上海市2型糖尿病患病情况现状调查

目的 了解上海市社区居民2型糖尿病、糖调节异常（IGR）患病率及其分布特征。方法 采用多阶段整群随机抽样方法,对上海市城、乡社区居民15-74岁者进行横断面的调查。结果 上海市居民2型糖尿病、糖耐量低减（IGT）和空腹血糖受损（IFG）患病率分别为8．6％（1000／11589）、6．9％（802／11589）和1．0％（120／11589）（标化率为6．2％、5．1％和0．8％）。超重、肥胖人群中2型糖尿病患病率为11．5％（454／3946）和16．3％（207／1273）,IGT患病率为8．9％（352／3946）和12．0％（153／1273）,IFG患病率为1．4％（57／3946）和2．3％（29／1273）,明显高于体质指数正常人群[分别为5．3％（337／6364）,4．6％（294／6364）,0．5％（34／6364）]（均P〈0．01）。中心性肥胖人群中2型糖尿病患病率为16．5％（525／3173）,IGT患病率为11．7％（372／3173）,IFG患病率为1．6％（52／3173）,明显高于无中心性肥胖人群[分别为5．6％（475／8416）,5．1％（430／8416）,0．8％（68／8416）]（均P〈0．01）。高血压人群中2型糖尿病患病率为17．4％（479／2752）、IGT患病率为11．0％（303／2752）、IFG患病率为2．0％（56／2752）,明显高于无高血压人群[分别为5．9％（521／8837）,5．6％（499／8837）,0．7％（64／8837）]（均P〈0．01）。男性2型糖尿病、IGT和IFG患病率分别为8．9％（412／4621）、6．4％（296／4621）和1．0％（47／4621）,女性2型糖尿病、IGT和IFG患病率分别为8．4％（588／6968）、7．3％（506／6968）和1．0％（73／6968）,2型糖尿病、IGT和IFG患病率在男女之间差异无统计学意义（均P〉0．05）。城市2型糖尿病、IGT和IFG患病率分别为11．2％（730／6500）、6．4％（419／6500）和1．2％（77／6500）（标化率分别为6．5％、4．9％和0．8％）,农村2型糖尿病、IGT和IFG患病率分别为5．3％（270／5089）、7．5％（383／5089）和0．8％（43／5089）（标化率分别为3．8％、5．4％和0．7％）,城乡之间2型糖尿病和IGT患病率差异有统计学意义（P〈0．05）,IFG患病率差异无统计学意义（P=0．073）。新诊断2型糖尿病比例为47．6％,其中农村为69．3％（187／270）,明显高于城市[39．6％（289／730）]（P〈0．01）。结论 上海市DM患病率呈快速增长趋势,应注重对富裕起来的农村地区居民的早期2型糖尿病筛查。

Cross-sectional investigation of prevalence of type 2 diabetes in Shanghai

OBJECTIVE: To investigate the prevalence of type 2 diabetes and impaired glucose regulation among the permanent urban and rural inhabitants in Shanghai. METHODS: Questionnaire survey, physical examination, and laboratory testing were conducted among 14401 urban and rural inhabitants aged 15 - 74 in Shanghai selected by multistage cluster random sampling. The data about the prevalence of type 2 diabetes and impaired glucose regulation were collected and analyzed. RESULTS: The respondent rate of this investigation was 80.5% (11,589/14,401). The prevalence rates of type 2 diabetes, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) were 8.6% (1000/11,589), 6.9% (802/11,589), and 1.0% (120/11,589) respectively (the standardized rates were 6.2%, 5.1% and 0.8%). The prevalence rates of type 2 diabetes, IGT, and IFG were significantly higher in those with overweight, obesity, central obesity, and hypertension. The prevalence rates of type 2 diabetes, IGT, and IFG in men were 8.9% (412/4621), 6.4% (296/4621), and 1.0% (47/4621) respectively, all not significantly different from those of the women, i.e. e., 8.4% (588/6968), 7.3% (506/6968), and 1.0% (73/6968) respectively (all P > 0.05). The prevalence rates of type 2 diabetes and IGT in the urban area were 11.2% (730/6500) and 6.4% (419/6500) respectively, both significantly higher than those in the rural area, i.e., 5.3% (270/5089) and 7.5% (383/5089) respectively (both P < 0.05). The prevalence rate of IFG in the urban area was 1.2% (77/6500), not significantly different from that in the rural area (0.8%, 43/5039, P > 0.05). The prevalence of type 2 diabetes, IGT, and IFG increased apparently with age, body mass index, waist hip ratio, and waist circumference. The ratios of undiagnosed type 2 diabetes in the urban area and rural area were 39.6% (289/730) and 69.3% (187/270) respectively (chi(2) = 74.07, P < 0.01). CONCLUSION: The prevalence rate of type 2 diabetes in Shanghai is higher than the mean national level and shows an increasing tendency. Screening of type 2 diabetes in rich rural areas should be emphasized.