2016-2017年上海市社区糖尿病高危人群筛查结果分析

  目的  描述2016-2017年上海市社区居民糖尿病高危人群筛查的结果，分析糖调节受损及糖尿病患者的危险因素。  方法  选择上海市长宁区和松江区35岁及以上居民进行糖尿病风险评估，对高危人群进行体格检查和血糖检测。  结果  两个社区共完成筛查33 469人，检出糖调节受损者4 555名和糖尿病患者3 412名，检出率分别13.6%和10.2%。高危人群中，随着年龄增加，居民发生糖尿病（男:P < 0.001；女:P < 0.001）和糖调节受损（男:P < 0.001；女:P < 0.001）的风险均增加；郊区男性患糖尿病的风险低于城区男性（OR=0.873，95%CI:0.771~0.988），而郊区女性发生糖调节受损的风险高于城区女性（OR=1.249，95%CI:1.131~1.379）；自述有糖调节受损史（男:P < 0.001；女:P < 0.001）、亲属有2型糖尿病家族史（男:P < 0.001；女:P < 0.001）、高血压（男:P < 0.001；女:P < 0.001）、血脂异常（男:P < 0.001；女:P=0.015）、体型超重/肥胖者（男:P < 0.001；女:P < 0.001）、长期静坐的生活方式的男性（P=0.002）和有多囊卵巢综合征史的女性（P=0.011）出现血糖异常的风险更高，居民的高危因素种类数越多，发生糖尿节受损和糖尿病的风险就越大（P < 0.001）。  结论  上海市社区糖尿病的发现和防治工作形势十分严峻，应继续加强对糖尿病高危人群的监测和干预，以减少糖尿病的发生。

Analysis of diabetes screening in high-risk population in different communities in Shanghai from 2016 to 2017

  Objective  To describe the results of screening for high-risk population of diabetes mellitus among community residents in Shanghai from 2016 to 2017 and analyze the characteristics of subjects with impaired glucose regulation or diabetes patients.  Methods  After the diabetes risk assessment for the residents aged 35 and older in Changning and Songjiang district of Shanghai, physical examination and blood glucose test were conducted for high-risk groups.  Results  A total number of 33 469 people in the two communities were screened, 4 555 patients with impaired glucose regulation and 3 412 patients with diabetes were detected. The detection rates were 13.6% and 10.2%, respectively. In high-risk population, aging was significantly correlated with the risk of diabetes(males: P < 0.001;females: P < 0.001) and impaired glucose regulation(males: P < 0.001;females: P < 0.001). The risk of diabetes in rural males was lower than that in urban males (OR=0.873, 95% CI: 0.771-0.988), while rural females had a higher risk of impaired glucose regulation than urban females (OR=1.249, 95% CI: 1.131-1.379). Self-reported history of impaired glucose regulation(males: P < 0.001;females: P < 0.001), family history of type 2 diabetes(males: P < 0.001;females: P < 0.001), hypertension(males: P < 0.001;females: P < 0.001), dyslipidemia(males: P < 0.001;females: P=0.015), overweight/obesity(males: P < 0.001;females: P < 0.001), long-term sedentary lifestyle in males (P=0.002) and a history of polycystic ovary syndrome in females (P=0.011) were related to the risk of dysglycemia. The more of the number of high-risk factors for residents, the higher the risk of impaired glucose regulation and diabetes (P < 0.001).  Conclusions  The situation of community diabetes detection and prevention in Shanghai is very serious. Therefore, it is necessary to strengthen the monitoring of high-risk groups of diabetes and take targeted intervention measures to reduce the occurrence of diabetes in high-risk population.