浙江省2型糖尿病高危人群流行现状分析

Prevalence of high risk adults of type 2 diabetes in Zhejiang

目的了解浙江省2型糖尿病高危人群流行特征。方法于2010年6—10月,采用四阶段分层整群抽样方法,选取浙江省15个县(市、区)7 571个调查家庭中年龄≥18周岁的常住人口作为调查对象,共19 113人。采用自行设计的调查问卷,调查研究对象的一般情况以及行为和生活方式,同时,检测其身高、体重、血压及血脂等指标,并依据2017年版中国2型糖尿病防治指南判定高危人群。结果最终17 437人完成全部调查项目。其中2型糖尿病高危人群14 455人,年龄(49.3±15.1)岁,男性6 902人(47.75%),女性7 553人(52.25%)。2型糖尿病高危人群粗流行率为82.90%,标化流行率为79.26%,2型糖尿病高危人群流行率在45~岁组(83.47%)、男性(84.49%)、1类农村(84.59%)、小学(87.04%)、在婚婚姻状况(84.40%)、家庭人均年收入<10 000元(83.66%)人群中较高(P均<0.05)。纳入的8个2型糖尿病高危险因素中年龄≥40岁的检出率最高,为78.12%;心血管疾病史检出率最低,为1.54%;超重或肥胖或中心性肥胖、血脂异常、高血压、静坐生活方式、糖尿病前期、2型糖尿病家族史的检出率分别为42.86%、31.28%、29.98%、29.18%、7.28%、3.81%。2型糖尿病高危人群以1个高危因素(31.75%)、2个高危因素(31.39%)和3个高危因素(22.13%)为主,4个高危因素占11.01%,5个以上高危因素占3.71%。不同年龄组、地区、文化程度、婚姻状况、家庭人均年收入的2型糖尿病高危人群间,高危因素呈现出不同的聚集和分布特征。结论浙江省2型糖尿病高危人群流行水平较高,应根据其人群分布特征尽早规范开展2型糖尿病人群的健康管理。

Objective To investigate the prevalence characteristics for high risk adults of type 2 diabetes in Zhejiang. Methods From June to October in 2010, 19113 local residents aged≥18 years old were selected among 7571 families from fifteen counties in Zhejiang by a four stage stratified-random sampling method. A self-designed questionnaire was completed to collect information on demographic characteristics, risk factors, and physical activity. At the same time, physical examinations including measurements of height, weight, blood pressure, and blood lipid levels were carried out. The high-risk population was determined according to the 2017 edition of China′s Guidelines for the Prevention and Treatment of Type 2 Diabetes. Results Finally, 17437 people completed all the investigation projects. Among them, 14455 people were at high risk of type 2 diabetes [aged (49.3+15.1) years, 6902 men (47.75%) and 7553 women (52.25%)]. The crude prevalence rate of high risk type 2 diabetes was 82.90%(standardized rate:79.26%). A significantly higher prevalence rate of high risk type 2 diabetes was associated with the age group of 45 to 60 years (83.47%), men (84.49%), class 1 rural area (84.59%), primary school education level (87.04%), marital status (84.40%), and average annual family income less than 10000 yuan (all P<0.05). Among the eight high risk factors, the detection rate of ≥40 years old was the highest (78.12%) and the detection rate of history of cardiovascular disease was the lowest (1.54%). The detection rates of overweight/obesity/central obesity, dyslipidemia, hypertension, sedentary lifestyle, pre-diabetes, and family history of type 2 diabetes were 42.86%, 31.28%, 29.98%, 29.18%, 7.28%, and 3.81%, respectively. High risk of type 2 diabetes was dominated by 1 high-risk factor (31.75%) or 2 high-risk factors (31.39%) or 3 high-risk factors (22.13%). The adults with 4 high-risk factors (11.01%) and 5 or more high-risk factors (3.71%) were less in number. The detection rates of all the risk factors and aggregation distribution of various risk factors were significantly different between different genders, age groups, regions and educational levels, marital status, and family per capita annual income. Conclusion The epidemic level of high-risk type 2 diabetes in Zhejiang province is relatively high, and health management of high risk of type 2 diabetes in community should be actively taken as early as possible according to the population distribution characteristics.