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.     

2型糖尿病患者血清Ghrelin水平与胰岛素抵抗的相关性研究

目的探讨2型糖尿病(T2DM)患者血清生长激素释放多肽(ghrelin)水平与胰岛素及胰岛素抵抗的关系。方法采用病例对照研究,T2DM患者(实验组)20例,健康体检者(对照组)28例。检测2组空腹血糖(FBG)、空腹胰岛素(FINS)、C肽、糖化血红蛋白(HbA1c)水平,计算胰岛素抵抗指数[(HOMA-IR)=FINS(mU/L)×FBG(mmol/L)/22.5],采用酶联免疫吸附法(ELISA)检测两组血清Ghrelin水平。结果实验组FBG、FINS、HOMA-IR、HbA1c、C肽均明显高于对照组[实验组四种指标分别为(9.5±2.0)mmol/L,(30±10)mU/L,10.8±6.4,7.8%±2.0%,(5.0±1.1)ng/mL,比对照组(4.1±0.2)mmol/L,(17±9)mU/L,4.7±2.0,5.5%±0.7%,(3.0±1.0)ng/mL,均P<0.01,实验组血清Ghrelin水平明显低于对照组(P<0.05),并分别与FBG、FINS、HOMA-IR、HbA1c、C肽呈负相关。结论低Ghrelin水平可作为形成胰岛素抵抗和2型糖尿病的可预见性危险因素之一。     

2002年中国城市居民糖尿病流行状况分析

目的了解我国城市居民糖尿病患病现状。方法以全国31省、直辖市、自治区的44个城市调查点中20岁以上成年人为调查对象,共16511人。以现场测定空腹血糖为主要诊断指标,并结合糖耐量试验和患病史调查结果确定糖尿病患者。结果大城市20岁及以上成年人糖尿病标化患病率为6．13％,男性6．08％,女性6．30％;20-、30-,40-、50-、60-、70-、80-岁年龄组患病率分别为1．07％、2．72％、6．50％、11．62％、17．36％、18．32％、10．06％,空腹血糖水平分别是（4．744-0．90）mmol／L、（4．934-1．03）mmol／L、（5．124-1．47）mmol／L、（5．424-1．76）mmol／L、（5．634-1．88）mmol／L、（5．704-2．07）mmol／L、（5．244-1．10）mmol／L。中小城市20岁及以上成年人糖尿病标化患病率为3．78％,男性3．98％,女性3．63％;20-、30-、40-、50-、60-、70-、80-岁年龄组患病率分别为0．41％、1．38％、3．41％、9．14％、12．56％、11．23％、5．56％,空腹血糖水平分别是（4．684±0．58）mmol／L、（4．824±0．74）mmol／L、（4．994±1．04）retool／L、（5．314±1．55）mmol／L、（5．494±1．73）mmol／L、（5．394±1．62）mmol／L、（5．224±1．30）mmol／L。结论大城市、中小城市居民糖尿病患病率和空腹血糖水平的增龄效应明显;与青年人群比较,中老年人群糖尿病患病率明显增高。大城市各年龄组居民糖尿病患病率和空腹血糖水平明显高于中小城市。     

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.     

青岛成人抑郁症和2型糖尿病患病率双向关联研究

目的 评估青岛成人抑郁和2型糖尿病的患病率以及相关危险因素,为社区开展早期慢性病危险因素预防提供科学依据.方法 研究对象来自青岛市2006年建立的横断面研究数据,通过分层随机抽样抽取6 100名35～74岁常住居民(居住时间≥5年).用Zung自评量表进行抑郁的筛检,标准2h糖耐量试验诊断糖尿病.结果 2 974名调查者纳入本研究,抑郁和2型糖尿病的患病率分别为10.1％和16.4％.多因素校正Logistic回归分析中,糖尿病增加抑郁患病风险,农村居民、高密度脂蛋白降低抑郁的风险(均有P ＜0.05);年龄、抑郁、体质指数、甘油三酯、高血压、糖尿病家族史、未婚与2型糖尿病患病率增长均呈正相关(均有P ＜0.05);空腹血糖与抑郁(x2=12.32,OR=1.366,95％ CI:1.151～1.622)、2h血糖与抑郁(x2=11.35,OR=1.212,95％ CI:1.081～1.358)皆存在剂量-反应关系.结论 抑郁和2型糖尿病互为两者患病率增加的独立危险因素.早期开展社区心理干预能够预防抑郁和糖尿病的发生.     

