基于GIS的中国中老年人糖尿病空间分布及其影响因素分析

Analysis on spatial distribution of diabetes and related factors among middle-aged and elderly population in China based on GIS

目的基于地理信息系统(geographic information system,GIS)技术了解中国45岁及以上中老年人糖尿病患病的空间分布状况,以及主要影响因素的空间分布异质性,为完善区域化糖尿病防控措施提供科学依据。方法采用2011年中国健康与养老追踪调查的基线数据,共纳入11 538名受访者。采用Geoda和Arc GIS 10.2软件进行糖尿病患病及其主要影响因素的空间分析。结果 2011年,我国(除香港、澳门、台湾、海南、宁夏和西藏外)45岁及以上中老年人糖尿病及糖尿病前期患病率分别为15.1%(患病率范围为7.9%~33.5%)和40.0%(前期患病率范围为17.6%~61.3%)。局部空间分析显示糖尿病患病率的聚集区域主要集中在我国北部(天津市和河北省)。地理加权回归显示高学历人群比重、超重率、高C反应蛋白率为糖尿病患病主要影响因素且存在空间分布异质性。结论中国有半数以上(55.1%)中老年人受到糖尿病威胁。糖尿病患病率及其主要影响因素具有空间分布异质性,重点防控区域主要集中在东北和北部地区,不同地区防治措施侧重应该有所不同。

Objective To explore the spatial distribution of diabetes and its main influencing factors among middle-aged and elderly population in China based on geographic information system（ GIS） and to provide useful information for the improvement of regional prevention and control of diabetes. Methods Data came from the baseline survey of the China Health and Retirement Longitudinal Study in 2011,which included 11 538 participants in this study. A spatial analysis was conducted to analyze prevalence of diabetes and its main risk factors by Geoda and Arc GIS 10. 2 software. Results The prevalence of diabetes and pre-diabetes among middle-aged and elderly population were 15. 1%（ range of prevalence of diabetes： 7. 9%-33. 5%） and 40. 0%（ range of prevalence of pre-diabetes： 17. 6%-61. 3%） in China except for Hong Kong,Macao,Taiwan,Hainan,Ningxia and Tibet in 2011. The local space analysis showed that the concentrated areas of prevalence were located in north of China including Tianjin and Hebei. The geographically weighted regression（ GWR） revealed that the percentage of the highly educated population,the rate of overweight and high levels of c-reactive protein（ CRP） were the main influencing factors for diabetes prevalence,and all the regression coefficients of these three factors showed spatial heterogeneity. Conclusions Over 50% of middle-aged and elderly Chinese are threatened by diabetes and pre-diabetes. Geographic visualization at the provincial level indicates widespread variation in diabetes prevalence and its main factors across China. The key areas for prevention and control are mainly located in northeast and north in China. Major measures should be regionalization.