北京市19593名儿童青少年糖尿病患病现况调查

The prevalence of diabetes in children and adolescents of Beijing

目的了解北京市儿童青少年糖尿病(DM)患病的流行特征并分析其在地区、性别和年龄的分布差异。方法以2004年3—10月北京地区6～18岁学龄儿童为研究对象,采用随机整群抽样方法抽取了北京市城乡7个区(县)19 593名在校中小学生。用空腹指末梢血糖进行DM筛查,根据1999年WHO的诊断标准进行DM(DM:空腹毛细血管全血血糖≥6.1 mmol/L)和空腹血糖受损(IFG:空腹毛细血管全血血糖≥5.6 mmol/L并<6.1 mmol/L)的诊断。结果总体DM和IFG年龄标化患病率分别为5.7‰和13.5‰,男性明显高于女性(7.7‰、3.6‰)。DM、IFG年龄标化患病率东城区最高,伴高肥胖率;而平谷县最低(8.9‰和27.4‰,2.0‰和7.5‰)。各区域之间DM患病率男、女性无明显差异,但男性IFG患病率东城区最高(P<0.0001)。总体DM患病率随年龄增长而增高;IFG患病率以10～14岁年龄组最高。男性DM和IFG发生率最高年龄组分别为15～18岁和10～14岁,女性均为10～14岁。结论北京市6～18岁儿童青少年DM及IFG存在较高流行率。

Objective To study the prevalence of Diabetes mellitus （DM） in children and adolescents and to describe the characteristics on age, gender and district distribution of schoolchildren, in Beijing. Methods A cross-sectional screening program the fasting capillary blood glucose （FCBG） was carried out in 19 593 schoolchildren in 7 areas of Beijing from March to October, 2004. According to the WHO diagnostic criteria： DM was set as FCBG≥6.1 mmol/L, impaired fasting glucose （IFG） was set as 5.6 mmol/L≤FCBG〈 6.1 mmol/L. Results The total aggregate age-adjusted prevalence rates of DM and IFG were 5.7%0 and 13.5%0, respectively. The prevalence rates of DM and IFG in males were significantly higher than that in females （7.7‰ vs. 3.69‰ and 26.89‰ vs. 11.39‰. DM Χ^2 = 12,27,P=0.0005;IFG = 47.29, P = 0. 0000）. Among seven districts, East District had the highest prevalence rates of DM and IFG, 8.9‰ and 27.4‰（companied high obesity 28.68% ） while Ping-Gu District having the lowest ones as 2.0‰ and 7.5‰（obese 12.75%） respectively （Χ^2= 13.75,and Χ^2= 32.65,P= 0.0002 and P〈 0. 0001 ）. The DM prevalence rates between districts ranged from 2.0‰ to 8.99‰, Χ^2 = 18.94, P = 0. 004 and the IFG prevalence of districts ranged from 7.59‰ to 27.49‰ （Χ^2= 52.05, P〈 0.0001）. The prevalence rates of DM among different age groups increased with age, with the highest prevalence of IFG on the 10-14 age group. Among boys, the highest prevalence rates of DM and IFG fell in the 15-18 and 10- 14 age groups respectively while the highest prevalence rates on both DM and IFG among girls were in the same age group 10-14. Conclusion The high prevalence rates on DM and IFG were seen in Beijing and showed significant discrimination on age, gender and district distribution. More developed urban district and males had a higher prevalence, companied by higher obesity prevalence. Age seemed to be a high risk factor on DM for boys while the puberty development seemed a high risk factor for girls.