Burkholderia pseudomallei in Environment of Adolescent Siblings with Melioidosis,Kerala, India, 2019

In 2019, Burkholderia pseudomallei was isolated from the backyard of 2 siblings with melioidosis in Kerala, India. This finding highlights the value of healthcare providers being aware of risk for melioidosis in febrile patients, of residents taking precautions when outside, and of increasing environmental surveillance for B. pseudomallei in this region.     

初诊断2型糖尿病患者周围神经病变的相关危险因素分析

目的观察初诊断2型糖尿病（type 2 diabetes mellitus,T2DM）患者糖尿病周围神经病变（diabetic pe-ripheral neuropathy,DPN）的患病率,并分析相关危险因素的影响。方法收集初诊断T2DM患者153例,分为DPN组和无糖尿病周围神经病变（NDPN）组。采集所有患者一般资料和相关生化指标。DPN的诊断标准采用2010年中国糖尿病防治指南的标准。结果 DPN在初诊断T2DM中患病率为38.56%;DPN组空腹血糖和糖化血红蛋白（HbA1c）高于NDPN组,空腹C肽低于NDPN组（均有P〈0.05）,其余指标两组间差异均无统计学意义（均有P〉0.05）;Logistic回归分析显示HbA1c是DPN的独立危险因素。结论研究结果提示临床医生在糖尿病早期即应该干预DPN和相关危险因素。     

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。     

Diabetes stigma,parent depressive symptoms and Type-1 diabetes glycemic control in India

ABSTRACT

Diabetes distress and stigma have been associated with worse patient outcomes in developed countries. However, diabetes stigma has not been studied in low and middle-income countries where clinical practices differ, diabetes awareness is lower, and families face different challenges for supporting children with Type 1 Diabetes (T1D). This study assessed the relationship between parental depression and diabetes stigma with a child’s glycemic control in a clinic-based survey in Nagpur, India. The association between self-reported T1D stigma, depressive symptoms, and child’s measured glycemic control (HbA1C) was assessed with data from 165 of the parents of school-aged (aged 5+) children receiving clinical T1D care at an urban nonprofit organization that provides free clinical care to children with Type-1 Diabetes (T1D) in India. Parents with moderate/severe depressive symptoms who experience stigma associated with their child’s diabetes had children with significantly worse glycemic control than parents with no/mild depressive symptoms who experience the same amount of stigma. Higher reports of stigma were associated with an average of 0.65 points higher HbA1C (β = 0.65, 95% Confidence Interval (CI): 0.18, 1.13) for parents with moderate/severe than parents with mild/no depressive symptoms. Indian parents with depressive symptoms who face social stigma associated with their child’s diabetes have children with worse T1D outcomes.     

昆明市城乡居民劳动强度对2型糖尿病患病率的影响

目的探讨昆明市20岁及以上城乡居民劳动强度与2型糖尿病(T2DM)的关系。方法采用多阶段抽样方法,随机抽取昆明市20岁及以上城乡居民5 191人,进行问卷调查、人体测量及生化指标检测。统计学处理采用SPSS统计软件,率的比较用χ2检验,P0.05为差异有统计学意义。结果调查对象的血压、体质指数(BMI)、腹围、空腹血糖(FPG)、2 h葡萄糖耐量实验(2h-OGTT)、糖尿病患病率均随劳动强度的增加而下降(P均0.001)。轻体力劳动(43.9%)、中等体力劳动(42.9%)和重体力劳动(13.2%)的糖尿病患病率分别为8.1%、4.5%和1.9%。多因素logistic回归分析,在调整了年龄、性别、肥胖等多种潜在混杂因素之后,轻体力劳动组、中等体力劳动组和重体力劳动组糖尿病的OR值分别为0.73(95%CI:0.44~1.31),0.58(95%CI:0.35~0.94),趋势分析P=0.02。结论体力劳动强度对糖尿病的患病率有明显的保护作用,经常性的适度体力劳动有助于降低居民糖尿病患病风险。     

