大连市40岁以上城市人群2型糖尿病及糖尿病前期患病情况及其影响因素分析

Prevalence and risk factors of type 2 diabetes mellitus and pre-diabetes in people over 40 years old from Dalian city

关键词:  糖尿病  糖尿病前期  患病率

Key words:  diabetes mellitus  pre-diabetes  prevalence

摘要:

目的　调查大连地区40岁及以上城市人群2型糖尿病及糖尿病前期患病情况及其影响因素。 　方法　依托中华医学会发起的“中国2型糖尿病患者并发症发生风险的流行病学调查研究”，在辽宁省大连市采用整群抽样的方法，选定李家街街道下属的6个社区的10198名居民为调查对象，既往无糖尿病的患者采用OGTT试验评估其血糖情况，既往明确诊断糖尿病的患者行标准馒头餐试验，检测血糖、血脂、胰岛素水平等相关指标。根据血糖情况，将受试者分为4组：正常血糖组，糖调节受损组，新诊断糖尿病组及既往糖尿病组。分析大连地区糖尿病及其糖尿病前期的患病率及其影响因素。　结果　糖尿病及糖尿病前期的患病率分别为23.4%和25.1%。糖尿病的患病率男性远高于女性，分别为31.8%和20.3%。糖尿病前期中，糖耐量减低（IGT）的比率明显高于空腹血糖受损（IFG）的比率。随着年龄的增长及BMI值的增加，糖尿病及糖尿病前期的患病率在逐年提高。年龄、肥胖、HOMA-IR增高是糖尿病与糖尿病前期的共同危险因素，HOMA-β增高是初发糖尿病与糖尿病前期的共同保护因素。　结论　大连地区糖尿病及糖尿病前期的患病率为23.4%和25.1%，高于全国平均水平。

Abstract:

Objective　 To investigate the prevalence and the risk factors of type 2 diabetes mellitus and pre-diabetes in Dalian city.　Methods　 A total of 10198 subjects aged over 40 years in Dalian area, who participated in an epidemiological study of tumor risk in Chinese type 2 diabetes mellitus patients, were enrolled. Using a cluster sampling, 10198 subjects from six community of Lijia Street in Dalian city were enrolled in this study. Subjects without diabetes history underwent 75 g OGTT, and the subjects with previously diagnosed diabetes underwent standardized steamed bread meal test. We measured plasma glucose level, plasma lipid and insulin levels. According to the history of diabetes and the results of OGTT, subjects enrolled in this study were divided into 4 groups, including normal glucose tolerant group, impaired glucose regulation group, newly diagnosed diabetes group and previous diabetes group. The prevalence rate of diabetes and prediabetes in Dalian city as well as the influence factors were analyzed.　Results　 The prevalence of diabetes mellitus and prediabetes were 23.4% and 25.1%, repectively. The prevalence of diabetes in male was higher than that in female (31.8% vs 20.3%). For prediabetes, the prevalence of IGT was higher than that of IFG. The prevalence of diabetes increased gradually with age and BMI. Logistic regression analysis indicated that age, obesity, and HOMAIR were independent risk factors for diabetes and prediabetes and HOMA-β was an independent protective factor for diabetes and prediabetes.　Conclusion　 The prevalence of diabetes mellitus and prediabetes are 23.4% and 25.1% in Dalian city, respectively, which are higher than the average of China.