崇明地区糖尿病及糖调节受损的患病率调查

Prevalence survey of diabetes mellitus and impaired glucose regulation of Changming area population in Shanghai

目的了解上海崇明地区糖尿病及糖调节受损的患病率。方法采用随机整群抽样方法,于2015年5~10月对崇明县城桥镇40~69岁3 248例常住居民进行横断面调查,内容涉及问卷调查、体格检查、75 g葡萄糖口服耐量试验。结果 3 026例居民完成调查,占崇明地区人口的42.99/10 000(3 026/703 722),其中男性879例,女性2 147例,平均年龄(55.4±7.7)岁。受调查者中糖尿病、糖耐量减低(IGT)和空腹血糖受损(IFG)患病率分别为20.59%(623/3 026),16.79%(508/3 026)和5.09%(154/3 026)(标化率为18.41%,16.86%和4.07%)。55~59岁年龄组患病率最高,其糖尿病、IFG及IFG+IGT均高于其他年龄组,IFG略低于50~54岁年龄组及60~64岁年龄组。男性糖尿病、IGT和IFG患病率分别为29.35%(258/879)、14.79%(130/879)和7.51%(66/879)。女性糖尿病,IGT和IFG患病率分别为17.00%(365/2147)、17.61%(378/2 147)和4.01%(88/2 147)。标化后糖尿病、IGT和IFG患病率在男女之间差异有统计学意义(P<0.05)。本次调查中新发现糖尿病患者331例,占全部糖尿病患者的53.13%(331/623),在新发现糖尿病患者中单纯以空腹血糖升高的患者43例,占12.99%(43/331),单纯以餐后血糖升高的患者157例,占47.43%(157/331),新诊断糖尿病患者在55岁以后患病率明显升高。本次调查中高血压患病率为30.60%(926/3 026),标化率为27.69%,糖尿病、IGR及正常人各组均随年龄的增加患病率上升,以65~69岁年龄组患病率最高。本次调查中超重占39.89%(1 207/3 026),肥胖占15.33%(464/3 026),糖尿病及IGR均表现以超重为主,糖尿病超重占46.23%(288/623);IGR超重占45.33%(383/845)。结论崇明地区40~69岁人群中已有较高的代谢异常患病率,因此对有高危因素者应进行定期筛查,并对伴有代谢异常者及早进行干预治疗,以防止糖尿病及代谢综合征的发生、发展。

Objective To understand the diabetes mellitus and impaired glucose regulation of Changming area population in Shanghai. Methods From May to October in 2015, cross-sectional survey was carried out on 3 248 residents aged 40~69 in Chengqiao town of Chongming County according to random cluster sampling, which involved questionnaire survey, physical examination and 75 g oral glucose tolerance test. Results A total of 3 026 residents completed the survey, accounting for 42.99/10 000(3 026/703 722) of Chongming area population, of whom 879 were male, 2 147 were female, with mean age for(55.4±7.7) years old. The prevalence rate of diabetes mellitus, impaired glucose tolerance(IGT) and fasting blood glucose damage(IFG) were respectively 20.59%(623/3 026), 16.79%(508/3 026) and5.09%(154/3 026)(standardized rate for 18.41%, 16.86% and 4.07%, respectively). The prevalence rate of diabetes mellitus, IFG and IFG+IGT in the 55~59 age group were higher than other age groups, while the prevalence rate of IFG was slightly lower than the 50~54 age group and 60~64 age group. The prevalence rate of diabetes mellitus, IFG and IGT in men with diabetes mellitus were 29.35%(258/879), 14.79%(130/879) and 7.51%(66/879) respectively; The prevalence rate of diabetes mellitus, IFG and IGT were respectively 17.00%(365/2 147), 17.61%(378/2 147) and 4.01%(88/2 147).There were statistically significant difference between female and male in the standardized prevalence rate of diabetes mellitus, IGT and IFG(P<0.05). In this investigation, 331 patients were newly found with diabetes mellitus, which accounted for 53.13%(331/623) of all diabetic patients. In the newly discovered patients with diabetes mellitus, 43 patients only with elevated fasting glucose accounted for 12.99%(43/331), 157 patients only with postprandial hyperglycemia accounted for 47.43%(157/331). In patients with newly diagnosed diabetes, the prevalence rate increased significantly after age 55. The prevalence rate of hypertension was 30.60%(926/3 026)(standard rate: 27.69%). The prevalence rate of diabetes mellitus and IGR in the normal groups increased with age, with the highest rate at the 65~69 age group. Super heavy patients accounted for 39.89%(1 207/3 026), obesity patients accounted for 15.33%(464/3 026), The patients with diabetes and IGR showed mainly in overweight, with diabetes for 46.23%(288/623) overweight and IGR for45.33%(383/845) overweight. Conclusion In Chongming area, 40~69 years old of the population has a higher prevalence rate of unusual metabolism. Therefore, the high-risk groups should undergo regular screening, and accompanied by early intervention treatment to prevent the occurrence and development of diabetes and the metabolic syndrome.