甘肃省成人糖调节受损特点及分布特征

Characteristics and distribution of impaired glucose regulation subjects in Gansu province

目的：分析甘肃省成人糖调节受损（IGR）的特点和分布情况。方法选取2013至2014年甘肃省糖尿病流行病学调查项目共31417人中的20至74岁经口服75 g葡萄糖耐量试验（OGTT）的28087例为调查对象，分为糖耐量正常（NGT）组、单纯空腹血糖受损（I-IFG）组、单纯糖耐量减低（I-IGT）组以及空腹血糖受损合并糖耐量减低（IFG/IGT）组，按照1999年WHO关于糖尿病诊断标准，比较城乡之间、不同性别、不同年龄段间糖调节受损的分布状况以及IFG、IGT的危险因素。组间差异的显著性比较分别采用独立样本t检验和χ^2检验。结果农村I-IFG和I-IGT的患病率高于城市，差异有统计学意义[4.4%（641/14480）比2.7%（464/16937），10.0%（1443/14480）比9.3%（1571/16937）,χ^2=65.5和4.3，P〈0.05]。农村中男女相比，男性I-IFG患病率高于女性，差异有统计学意义[4.8%（310/6417）比4.1%（331/8063），χ^2=4.4，P〈0.05]。城市中男女相比，男性I-IGT患病率高于女性，差异有统计学意义[10.0%（765/7666）比8.7%（806/9271），χ^2=8.2，P〈0.05]。IGR组分的分布有随年龄增加而增高的趋势。I-IGT各年龄段的患病率分别为5.99%、8.33%、9.80%、10.22%和12.28%，其中20岁组与30岁组、30岁组与40岁组、50岁组与60岁组相比差异有统计学意义（χ^2=21.0、8.0、14.0，均P〈0.05）。IFG/IGT各年龄组患病率分别为0.67%、1.02%、1.98%、2.51%和3.44%，其患病率在30岁以上各相邻年龄段差异均有统计学意义（χ^2=18.2、4.5、9.8，均P〈0.05）。男性、老年、糖尿病家族史、超重、农村居民为IFG的危险因素（OR=1.13、1.16、1.30、1.15、1.52，均P〈0.05），老年、饮酒、超重、均匀性肥胖和向心性肥胖为IGT的危险因素（OR=1.18、1.17、1.27、1.44、1.08，均P〈0.05）。结论 IGR人群在城乡之间、性别和年龄上分布情况不同，关注并控制IGR有助于降低糖尿病的患病率。

Objective To analysis the characteristics and distribution of impaired glucose regulation （IGR） in Gansu province. Methods We selected 28 087 participants who were 20-74 years old in diabetes epidemiology survey between 2013 and 2014 in Gansu province which enrolled 31 417 participants and then divided them into 4 groups by blood glucose level after the 75 g oral glucose tolerance test （OGTT） according to the 1999 WHO diabetes diagnostic criteria： normal glucose tolerance （NGT）, isolated impaired fasting glucose （I-IFG） and isolated impaired glucose tolerance （I-IGT） groups, combined IFG and IGT （IFG/IGT） groups. Then we analyzed the distribution of IGR between city and countryside, different gender and age groups and risk factors of IFG and IGT. Comparison between two groups was done within independent sample t test and chisquare test. Results The prevalence of I-IFG and I-IGT in countryside was higher than in the city, the difference was statistically significant （4.4% （641/14 480） vs 2.7%（464/16 937） and 10.0%（1443/14 480） vs 9.3%（1571/16 937）,χ^2=65.5 and 4.3, respectively, P〈0.05）. In rural area, the prevalence of I-IFG was higher in men than in women, the difference was statistically significant （4.8%（310/6 417） vs 4.1%（331/8 063）,χ^2=4.4, P〈0.05）. In urban area, the prevalence of I-IGT was higher in men than in women, the difference was statistically significant （10.0% （765/7 666） vs 8.7% （806/9 271）,χ^2=8.2, P〈0.05）. The prevalence of I-IGT and IFG/IGT increased with age. The prevalence of I-IGT among different age groups was 5.99%, 8.33%, 9.80%, 10.22%and 12.28%, the differences between 20 and 30,30 and 40, 50 and 60 group were statistically significant（χ^2=20.95,8.0 and 14.0, P〈0. 05 all above）. The prevalence of IFG/IGT among different age groups was 0.67%,1.02%,1.98%,2.51% and 3.44%.The differences between adjacent groups above 30 years old were statistically significant （χ^2=18.2, 4.5 and 9.8, P〈0. 05 all above）. The risk factors for IFG were male, the old age, family history of diabetes, overweight and rural residents （OR=1.13, 1.16, 1.30, 1.15, 1.52, P〈0.05 all above）; the risk factors for IGT were the old age, drinking, overweight, general obesity and central obesity（OR=1.18, 1.17, 1.27, 1.44, 1.08, P〈0.05 all above）. Conclusions The characteristics and distribution of IGR between different gender, different age groups and different areas （city or countryside） were significantly different. It is helpful to pay attention to IGR and control risk factors to reduce the incidence of diabetes.