomic status. SETTING: Middlesbrough and East Cleveland, United Kingdom, district population 287,157. PATIENTS: 4313 persons with diabetes identified from primary care and hospital records. RESULTS: The overall age adjusted prevalence was 15.60 per 1000 population. There was a significant trend between the prevalence of type 2 diabetes and quintile of deprivation score in men and women (chi 2 for linear trend, p < 0.001). In men the prevalence in the least deprived quintile was 13.4 per 1000 (95% confidence intervals (95% CI) 11.44, 15.36) compared with 17.22 per 1000 (95% CI 15.51, 18.92) in the most deprived. For women the prevalence was 10.84 per 1000 (95% CI 9.00, 12.69) compared with 15.48 per 1000 (95% CI 13.84, 17.11) in the most deprived. The increased prevalence of diabetes in the most deprived areas was accounted for by increased prevalence of type 2 diabetes in the age band 40-69 years. There was no association between the prevalence of type 1 diabetes and socioeconomic status. CONCLUSION: These data confirm an inverse association between socioeconomic status and the prevalence of type 2 diabetes in the middle years of life. This finding suggests that exposure to factors that are implicated in the causation of diabetes is more common in deprived areas.     

Incidence and prevalence of diabetes mellitus in the Americas.

OBJECTIVE: To present the incidence and prevalence of diabetes mellitus in the Americas as found through a thorough review of published information on the subject. METHODS: Data were obtained through a comprehensive review using the MEDLINE and BIREME bibliographical databases. In addition, government publications, conference reports, and meeting documents were identified by contacting government and nongovernmental organizations and other institutions. Incidence and prevalence rates were adjusted by age and sex, when possible, by the direct method using the world Segi population as the standard. The 95% confidence intervals were calculated using the Poisson distribution or the normal distribution. RESULTS: Diabetes mellitus represents a major public health problem in the Americas, and there is evidence that its prevalence is increasing in some countries. CONCLUSIONS: Given that most Latin American and Caribbean nations are experiencing a demographic transition, it is expected that the prevalence of diabetes will continue to increase rapidly in the near future. Despite the economic constraints faced by the countries of the Americas, there is a clear need for more efforts in the area of diabetes prevention and control.     

教育程度和肥胖对2型糖尿病患病交互作用分析

目的了解教育程度和肥胖对2型糖尿病(T2DM)患病交互作用。方法采用概率比例抽样方法,于2012年对昆山市≥18岁居民进行问卷调查与体格检查。样本数据通过复杂加权后进行统计分析,使用多因素logistic回归探究教育程度和BMI、腰围身高比(WHtR)对T2DM的关联及交互作用。结果通过复杂加权后总人群、男性及女性T2DM患病率(95%CI)分别为3.9%(3.7%~4.1%)、3.6%(3.3%~3.8%)和4.2%(3.9%~4.5%)。调整混杂因素(年龄、性别、吸烟、饮酒状态及日常体力活动)后,教育程度(OR=2.99,95%CI:2.69~3.32)、BMI(OR=1.69,95%CI:1.57~1.81)、WHtR(OR=2.12,95%CI:1.91~2.37)与T2DM患病之间存在统计学关联。在调整混杂因素(年龄、性别、吸烟和饮酒状态、体力活动情况)后,教育程度和WHtR交互作用与T2DM患病之间有统计学意义(β=-0.127,Sβ=0.059,χ2=4.58,P=0.032)。结论教育程度及腹型肥胖对T2DM患病呈现相乘交互作用。     

2型糖尿病合并骨质疏松相关因素分析

目的 探讨2型糖尿病患者合并骨质疏松的危险因素,为预防和早期诊断糖尿病合并骨质疏松提供依据。 方法 根据2014年2月-2015年7月茂名市人民医院收治的175例2型糖尿病确诊患者的骨密度值,将患者分为骨质疏松组(OP组)80例和非骨质疏松组(NOP组)95例。比较两组年龄、性别、病程、体重指数(BMI)、血磷、糖化血红蛋白(HbA1c)、碱性磷酸酶(ALP)等一般资料和生化指标的差异,采用Pearson相关分析对各因素和骨密度的相关性进行分析。 结果 OP组骨密度为(0.82±0.17)g/cm,显著低于NOP组(1.25±0.12)g/cm的骨密度值(t=5.862,P＜0.01)。OP组年龄[(67.26±11.35) vs.(61.85±10.62)]岁、病程[(10.44±10.13) vs.(7.03±3.45)年]、BMI[(24.38±3.51) vs.(26.82±4.89) kg/m²]、空腹胰岛素[(12.887±5.265) vs.(18.429±6.166)mIU/L]、HbA1c[(8.23±2.57) vs.(8.23±2.57)%]和ALP[(69.75±23.37) vs.(62.26±20.81) U/L]与NOP组差异有统计学意义(P<0.05)。Pearson相关性分析显示:年龄、病程、HbA1c、ALP与2型糖尿病合并骨质疏松患者骨密度有负相关关系(r=-0.753、-0.657、-0.587、-0.641、-0.714,P<0.05)。BMI和空腹胰岛素与骨密度存在正相关关系(r=0.626、0.765,P<0.05)。 结论 高龄、病程长、低体质量、血糖控制差及高ALP和HbA1c的2型糖尿病患者发生骨质疏松的风险更高,宜给予特殊关注。     

The prevalence of diabetes mellitus in a rural community in Iraq.

A survey was undertaken to estimate the prevalence of diabetes mellitus in a rural community in Iraq. Blood-sugar estimations after glucose-loading were performed on a sample of a village population 15 + years. 4.8% had diabetes and a majority of them had symptoms referable to their diabetic state. Diabetes was totally unknown among this rural population before the survey.     

The impact of type 2 diabetes mellitus on daily functioning.

BACKGROUND: Traditionally, health and the outcomes of medical treatment have been measured in terms of morbidity, incidence or prevalence of disease, or even mortality. This disease model provides an adequate framework for acute illnesses, but for chronic diseases, severity and their effect on everyday functioning are paramount. For chronic diseases, functional health status, as a vital part of quality of life, is now recognized as an important outcome measure of the GP's care. OBJECTIVE: We aimed to assess the impact of type 2 diabetes mellitus on functional health status in Dutch general practice. METHOD: We conducted a cross-sectional study of the functional health status of all patients with type 2 diabetes mellitus under 85 in two general practices, using the Sickness Impact Profile (SIP) and the COOP/WONCA charts. A control group of non-diabetic patients was selected, matched for practice, sex and age. RESULTS: In total, 127 type 2 diabetes mellitus patients and 127 controls participated in the study, the responses being 78 and 70%, respectively. Between these groups the following were significantly different: the SIP subscore Physical, the SIP sum score and the COOP/WONCA scores for physical fitness and overall health. Type 2 diabetes mellitus patients were 2.46 (95% CI 1.5-4.1) times more likely to experience functional impairment. Cardiovascular morbidity (odds ratio 2.5, 95% CI 1.3-4.7), locomotory morbidity (odds ratio 2.6, 95% CI 1.4-5.1) and diabetes itself (odds ratio 1.4, 95% CI 1.1-1.9) were significantly associated with the presence of functional impairment. CONCLUSION: This study demonstrates the impact of type 2 diabetes mellitus on functional status, particularly in relation to cardiovascular morbidity.