深圳市沙井街道户籍人口糖耐量减低15年转归追踪调查

Tracking survey of 15-years impaired glucose tolerance outcome of Shajing Street registered population in Shenzhen City

目的：调查随访经济发达农村城市化地区糖耐量减低（IGT）人群的自然转归及影响因素。方法对深圳市沙井街道2000年流行病学调查126例确诊IGT人群进行15年后转归追踪调查,采用统一调查表格询问病史,测量身高、体重、腰围及血压,计算体重指数（BMI）,进行标准的75 g口服葡萄糖耐量试验,测定空腹血糖（FPG）及餐后2 h血糖（2hPG）。糖尿病（DM）及IGT诊断按1999年WHO诊断标准,肥胖按中国成人超重和肥胖症预防控制指南诊断标准。危险因素分析采用Logistic逐步回归分析。结果126例IGT患者中转化为DM 65例,转化率为51.6%,年转化率为3.44%；与转化为正常糖耐量患者（NGT组）比较,转为DM患者（DM组）的年龄、BMI、FBG、2hPG均明显升高,差异有统计学意义（P〈0.05）。 Logistic逐步回归分析结果显示,与IGT转归为DM相关的危险因素是年龄（OR=1.166,95%CI 1.054~1.311,P=0.031）、BMI（OR=1.445,95%CI 1.152~2.802,P=0.0210）和2hPG （OR=3.015,95%CI 1.166~7.789,P=0.0214）。结论 IGT患者发生DM的主要影响因素为年龄、肥胖和2hPG；转化率低与当地IGT及肥胖患病率低相关；生活方式干预为最有效的预防手段,应加强糖尿病宣传教育,保持良好的饮食烹调方式,加强运动,控制超重及肥胖,继而减少DM的发生,这对经济发达农村城市化地区的DM防控有一定的指导意义。

Objective To investigate the natural outcome and influencing factors of glucose tolerance reduction （IGT） in the developed rural urbanization area. Methods A 15 years outcome tracking survey on 126 cases of IGT population confirmed by epidemiological investigation in 2000 in Shajing Street of Shenzhen City was carried out. A unified survey form was adopted to investigate medical history, measurements of height, weight, waist circumference and blood pres-sure, calculated body mass index （BMI）. Standard OGTT was used to measure FPG and 2hPG. Diabetes mellitus （DM） and glucose tolerance （IGT） were diagnosed according to the 1999 WHO diagnostic criteria. Obesity was diagnosed ac-cording to Chinese adult overweight and obesity prevention and control guidelines. Risk factors were analyzed by Logis-tic stepwise regression. Results 65 cases conerted to DM among 126 patients with IGT, the conversion rate was 51.6%, the annual conversion rate was 3.44%. Compared with the patients conerted to nomal glucose tolerance （NGT group）, age, BMI, FBG, 2hPG were significantly higher in DM group, the differences were statistically significant （P〈0.05）. Lo-gistic stepwise regression analysis results showed that age （OR=1.166, 95%CI 1.054-1.311, P= 0.0031）, BMI （OR=1.445, 95%CI 1.152-2.802, P=0.0210） and 2hPG （OR=3.015, 95%CI 1.166-7.709, P=0.0214） were the risk factors of IGT conerted to DM. Conclusion Main influencing factors of IGT conerted to DM are age, obesity and 2hPG. Low con-version rate is related to low incidence of IGT and obesity in local. Lifestyle intervention is the most effective means of prevention, should strengthen the publicity and education of DM, maintain good cooking mode, strong motion, control overweight and obesity, in order to reduce the incidence of DM, which has a certain guidance meaning for DM preven-tion in economically developed rural urbanization area.