西安市50岁以上人群糖尿病患病率及其合并疾病调查：以社区为基础的研究

Diabetes prevalence and its comorbidities in people aged 50 years and above in Xi＇an： a community-based survey

目的调查西安市50岁以上人群中糖尿病患病情况及其疾病负担。方法西安老年人群糖尿病社区管理计划实施于2014年6月至2016年9月，是一个多中心、以社区为基础的横断面研究，所有人群进行口服葡萄糖耐量试验，应用世界卫生组织标准诊断糖尿病。Logistics回归分析糖尿病患病率的影响因素。结果在3001名研究对象中，糖尿病患病率为26．3％（789／3001），其中男性和女性患病率分别为29．4％（319／1086）和24．5％（470／1915）。城市、郊区和农村人群患病率分别为27．7％、28．7％和17．1％；50～59岁、60～69岁和70岁及其以上人群患病率分别为19．0％、26．4％和40．6％。糖尿病知晓率为57．8％（456／789），男性和女性分别为64．9％（207／319）和53．0％（249／470）。自我报告的糖尿病慢性并发症患病率为9．9％（78／789）；此外，61．2％（483／789）合并有高血压，46．3％（365／789）和21．9％（173／789）合并超重和肥胖，66．4％（524／789）合并血脂异常，70．1％（553，789）合并代谢综合征。Logistic多因素回归分析显示，年龄、农村人群、糖尿病家族史是糖尿病患病率的独立影响因素（OR=O．617～3．815，均P〈0．05）。结论50岁以上人群有着较高的糖尿病患病率和合并疾病。本研究提示应在50岁以上人群中加强糖尿病及其合并疾病的筛查及管控。

Objective To investigate the prevalence and disease burden of diabetes in people aged 50 years or above in Xi＇an. Methods Xi＇an Community-based Management of Diabetes in the Elderly project （from June 2014 to September 2016） was a muhicenter cross-sectional study using multistage, stratified cluster sampling methods. All individuals were given oral glucose tolerance tests. Standard World Health Organization criteria were used for the diagnosis of diabetes. Logistics analysis was used to examine the risk factors of diabetes prevalence. Results A total of 3 001 individuals were included. The prevalence of diabetes was 26.3% （789/3 001） in total. It was 29.4% （319/1 086） and 24.5% （470/1 915） in men and women, respectively, 27.7%, 28.7% and 17.1% in urban, semi-urban and country, respectively, and 19.0%, 26.4% and 40.6% in 50-59 years age group, 60-69 years age group and 70 years or above age group, respectively. The awareness of diabetes was 57.8% （456/789） in total, 64.9% （207/319） in men and 53.0% （249/470） in women. The prevalence of self-reported diabetic chronic complications was 9.9% （78/789）. Besides, 61.2% （483/789） of patients had hypertension, 46.3% （365/789） and 21.9% （173/789） had overweight and obesity, respectively, 66.4% （524/789） had dyslipidemia, and 70.1% （553/789） had metabolic syndrome. Logistics analysis showed that age, rural area and family history of diabetes were independent risk factors of diabetes prevalence （OR=0.617-3.815, all P〈0.05）. Conclusion People aged 50 years or above have a higher prevalence of diabetes than general population. Our study suggests the importance of screening and control of diabetes and its complications in the elderly population.