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山东沿海居民糖尿病及糖尿病前期患病率5年变迁研究

Change in prevalence of diabetes mellitus and prediabetes during 5 years in Shandong coastal area

摘要:

目的 调查山东沿海地区20岁以上居民5年随访2型糖尿病及糖调节受损(IGR)患病情况及其影响因素.方法 采用随机、分层、整群抽样的方法,入户调查青岛、烟台、威海、日照、东营常住居民5 191名.结果 (1)按照同一人口标化后,2009年糖尿病的标化患病率为9.51%,比2004年增加1.53%(P<0.05);其中男性标化患病率为9.86%、女性为9.26%,分别比2004年增加2.11%、0.94%(P<0.05).新诊断糖尿病374例,占所调查糖尿病患者的61.51%,较2004年高10.2% (P<0.05).(2)IGR标化患病率为11.86%,较2004年增加2.02%(P<0.05);其中男性标化患病率为14.19%,女性标化患病率为9.79%.(3)糖尿病和IGR患病率随年龄增长而升高,50岁以前男性、女性各年龄段糖尿病患病率较2004年均明显升高(P<0.05);60岁以前男、女各年龄段IGR患病率较2004年也明显升高(P<0.05).(4) IGR及糖尿病患者的舒张压、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、血尿酸水平较2004年明显升高(P<0.05).糖尿病患者的TG水平高于IGR患者(P<0.05),而血尿酸水平明显较低(P<0.01).(5)logistic回归分析显示年龄、体重指数、收缩压、TG、LDL-C为血糖调节异常的危险因素,高密度脂蛋白胆固醇、每日进食海产品量为糖调节异常的保护因素.结论 5年间人群整体糖尿病和糖尿病前期患病率均有所增高,且呈明显年轻化,男性增加尤为显著;增龄、肥胖、高血压、脂代谢紊乱为糖尿病的危险因素,适量的海鲜摄入有助于血糖的控制;血尿酸在糖尿病启动阶段发挥重要作用.

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abstracts:

Objective To determine the changes in prevalence of type 2 diabetes mellitus (DM) and prediabetes in residents aged over 20 years in Shandong coastal areas during 2004-2009 years.Methods A random stratified cluster sampling was conducted,and 5191 inhabitants were investigated in Qingdao,Yantai,Weihai,Rizhao,and Dongying.Results (1) According to the uniform population standardization,the standardized rate of DM prevalence was 9.51% in 2009,increased by 1.53% (P<0.05) as compared with 2004.The standardized rates were 9.86% in males and 9.26% in females,increased by 2.11% and 0.94 % (P<0.05) respectively compared with 2004.In this epidemiological study,there were 374 newly diagnosed DM patients,accounting for 61.51% of the DM patients,increased by 10.2% (P<0.05) as compared with 2004.(2) the standardized rate of prediabetes was 11.86% in 2009,increased by 2.02% (P<0.05) compared with 2004.The standardized rate was 14.19% in males and 9.79% in females.(3) The prevalence of DM in individuals aged under 50 years in 2009 was significantly higher than that in 2004 (P<0.05).The prevalence of prediabetes in individuals aged under 60 years was also significantly higher than that in 2004 (P < 0.05).(4) Compared with 2004,the levels of diastolic blood pressure,serum triglyceride (TG),total cholesterol (TC),low density lipoprotein-cholesterol (LDL-C),and uric acid in subjects with prediabetes and DM increased obviously in 2009 (P<0.05).TG level in DM patients was higher than that in prediabetic patients (P<0.01),while the serum uric acid level was lower (P<0.01).(5) Logistic regression analysis showed that age,body mass index,systolic blood pressure,TG,LDL-C were the risk factors for abnormal glucose regulation,while high density lipoprotein-cholesterol and daily intake of sea-food were the protective factors.Conclusion The prevalence of DM and prediabetes increased during 5 years (2004-2009),especially in males.Aging,overweight,hypertension,and lipid disorders were the risk factors of DM.The quantitative intake of sea-food was helpful for controlling blood glucose.Uric acid plays an important role in the onset of DM.

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