甘肃省糖尿病前期患病情况及相关因素分析

目的  探讨甘肃省糖尿病前期(pre-diabetes mellitus, PDM)患病情况及相关影响因素。方法  通过多阶段分层整群随机抽样的方法选取甘肃省内2 866名成年居民进行调查，使用直接标化法计算标化患病率。通过χ²检验分析PDM患病率差异，采用Pearson相关性分析探讨FPG及口服葡萄糖耐量试验(oral glucose tolerance test, OGTT)负荷后2 h血糖(2 h postprandial blood glucose, 2 h PBG)相关影响因素，采用Logistic回归分析模型分析PDM人群患病危险因素。结果  甘肃省PDM总患病率为15.07%，其中糖耐量受损(impaired glucose tolerance, IGT)患病率最高，且不同年龄组间PDM患病率差异均有统计学意义(均有P < 0.05)。PDM组年龄、BMI、SBP、DBP、腰围、TC、TG、LDL-C、尿酸(uric acid, UA)高于正常组，维生素D和尿碘低于正常组(均有P < 0.05)。PDM人群FPG水平与年龄、BMI、SBP、DBP、腰围、TG、TC、LDL-C、UA呈正相关，与HDL-C、血钙、维生素D呈负相关(均有P < 0.05);2 h PBG与年龄、BMI、SBP、DBP、腰围、TG、TC、LDL-C、UA呈正相关，与维生素D呈负相关(均有P < 0.05)，通过Logistic回归分析模型分析得出PDM的危险因素有年龄增长、高BMI、高SBP、高TG、高TC、高UA和患有甲状腺结节，而适宜水平的HDL-C和促甲状腺激素(thyroid-stimulating hormone, TSH)为保护因素。结论  甘肃地区PDM中老年人群患病率相对较高，要重视对PDM高危人群糖耐量水平的监测; PDM人群要提高对UA水平和维生素D水平的关注度，及时进行相应调控干预; 甲状腺结节患病人群要警惕糖调节状态异常，注意甲状腺功能状况，通过调整饮食结构和生活方式来预防PDM。

Analysis of prevalence and related factors of pre-diabetes mellitus in Gansu Province

  Objective  To investigate the prevalence and related influencing factors of pre-diabetes mellitus (PDM) patients in Gansu Province.  Methods  By using the method of multi-stage stratified cluster random sampling, 2 866 adult residents in Gansu Province were investigated, and the standardized prevalence rate was calculated by direct standardized method. χ2 test was used to analyze the prevalence difference of PDM. Pearson correlation analysis were used to analyze the fasting blood glucose (FPG) and oral glucose tolerance test (OTGG) 2 h blood glucose (2 h PBG) related influencing factors. Logistic regression analysis was used to analyze the risk factors of PDM population.  Results  The total prevalence rate of PDM in Gansu Province was 15.07%, among which the prevalence rate of impaired glucose tolerance (IGT) was the highest, and there was a statistically significant difference in the prevalence rate of PDM among different age groups (all P < 0.05). Age, BMI, SBP, DBP, waist circumference, TC, TG, LDL-C and uric acid (UA) in PDM group were higher than those in normal group, while Vitamin D and urinary iodine were lower than those in normal group (all P < 0.05). The level of FPG in PDM population was positively correlated with age, BMI, SBP, DBP, waist circumference, TG, TC, LDL-C and UA, but negatively correlated with HDL-C, serum calcium and Vitamin D (all P < 0.05). The 2 h PBG was positively correlated with age, BMI, SBP, DBP, waist circumference, TG, TC, LDL-C and UA, but negatively correlated with Vitamin D (all P < 0.05). Logistic regression analysis showed that the risk factors of PDM were aging, high level of BMI, SBP, TG, TC, UA and thyroid nodules, while the appropriate levels of HDL-C and thyroid-stimulating hormone (TSH) were protective factors.  Conclusions  The prevalence rate of PDM in middle-aged and elderly people in Gansu area is relatively high, so attention should be paid to the monitoring of glucose tolerance level of PDM high-risk population; PDM people should pay more attention to UA level and Vitamin D level, and timely regulation and intervention should be carried out; people with thyroid nodules should be alert to abnormal glucose regulation status, pay attention to thyroid function status, and adjust diet and lifestyle to prevent PDM.