山东省居民糖尿病及糖调节受损的流行因素分析

Analysis of epidemiological feature and risk factors of diabetes mellitus and impaired glucose regulation in residents of Shandong province,China

目的了解山东省居民糖调节受损(IGR)和糖尿病(DM)的流行因素。方法采用多阶段分层随机抽样方法,共调查15 350人,以现场测定空腹血糖为主要诊断指标,结合糖耐量试验(OGTT)和既往病史,确定空腹血糖受损(IFG)、口服糖耐量受损(IGT)和DM,同时调查相关的流行因素。结果本次共筛查出IFG、IGT和DM患者分别为1 618、262和941人,患病率分别为9.34%、1.53%和5.50%。IGR和DM患病率均随年龄、体质指数(BMI)和血压水平升高而升高。男性40岁以上,女性50岁以上人群IFG患病率明显增加;无论男性女性,IGT和DM患病率随年龄增加有增高的趋势。随BMI和血压升高,IGR和DM患病率明显升高,超重和肥胖者IGT和DM患病率显著高于低体重和体重正常的人群(P<0.05);理想血压人群患病率显著低于高血压人群(P<0.05)。DM患病率鲁东地区最高,鲁中南次之,鲁西北地区最低,且城市均大于农村;IGR的患病率反之,但两者差异无统计学意义(P>0.05)。IGR和DM患病率均随文化程度增高而降低,文盲者IGR和DM患病率显著高于大专及以上学历居民(P<0.05)。离退休人员DM患病率最高,其次为单位负责人,在校学生IGR和DM的患病率最低。以家庭人均年收入5 000元和20 000元为界划分,IFG和IGT患病率随收入增加而降低,而DM患病率随收入增加呈现"V"型分布。结论山东省居民IGR和DM患病率均随年龄增长出现显著升高趋势,且城市高于农村;职业、收入、BMI和血压水平对IGR和DM的发病有影响。

Objective To investigate the epidemiological feature and risk factors of IGR and DM in residents of Shandong province. Methods Using multistage stratified cluster random sampling method, a total of 15 350 residents were enrolled into the study. IGR, IFG and DM were determined mainly based on the fasting plasma glucose level, combined with OGTT and medical history. Results There were 1618, 262 and 941 cases of IFG, IGT and DM identified with the incidence of 9.34%, 1.53% and 5.50% respectively. The prevalence of 1FG, IGT and DM increased along with age, BMI and blood pressure. Usually, the prevalence of IFG was up among males over 40 and females over 50. There were positive correlations between the incidence of IGT and age, and between the incidence of IGR and BMI as well as blood pressure. People of overweight or obesity had much higher risk of suffering DM and IGT compared with normal population （P〈0.05）, and those with normal blood pressure had much lower risk compared to people with high blood pressure （P〈0.05）.Geographic analysis revealed that the majority of DM cases were from east part of Shandong, followed by mid-south region, and fewer came from northwest part. Also more patients of DM were found in urban other than in rural areas, while more patients from rural areas suffered from IGR, but the differences were not statistically significant （P〉O. 05）. The prevalence of IGR and DM varied along with education level, which showed much higher among illiterate population compared to those with college and above levels （P〈0.05）. Residents who retired had the highest incidence rate of DM, followed by executive leaders, while students had the lowest. Moreover, the prevalence of IFG and IGT decreased as the family income increased when the family annual income was between 5000-20000 Yuan, but the prevalence of DM showed a ＂ V＂ distribution shape. Conclusions The prevalence of IGR and DM shows an upward trend along with age in Shandong province, which is higher among residents from urban than from rural areas. Occupation, income, BMI and blood pressure level are all influencing factors of IGR and DM.