Stress and diabetes in socioeconomic context: A qualitative study of urban Indians

Type 2 diabetes has escalated in urban India in the past two decades. Historically a disease of the affluent, recent epidemiological evidence indicates rising diabetes incidence and prevalence in urban India's middle class and working poor. Although there is substantial qualitative data about people with diabetes from high-income countries, scant resources provide insight into diabetes experiences among those in India, and lower-income groups specifically. In this article, we use individual-level analysis of illness narratives to understand how people experience and understand diabetes across income groups in Delhi, India. We conducted in-depth qualitative interviews and administered the Hopkins Symptoms Check-List (HSCL-25) to evaluate depression among 59 people with diabetes in northeast Delhi between December 2011 and February 2012. We analyzed their responses to: 1) what caused your diabetes?; 2) what do you find most stressful in your daily life?; and 3) where do you seek diabetes care? We found few people held diabetes beliefs that were congruent with socio-spiritual or biomedical explanatory models, and higher income participants commonly cited “tension” as a contributor to diabetes. Stress associated with children's futures, financial security, and family dynamics were most commonly reported, but how these subjective stresses were realized in people's lives varied across income groups. Depression was most common among the poorest income group (55%) but was also reported among middle- (38%) and high-income (29%) participants. One-quarter of respondents reported diabetes distress, but only those from the low-income community reported co-occurring depression and these respondents often revealed poor access to diabetes care. These data suggest that lower-income populations not only have higher rates of depression but also may be more likely to delay health care and therefore develop diabetes complications. This research has many implications for public health care in India as diabetes prevalence shifts to affect lower income groups who concurrently experience higher rates of depression and poorer access to medical care.     

四川凉山彝族农民和移民2型糖尿病患病情况及危险因素

目的 分析四川凉山地区彝族农民和移民2型糖尿病患病情况及其影响因素.方法 在2007-2008年以四川凉山彝族人群为研究对象,采用多阶段整群抽样方法,进行问卷调查以及血样生化检测,共调查彝族人群2878名,其中农民1549名,移民1329名.所有调查对象年龄在16～76岁之间,分为16～、25～、35～、45～、55～76岁5个年龄组.用2000年全国人口普查数据进行标化,计算2型糖尿病标化患病率.对调查的2型糖尿病可能危险因素进行非条件logistic回归分析.结果 彝族农民2型糖尿病患病率为4.33%(67/1549),男性为6.15%(42/683),女性为2.89%(25/866);彝族移民糖尿病患病率为9.03%(120/1329),男性为11.31%(88/778),女性为5.81%(32/551).经2000年全国人口普查数据标化,得到彝族农民男性2型糖尿病标化患病率为5.97%,农民女性为2.40%;彝族移民男性2型糖尿病标化患病率为10.25%,移民女性为6.29%.多因素非条件logistic回归分析结果显示,性别(男性相比女性OR=1.69,95%CI:1.02～2.81)、年龄(相比16～、25～岁组,35～54岁组OR=5.04,95%CI:2.93～8.69;55～76岁组OR=6.19,95%CI:3.23～11.86)、血压(较血压正常组,正常高值OR=1.61,95%CI:1.08～2.38;高血压OR=2.40,95%CI:1.37～4.22)、吸烟(OR=1.55,95%CI:1.01～2.37)、甘油三酯(TG)(OR=1.65,95%CI:1.10～2.46)和高密度脂蛋白胆固醇(HDL-C)(OR=1.64,95%CI:1.13～2.37)水平异常与彝族人群2型糖尿病存在正相关,饮酒量为22.67～52.50 g/d时与2型糖尿病存在负相关(OR=0.53,95%CI:0.30～0.95).结论 彝族移民2型糖尿病患病率高于彝族农民;性别、年龄、血压、吸烟、TG、HDL-C、饮酒是2型糖尿病的影响因素.     

