中国成年人糖尿病前期发病状况及其影响因素研究

Study on the incidence and influencing factors of prediabetes in Chinese adults

目的了解我国成年人糖尿病前期的发病状况及其影响因素。方法基于2010年中国慢性病及其危险因素监测调查数据,从中抽取10省份,再从每省份中选择2个监测点作为随访点,于2016-2017年进行随访调查。采用非条件logistic回归模型分析糖尿病前期的影响因素。结果本研究纳入5578人,随访期间糖耐量受损(IGT)发生612人(男性268人,女性344人),总计随访37364.82人年,IGT发病率为16.4/1000人年;空腹血糖受损(IFG)发生290人(男性128人,女性162人),总计随访39731.31人年,IFG发病率为7.3/1000人年。多因素非条件logistic回归模型纳入年龄、城乡、糖尿病家族史、BMI、中心性肥胖、血脂异常、高血压以及身体活动水平,结果显示,年龄≥50岁(OR=1.60,95%CI:1.32~1.95)、城市居民(OR=1.41,95%CI:1.16~1.71)、肥胖(OR=1.56,95%CI:1.12~2.19)、血脂异常(OR=1.52,95%CI:1.25~1.83)、高血压(OR=1.32,95%CI:1.07~1.61)以及身体活动不足(OR=1.25,95%CI:1.04~1.50)是IGT发病的危险因素;年龄≥50岁(OR=1.31,95%CI:1.01~1.70)、糖尿病家族史(OR=1.71,95%CI:1.13~2.60)、超重(OR=1.41,95%CI:1.04~1.92)、肥胖(OR=2.09,95%CI:1.38~3.17)以及高血压(OR=1.53,95%CI:1.18~2.00)是IFG发病的危险因素。结论相比IFG,IGT发病率较高。年龄≥50岁者、超重/肥胖人群、高血压患者、血脂异常者、身体活动不足者以及有糖尿病家族史者易发生糖尿病前期。

Objective To explore the incidence and influencing factors of prediabetes in adults in China.Methods Ten provinces(cities)were selected from the surveillance survey of chronic diseases and their risk factors in China in 2010;two monitoring sites were selected from each province(city)as follow-up spots,and a follow-up survey was conducted from 2016 to 2017.An unconditional logistic regression model was used to analyze the influencing factors of prediabetes.Results A total of 5578 participants were included in this study.During the follow-up period,612 patients(268 males and 344 females)developed impaired glucose tolerone(IGT),with a total follow-up of 37364.82 person-years,and the incidence of IGT was 16.4/1000 person-years.Impaired fasting glucose(IFG)occurred in 290 patients(128 males and 162 females)with a total follow-up of 39731.31 person-years,and the incidence of IFG was 7.3/1000 person-years.The multivariate unconditional logistic regression model included age,urban and rural areas,family history of diabetes,BMI,central obesity,dyslipidemia,hypertension,and physical activity,and the results showed that age(≥50 years old:OR=1.60,95%CI:1.32-1.95),urban residents(OR=1.41,95%CI:1.16-1.71),obesity(OR=1.56,95%CI:1.12-2.19),dyslipidemia(OR=1.52,95%CI:1.25-1.83),hypertension(OR=1.32,95%CI:1.07-1.61)and physical inactivity(OR=1.25,95%CI:1.04-1.50)increase the risk of IGT.Age(≥50 years old:OR=1.31,95%CI:1.01-1.70),family history of diabetes(OR=1.71,95%CI:1.13-2.60),overweight(OR=1.41,95%CI:1.04-1.92),obesity(OR=2.09,95%CI:1.38-3.17)and hypertension(OR=1.53,95%CI:1.18-2.00)increase the risk of IFG.Conclusions The incidence of IGT is higher than the IFG.People aged 50 and above,overweight and obese people,hypertension patients,dyslipidemia patients,people with insufficient physical activity,and family history of diabetes are prone to prediabetic events.