上海市闸北区45岁及以上糖尿病高危人群的特征及其危险因素分析

Characteristics and Risk Factors among Diabetic High Risk Population over and Include 45 Years Old in Zhabei District in Shanghai

目的了解上海市闸北区45岁及以上居民糖尿病高危人群的特征,并研究其危险因素,为辖区糖尿病预防工作前移提供依据。方法于2009年1-6月采用随机整群抽样的方法,以居委会为单位,按5%的比例从闸北区常住人口中抽取16151非糖尿病患者,参考《上海市社区糖尿病防治指南》将其分为糖尿病高危人群和非高危人群,并对其进行问卷调查、体格检查和生化指标测定。采用非条件logistic回归分析糖尿病高危人群的危险因素。结果筛选出糖尿病高危人群11323人,占70.1%。糖尿病高危人群的年龄、男性比例、颈围、体重、体质指数、腰臀比、血压值、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、肝功能指标、癌胚抗原、大便隐血阳性比例、是否吸烟、是否饮酒等指标均明显高于非高危人群,高密度脂蛋白胆固醇水平和每日睡眠时间低于非高危人群,差异均有统计学意义(P<0.01)。非条件logistic回归分析结果显示,腰臀比(OR=90.969,95%CI=48.032～172.291)、甘油三酯(OR=2.142,95%CI=2.006～2.288)、空腹血糖(OR=1.328,95%CI=1.251～1.409)、舒张压(OR=1.065,95%CI=1.058～1.072)、收缩压(OR=1.045,95%CI=1.040～1.049)、血清丙氨酸转氨酶(OR=1.020,95%CI=1.015～1.025)和血尿酸(OR=1.004,95%CI=1.003～1.004)水平越高,年龄(OR=1.017,95%CI=1.013～1.022)越大,越容易成为糖尿病高危人群,同时女性(OR=1.772,95%CI=1.607～1.953)比男性更容易成为糖尿病高危人群。而血清天冬氨酸转氨酶(OR=0.979,95%CI=0.973～0.985)水平越高,则越不容易成为糖尿病高危人群。结论闸北区糖尿病高危人群比例较大,健康状况低于非高危人群。应将预防控制策略前移,通过改善糖尿病高危人群的生活方式达到预防糖尿病的目的 。

Objective To understand the condition and the risk factors of diabetic high-risk population aged 45 and over years old in Zhabei district, Shanghai. Methods With random cluster sampling, 16 151 non-diabetic residents were selected among 5% of permanent residents of Zhabei district during January to June, 2009 and were divided into 2 groups, one was diabetic high-risk group and the other was non-high-risk group according to Shanghai Community Diabetic Prevention Guide. The risk factors were analyzed by non-conditional logistic regression. Results The study showed that people in diabetic high-risk group accounted for 70.1%. The univariate analysis showed that people were older in non-high-risk group than in diabetic high-risk group, and in non-high-risk group there were more males, more residents with FOB positive, and more residents who smoked, drank, and slept less. Also, the education level and values of neck circumference, weight, BMI, WHR, BP, FPG, TG, TC, LDL-C, liver function and CEA of people in diabetic high-risk group were higher than those of people in non high-risk group. Whereas, the value of HDL-C was lower in diabetic high risk group than that in non-high-risk group. The multivariate analysis showed that factors such as WHR （OR=90.969, 95% CI： 48.032-172.291）, TG （OR=2.142, 95% CI： 2.006-2.288）, gender （OR=1.772, 95% CI： 1.607-1.953）, FPG （OR=1.328, 95% CI： 1.251-1.409）, DBP （OR=1.065, 95% Ch 1.058-1.072）, SBP （OR-1.045, 95% CI： 1.040-1.049）, ALT（OR=1.020, 95% CI： 1.015-1.025）, age （ OR =1 .017 , 95% CI： 1.013-1.022）, UA（OR=I.004, 95% CI： 1.003-1.004 ）, and AST（ OR-0.979, 95% CI： 0.973-0.985 ）, were all the risk factors for people at high risk of diabetes mellitus. Conclusion There are quite amount of people with diabetic high risks. Their overall health condition is worse than the average. Early prevention strategy to effectively prevent people should be conducted from being at high risk of diabetes and help them to form good living habits.