血清尿酸对2型糖尿病预测价值的分析

目的 分析成都地区1992年中年居民血清尿酸水平对2007年该人群2型糖尿病患病的预测价值.方法 1992年进行代谢综合征研究时共纳入1061人,其中年龄45 ～ 60岁且血糖正常者共71 1人,并依据血清尿酸水平分为尿酸正常组及增高组,采用x2检验和logistic回归分析1992年高尿酸血症与2007年该人群(711人)2型糖尿病患病率的相对危险度(RR).结果 (1)1992年血尿酸增高人群在2007年时空腹血糖(FBG)皆高于尿酸正常人群,t检验示组间FBG的差异有统计学意义.2007年糖尿病患病率亦呈类似FBG的特点,为尿酸增高组高于尿酸正常组,经X2检验,组间糖尿病患病率差异有统计学意义.(2)根据该队列人群1992年血尿酸增高与否,计算2007年2型糖尿病患病,RR=3.749,P=0.000,95％CI:2.387 ～ 5.890.(3)使用logistic回归模型分析1992年基线血尿酸对2007年2型糖尿病患病的影响,在调整了其他危险因素后,高尿酸血症RR=1.426,P=0.003,95％CI:1.173～1.705.结论 尿酸异常与血糖代谢异常关系密切,高尿酸血症可预测2型糖尿病的发生.     

Prevalence,incidence and mortality of type 2 diabetes mellitus revisited: a prospective population-based study in The Netherlands (ZODIAC-1)

Background: To present actual data to estimate prevalence, incidence and mortality of known type 2 diabetes mellitus in all age categories in The Netherlands. Methods: Prospective population-based study between 1998 and 2000 in The Netherlands. Baseline population of 155,774 patients, registered with 61 general practitioners participating in the Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC)-study. Results: Age- and sex-adjusted prevalence of type 2 diabetes was 2.2% at baseline and 2.9% after 2 years of follow-up; for women and men it was 3.1 and 2.7% at follow-up, respectively. Patients aged > 70 years account for almost 50% of all type 2 diabetes patients. Age- and sex-adjusted mean annual incidence per 10,000 over 3 years was 22.7 overall; for women 23.1 and for men 22.2. Incidence - even though high - decreases after the age of 70 years. The mortality rate was 47.9/1000 and standardised mortality ratio 1.40. Based on these results, the estimated total number of subjects known with type 2 diabetes was 466,000 for The Netherlands in 2000; the number of patients with newly diagnosed diabetes 36,000. Conclusions: Prevalence and incidence rates exceed all estimates regarding known type 2 diabetes for The Netherlands. Elderly patients, aged 70 years and over, account for 50% of the type 2 diabetic population. These results are important for health-care planning.     

结核分枝杆菌Ｈ３７Ｒａ感染小鼠模型建立及其对Ｂ细胞发育分化特征的实验研究

摘要：目的　建立减毒结核分枝杆菌Ｈ３７Ｒａ感染ＢＡＬＢ／ｃ小鼠模型并探讨Ｈ３７Ｒａ感染对小鼠Ｂ 淋巴细胞分化发育的影响。方法　将２４只ＢＡＬＢ／ｃ小鼠随机分为感染组和对照组,感染组尾静脉注射Ｈ３７Ｒａ菌液１０６ ＣＦＵ／０．２ｍｌ,对照组注射等量生理盐水,感染４周及８周分别取小鼠的肝脏、肺脏及肾脏组织,切片ＨＥ 染色,组织匀浆液接种罗氏培养基培养; 取小鼠骨髓细胞和脾脏细胞经荧光抗体染色, 采用ＦＡＣＳＣａｌｉｂｕｒ分析感染早期及晚期小鼠的Ｂ淋巴细胞表型。结果　感染组小鼠肝脏、肺脏及肾脏肿大,培养后均有Ｈ３７Ｒａ菌株生长。感染组与对照组比较,骨髓总Ｂ 淋巴细胞、脾脏总Ｂ 淋巴细胞、未成熟Ｂ 细胞比例低于对照组,差异有统计学意义（均犘＜０．０５）;感染组骨髓成熟Ｂ淋巴细胞、脾脏成熟Ｂ淋巴细胞比例高于对照组,差异有统计学意义（均犘＜０．０５）;感染组８周骨髓成熟Ｂ淋巴细胞、脾脏成熟Ｂ淋巴细胞较感染组４周时增多（均犘＜０．０５）。结论　本研究成功建立了Ｈ３７Ｒａ感染ＢＡＬＢ／ｃ鼠模型; 小鼠被Ｈ３７Ｒａ感染后影响了Ｂ淋巴细胞的分化发育,促使Ｂ 淋巴细胞向成熟阶段分化,为机体抵御Ｈ３７Ｒａ感染奠定了基础。关键词：结核;分枝杆菌;小鼠模型;Ｂ淋巴细胞;发育分化中图分类号：Ｒ３３２　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１９）０１ ００５８ ０５     

