河南省开封地区2型糖尿病及糖尿病前期横断面研究

Cross-sectional study of type 2 diabetes mellitus and prediabetes in Kaifeng area of Henan province

目的了解开封地区2型糖尿病(T2DM)和糖尿病前期(IGR)患病率及危险因素,确定合适的身体测量指标的切点。方法采用整群抽样的方法,选取通许县朱砂镇和城关镇673名15岁以上居民为调查对象进行横断面调查(以户为单位),并对研究对象进行问卷调查和体格检查,留取空腹和餐后2 h静脉血进行生化指标测定。结果开封地区居民T2DM粗患病率为8.77%,标化患病率为10.01%,IGR粗患病率为40.56%,标化患病率为42.10%;多元logistic回归分析显示,年龄、空腹血糖和既往有其他慢性病史是IGR和T2DM共有的独立危险因素;腰臀比和腰身比在预测T2DM和IGR时比较稳定,一致性较好,预测效果优于体质指数(BMI)。预测T2DM时腰臀比的预测切点是0.89,预测IGR时腰臀比的预测切点是0.87,腰身比预测切点均是0.51。结论开封地区的IGR患病率较高,应采取多种有效措施降低糖尿病的发病风险。

Objective To obtain the prevalence and risk factors of type 2 diabetes mellitus（T2DM） and prediabetes in Kaifeng area and to determine the appropriate cut-off point of the body measurement indexes. Methods The random sampling method was used to select 673 residents（ 15 years old and household as unit） from Zhusha town and Chengguan town of Xu county as the subjects for this cross-sectional study. The investigation was performed by questionnaire, physical examination and detecting fasting plasma glucose（FPG） or postprandial 2 h blood glucose for all subjects. Results The crude morbidity and standardized morbidity of T2 DM in Kaifeng area were 8.77% and 10.01%, respectively. The crude morbidity and standardized morbidity of prediabetes in Kaifeng area were 40.56% and 42.10%, respectively. Multivariate logistic regress analysis showed that age, FPG and chronic disease history were independent risk factors for T2 DM and prediabetes; the waist hip ratio（WHR） and waist to height ratio（WHt R） were more stable and consistent in the prediction of T2 DM and prediabetes, as compared with BMI. The cut-off point of WHR was 0.89 for predicting T2 DM and 0.87 for predicting prediabetes. The cut-off point of WHt R was 0.51 for predicting T2 DM and prediabetes. Conclusion The prediabetes morbidity is much higher in Kaifeng area. The multiple effective measures should be taken to reduce the risk of diabetes.