拉萨地区藏族成年人群糖尿病前期及糖尿病患病率初步调查分析

Preliminary investigation on prevalence of pre-diabetes and diabetes among Tibetan adults in Lhasa

目的初步调查分析拉萨地区(平均海拔3680 m)藏族成年人糖尿病前期和糖尿病的患病情况。方法应用甲状腺和糖尿病疾病全国调查研究数据库进行分析,选取≥18岁的近三代未通婚藏族城乡居民为调查对象,行体格检查、问卷调查及FPG、TG、LDL-C、HDL-C、SUA、HbA1c等生化指标检测。既往未诊断糖尿病人群行75 g OGTT,已诊断糖尿病人群行空腹静脉血检查。结果(1)入组2603例,男性951例,占36. 53%。拉萨地区藏族糖尿病、糖尿病前期总患病率为4. 42%(115/2603)、6. 95%(181/2603),根据2010年第6次全国人口普查数据标化后患病率为4. 6%、7. 2%;(2)城镇和农村糖尿病患病率为4. 24%(77/1816)、4. 83%(38/787),标化后患病率为4. 90%、4. 20%,城镇和农村糖尿病前期的患病率为5. 56%(101/1816)、10. 17%(80/787),标化后患病率为6. 3%、9. 9%;(3)新诊断糖尿病比例为53. 04%(61/115),其中农村为73. 68%(28/38),远高于城镇42. 86%(33/77);(4)增龄、中心性肥胖、高甘油三酯血症均为糖尿病及糖尿病前期的危险因素。结论拉萨地区藏族成人糖尿病、糖尿病前期患病率低于全国平均水平;糖尿病诊断率低,农村地区更为明显;需根据危险因素制定针对高危人群的干预措施。

Objective To understand the prevalence of diabetes mellitus(DM)and pre-diabetes in Tibetan adults in Lhasa City(average elevation of 3680 m)in the plateau area.MethodsThe study was conducted based on the national survey of thyroid diseases and diabetes diseases(TIDE)database. Tibetans and township residents aged 18 and over(the latest three generations having no intermarriage)were selected for physical examination,questionnaires and blood biochemical indicators detection(FPG,TG,LDL-C,HDL-C,SUA,HbA1 c). A standard 75 g oral glucose tolerance test was performed in previously undiagnosed diabetes.Results(1)2603 people were enrolled,with 951 men accounting for 36. 53%. The prevalence of Tibetan diabetes mellitus and pre-diabetes in Lhasa was 4. 42%(115/2,603)and 6. 95%(181/2603)respectively. The prevalence after standardization according to the data of the sixth national census data in 2010 was 4. 6%,7. 2%,respectively;(2)The prevalence of diabetes mellitus in urban and rural areas was4. 24%(77/1,816)and 4. 83%(38/787),respectively. The prevalence after standardization was 4. 90%and 4. 20%,respectively. The prevalence of pre-diabetes in rural areas was 5. 56%(101/1816)and10. 17%(80/787),respectively. The prevalence after standardization was 6. 3%,9. 9%;(3)The proportion of newly diagnosed diabetes was 53. 04 %(61/115),of which 73. 68%(28/38)in rural areas,much higher than 42. 86%(33/77)in urban areas;(4)Age,central obesity and hypertriglyceridemia were risk factors for diabetes and pre-diabetes.ConclusionThe prevalence of diabetes mellitus and pre-diabetes in Tibetan adults in Lhasa is lower than the national average. The diagnostic rate of diabetes is low,especially in rural areas. Interventions for high-risk groups need to be developed based on risk factors.