老年2型糖尿病患者糖尿病视网膜病变相关因素分析

目的探讨老年2型糖尿病患者发生糖尿病视网膜病变的相关因素。方法选择我院收治的老年2型糖尿病患者180例,其中90例伴有视网膜病变为观察组,90例不伴有视网膜病变为对照组,分析两组患者的病程、空腹血糖、餐后2h血糖、糖化血红蛋白、收缩压、舒张压、总胆固醇、血清脂蛋白α、载脂蛋白A1、载脂蛋白B等因素与糖尿病视网膜病变发生的相关性。结果两组患者病程、空腹血糖、餐后2h血糖、糖化血红蛋白、收缩压、舒张压、总胆固醇、血清脂蛋白α、载脂蛋白A1、载脂蛋白B方面比较具统计学意义(P<0.05)。结论病程、空腹血糖、餐后2h血糖、糖化血红蛋白、收缩压、舒张压、总胆固醇、血清脂蛋白α、载脂蛋白A1、载脂蛋白B等均是发生视网膜病变的主要相关因素,对于存在有高危因素的老年2型糖尿病患者应给予定期眼底检查。     

不同民族儿童2型糖尿病基因研究进展

儿童2型糖尿病(T2DM)是一种多基因型遗传疾病,发病与种族有明显的关系,不同民族影响儿童T2MD的遗传物质不同。研究显示,T2DM遗传估计率为70%~80%,主要涉及胰岛素及其受体相关基因、糖类和脂肪转运及代谢相关基因、与升糖有关的基因及参与信号传导的基因等。如过氧化物酶体增殖物激活受体Y基因、钙蛋白酶10(calpain 10)基因,葡萄糖转运体l基因、载脂蛋白基因、肿瘤坏死因子Q(TNF Q)基因等。已知与T2MD发病有关的基因仅占1%左右,而99%的基因尚未发现。因此,T2DM遗传基因的确定还需要进一步研究。     

睡眠时间与2型糖尿病关系的研究进展

糖尿病已成为21世纪全球最严重的公共卫生问题。健康睡眠在国外已得到越来越多的重视,而在国内的关注较少。通过文献复习,从流行病学和实验室研究两个方面概述了睡眠时间与2型糖尿病发生、胰岛素敏感性和血糖控制的研究现状和进展。介绍了睡眠时间影响糖尿病的可能机制,为今后相关研究提供依据,为糖尿病的预防和管理提供参考意见。     

天津市社区成年肥胖人群糖尿病患病率和危险因素分析

目的 研究天津市社区成年肥胖人群2型糖尿病(T2DM)患病率及其危险因素.方法 2006年在天津市采用分层整群随机抽样方法抽取全市3个城区和3个郊县≥18岁的成年人进行现况调查,从中选取体重指数(BMI)≥28 kg/m2的人群,共2888人作为研究对象.经过考试培训的调查员对抽样人群进行面对面问卷调查和空腹血糖测定,空腹血糖值≥6.1 mmol/L者再进行餐后2 h血糖测定.描述该人群的T2DM患病率及其人群分布特征,分析患T2DM的危险因素.结果 天津市社区成年肥胖人群T2DM患病率为11.74%,女性患病率(13.90%)高于男性(8.75%).肥胖人群按不同人群特征分组后,不同年龄、文化程度、职业、地区和BMI之间T2DM患病率差异有统计学意义.经单因素和多因素的logistic回归分析,年龄(OR=1.383,95%CI:1.254～1.525)、性别(OR=1.591,95%CI:1.230～2.059)是成年肥胖人群患糖尿病的危险因素,食用水果(OR=0.867,95%CI:0.774～0.971)是保护因素.结论 肥胖人群的T2DM患病率较高,T2DM在不同肥胖人群特征的分布和影响因素与全人群有所不同,可能与肥胖者本身存在的危险因素有关.