广西柳州市2个社区糖耐量低减与正常人群糖尿病发病率比较及影响因素分析

背景糖尿病发病率可预测其发展趋势,目前国内糖尿病发病率较以前有所升高.目的对糖耐量低减和正常人群的糖尿病发病率进行比较,分析相关影响因素的危险性.设计以广西柳州市2个社区的成年人为研究对象的整群抽样调查.单位一所大学医院的内分泌科.对象1994-07/08对柳州市4个较大单位社区的人群进行糖尿病患病率调查,常住人口11886名,均为20～75岁的成年人,且在柳州市城乡居住5年以上.1999-10对其中2个单位社区的糖耐量低减和正常者进行随访,应查9230例,实查6 020例,反映率65.22%(因下岗、退休等原因失访人数较多).纳入标准最终两次资料均完整者5539例进入统计.正常者5 273例,糖耐量低减者266例;男3 177例,含糖耐量低减110例,平均年龄(40±12)岁;女2362例,含糖耐量低减156例,平均年龄(41±10)岁.排除标准继发性糖尿病.方法1994年广西柳州市2个单位社区糖尿病患病率调查中确定为非糖尿病(包括糖耐量低减和正常人)的5539例,于1999年复查血糖、体质量指数、血压及血脂,分析各因素对糖尿病发病率的影响.主要观察指标①终点结局指标各年龄组糖尿病发病率.②危险性指标糖尿病发病率相关危险因素比较.结果纳入统计5539例.5 273例正常者中,46例转变为糖尿病,年转化率为0.19%;而266例糖耐量低减者中,50例转化为糖尿病,年转化率为3.84%,相对危险性是正常人的20.9倍,差异有显著性意义(x2=1063.1,P<0.000 1).结论糖耐量低减者转化为糖尿病的危险性远高于正常人.年龄、体质量指数、高血压、空腹血糖、血糖、葡萄糖耐量试验1h血糖、葡萄糖耐量试验2 h血糖是糖尿病发病的危险因素.

Diabetic morbiditycomparison and its influencing factors between populations with impaired glucose toleranceand normal blood glucose tolerance in two communities of Liuzhou city Guangxi ZhuangAutonomous Region

BACKGROUND: Diabetic morbidity can predict its progress tendency. National diabetic morbidity has been increased compared with previous level at present.OBJECTIVE: To compare the diabetic morbidity between populations with impaired glucose tolerance or normal blood glucose tolerance to analyze its correlative influencing factors.DESIGN: A cluster sampling survey in two communities of Liuzhou City Guangxi Zhuang Autonomous Region based on adults.SETTING: Department of endocrinology in a university hospital.PARTICIPANTS: Diabetic morbidity was investigated in 4 relative big unit communities of Liuzhou City between July and August 1994. The resident population of the communities was 11 886, which were all adults between 20 and 75 years old and lived in Liuzhou City for more than 5 years. Populations with either impaired glucose tolerance or normal blood glucose tolerance in 2 of the 4 unit communities were followed up in October 1999. Totally 9 230 individuals should be checked and 6 020 subjects were actually checked with the response rate of 65.22% (quite a few cases lost followed up due to unemployment and retirement, etc. ) . Inclusion criteria: Finally 5 539 subjects with complete data of two surveys entered into statistics. There were 5 237 normal individuals and 266 individuals with impaired glucose tolerance. And there were 3 177 males including 110 individuals with impaired glucose tolerance with an average age of(40 ± 12) years old, and 2 362 females including 156 individuals with impaired glucose tolerance with an average age of(41 ± 10) years old. Exclusion criterion: secondary diabetes.METHODS: Totally 5 539 subjects(including individuals with normal blood glucose or impaired glucose tolerance) who confirmed without diabetes in 1994 survey for diabetic morbidity in 2 unit communities of Liuzhou City Gugangxi Zhuang Autonomous Region received recheck in 1999 including blood glucose, body mass index(BMI), blood pressure and blood fat to analyze the impacts of each factor on diabetic morbidity.bidity among correlative risk factors.RESULTS: Totally 5 539 individuals were included into statistics. A totally of 46 of 5 237 normal individuals developed diabetes with the annual percent of conversion of 0.19%, while 50 of 226 individuals with impaired glucose tolerance developed diabetes with the annual percent of conversion of 3.84%, which had 20.9 times of correlative risk significantly higher than normal individuals(x2 = 1 063.1, P < 0. 000 1).CONCLUSION: The risk of diabetes is higher in individuals with impaired glucose tolerance than normal individuals. Age, BMI, hypertension, fasting blood glucose, blood glucose, and 1 hour blood glucose in Glucose tolerance test are risk factors of diabetic morbidity.