上海市长风社区2型糖尿病高危人群糖代谢异常和危险因素分析

Abnormal glucose metabolism in subjects with high-risk for diabetes and analysis for its risk factors in Changfeng community,Shanghai

目的了解社区糖尿病高危人群中糖代谢异常情况及相关危险因素。方法对40～80岁符合糖尿病高危人群招募条件的1197位上海市长风社区居民,进行问卷调查、体检和生化检测,确定是否有糖尿病高危因素。同时予75 g 口服葡萄糖耐量试验。结果根据检测结果,982人符合糖尿病高危人群定义(高危组),215人不符合糖尿病高危人群定义(非高危组)。高危组中糖代谢异常占47.9%(470/982),新诊断糖尿病占11.5%(113/982),糖调节受损占36.4%(357/982),其中单纯空腹血糖受损(IFG)占14.8%(145/982),单纯糖耐量异常(IGT)占10.7%(105/982),IFG 合并IGT 占10.9%(107/982),明显高于非高危组[分别为17.2%(37/215),0.9%(2/215),16.3%(35/215),9.3%(20/215),5.1%(11/215),1.9%(4/215)](P 均<O.05)。Logistic 回归分析显示,年龄、糖尿病家族史、体重指数、收缩压、甘油三酯与糖代谢片常呈正相关,高密度脂蛋白胆固醇与糖代谢异常呈负相关。结论采用糖尿病高危人群筛查模式能提高糖代谢异常的筛查效率。增龄、糖尿病家族史、超重或肥胖、高血压、脂代谢紊乱是糖代谢异常的主要危险因素。

Objective To investigate prevalence of abnormal glucose metabolism in subjects with high-risk for diabetes and its risk factors in Changfeng community of Shanghai. Methods Totally, 1197 people aged 40 to 80 years without diabetes history eligible for risk for diabetes from Changfeng community in Shanghai were screened by questionnaire, physical examinations and blood biochemical tests to confirm whether they have risk factors for diabetes. Oral glucose tolerance test was performed to all the subjects. Results All the subjects could be divided into high-risk group （982） and non-high-risk group （215） according to their results of the tests mentioned above. Prevalence of abnormal glucose metabolism was 47.9% （470/982） in high-risk group, 113 with newly diagnosed diabetics [ 11.5% （113/982）], 357 with impaired glucose regulation [ 36. 4% （ 357/982 ） ] , 145 with simple impaired fasting glucose （IFG） [ 14. 8% （ 145/982 ） ], 105 with simple impaired glucose intolerance （ IGT ） [ 10.7% （ 105/982 ） ] and 107 with both IFG and IGT [ 10. 9% （ 107/982 ） ], all significantly higher than those in non high-risk group, 17. 2% （37/215） ,0. 9% （2/215）, 16. 3% （35/215） ,9. 3% （ 20/215 ）, 5.1% （ 11/215 ）, and 1.9% （4/215） , respectively （all P 〈 0. 05 ）. Logistic regression analysis showed that age, family history of diabetes, body mass index, systolic blood pressure, serum level of triglyceride positively associated with abnormal glucose metabolism and serum level of high-density lipoprotein cholesterol reversely associated with abnormal glucose metabolism. Conclusions Efficiency of such screening for those with abnormal glucose metabolism could be improved when multiphasic screening was applied for the subjects with high-risk for diabetes. Age, family history of diabetes, overweight or obesity, hypertension and dyslipidemia all were main risk factors for abnormal glucose metabolism.