中国儿童青少年糖尿病患病率Meta分析

A Meta-analysis of prevalence of diabetes mellitus among Chinese adolescents

目的采用Meta分析了解中国儿童青少年糖尿病流行情况,为糖尿病的早期防治提供科学依据。方法系统检索中国期刊全文数据库（CNKI）、万方数据资源系统（Wan-fang）、维普数据库（VIP）和Pub Med中2000年1月1日至2015年12月31日期间所有关于儿童青少年DM患病率研究的文献。中文检索策略以主题词、摘要、题名以及关键词分别进行＂儿童＂或＂青少年＂＋＂糖尿病＂或＂血糖升高＂＋＂患病率＂或＂流行＂或＂趋势＂检索。外文检索策略为（child＊OR adolescent＊OR prepubescent＊OR postpubescent＊OR pubescent＊OR youth＊OR teen＊）AND（diabetes OR diabetes mellitus OR DM）AND（prevalence OR incidence OR epidemiology OR trend）AND（China OR Chinese）。采用Stata 12.0软件进行数据合并,采用随机效应模型和自然对数转换法计算合计患病率,按诊断标准、性别和年龄段进行亚组分析。结果共纳入8篇文献（5篇中文、3篇英文）。Meta分析显示,中国儿童青少年糖尿病患病率为0.80‰（95%CI=0.17‰~3.73‰）。亚组分析中,按照诊断标准进行分组,WHO标准诊断糖尿病,中国儿童青少年糖尿病患病率为1.73‰（95%CI=0.70‰~4.26‰）,高于美国糖尿病学会标准诊断糖尿病患病率的0.49‰（95%CI=0.12‰~1.89‰）;按性别分层后,男、女生糖尿病合并患病率分别为0.93‰（95%CI=0.07‰~12.22‰）和0.62‰（95%CI=0.11‰~3.48‰）,男生略高于女生;按年龄段分组,13~18岁的儿童青少年糖尿病合并患病率为1.13‰（95%CI=0.11‰~12.25‰）,高于0~6岁的糖尿病合并患病率1.05‰（95%CI=0.09‰~12.92‰）,7~12岁糖尿病合并患病率最低[0.87‰（95%CI=0.13‰~5.76‰）]。结论中国儿童青少年糖尿病的患病率较高,不同诊断标准对儿童青少年糖尿病的检出率影响较大。儿童青少年糖尿病的防治任务刻不容缓。

Objective This study aims to evaluate the prevalence of diabetes mellitus（ DM） among Chinese adolescents in order to provide scientific basis for early prevention of DM. Methods Studies on prevalence of diabetes mellitus among Chinese adolescents from 2000 to 2015 were searched with the inclusive and exclusive criteria. Stata 12. 0 software was used to estimate the prevalence of diabetes mellitus and the pooled prevalence was calculated by adopting Natural Logarithm Transformation Method.Subgroup analysis was made based on different diagnosis, gender, and age groups and the meta-analysis of data was conducted based on the random effects model. Results Eight studies were included in the meta-analysis with a total sample of about three million study participants. According to the result of Meta-analysis, the prevalence rate of diabetes mellitus among Chinese adolescents was seen as 0.80‰（ 95%CI = 0.17‰-3.73‰）. According to the diagnostic criteria in WHO and American Diabetes Association（ ADA）, the prevalence rates of diabetes mellitus among Chinese adolescents were 1. 73‰（ 95% CI = 0. 70‰- 4. 26‰） and0. 49‰（ 95%CI = 0.12‰-1.89‰）, respectively. In consideration of gender, the prevalence rates of diabetes mellitus were 0.93‰（ 95%CI = 0.07‰- 12. 22‰） among boys and 0. 62‰（ 95% CI = 0. 11‰- 3. 48‰） among girls. When considering age group, the prevalence rates were 1.13‰（ 95%CI = 0.11‰-12.25‰） in 13-18 years age group, 1.05‰（ 95%CI = 0.09‰-12.92‰） in 0- 6years age group and 0. 87‰（ 95%CI = 0.13‰-5.76‰） in 7-12 years age group, respectively. Conclusion There is a high prevalence rate of diabetes mellitus among Chinese adolescents, and different standards of diagnosis greatly influence the detection rate of DM. So it is very urgent to prevent and control the DM among Chinese adolescents.