南京市城区糖尿病流行状况调查及相关危险因素分析
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摘要
目的了解南京城区糖尿病患病情况,分析其影响因素,从而为防治糖尿病发生提供依据。方法2018年1～9月采用随机整群抽样方法抽取鼓楼区的8个社区≥40岁常驻居民参与本研究。采用标准化问卷调查,收集年龄、性别、婚姻状况、子女居住情况、受教育程度、职业、体力活动、吸烟、饮酒情况等。根据2010年ADA糖尿病诊断标准进行糖尿病筛查,然后采用单因素和Logistic回归分析筛选相关危险因素。结果 2 125人中在糖尿病筛查中共发现109例,检出率为5.13%。单因素分析结果显示性别、年龄、婚姻状况、职业、文化程度、居住情况、体力活动、饮酒、体重指数(BMI)、收缩压、母亲是否患有糖尿病与是否罹患糖尿病相关; Logistic回归分析结果显示性别[OR:1.339(1.154～1.553)]、年龄[OR:1.495(1.382～1.622)]、BMI[OR:1.338(1.217～1.470)]、母亲患有糖尿病[OR:1.860(1.392～2.487)]、职业[OR:1.505(1.281～1.774)]以及体力活动[OR:1.497(1.302～1.823)]为糖尿病的独立危险因素。结论南京城区中老年人糖尿病发生率较高,存在的危险因素广泛,应当加大宣传力度,提倡合理饮食,控制体重,增加运动,从而预防和减少糖尿病的发生。
Objective To investigate the prevalence of diabetes and related risk factors in Nanjing urban area so as to provide the basis for prevention and treatment of diabetes.Methods The residents over 40 years in eight communities of Gulou district of Nanjing city from January to September 2018 were selected by random cluster sampling method to be enrolled in the study.A standardized questionnaire was performed,and the data including age,gender,marital status,children living conditions,level of education,occupation,physical activity,smoking,drinking were collected.According to ADA 2010 diabetes diagnostic criteria,the diabetes screening was conducted,then the single factor and Logistic to analysis were used to analyze the related risk factors.Results Among the 2125 subjects,there were 109 cases of diabetes,with the detection rate being5.13%.The single factor analysis showed that gender,age,marital status,occupation,cultural degree,living conditions,physical activity,alcohol consumption,BMI,systolic blood pressure,the mothers with diabetes were correlated with incidence of diabetes.Logistic regression analysis showed that gender [OR:1.339(1.154～1.553),age(OR:1.495(1.382～1.622) ]and BMI [OR:1.338(1.217～1.470) ],the mothers with diabetes [OR:1.860(1.392～2.487) ],occupation [OR:1.505(1.281～1.774) ],and physical activity [OR:1.497(1.302～1.823) ] were the independent risk factors of diabetes.Conclusion The incidence rate of diabetes is higher in middle and aged people in Nanjing urban area,there exist wide risk factors,therefore,it is necessary to intensify propaganda,advocate reasonable diet,control body weight,increase the movement,so as to prevent and reduce the incidence of diabetes.
Objective To investigate the prevalence of diabetes and related risk factors in Nanjing urban area so as to provide the basis for prevention and treatment of diabetes.Methods The residents over 40 years in eight communities of Gulou district of Nanjing city from January to September 2018 were selected by random cluster sampling method to be enrolled in the study.A standardized questionnaire was performed,and the data including age,gender,marital status,children living conditions,level of education,occupation,physical activity,smoking,drinking were collected.According to ADA 2010 diabetes diagnostic criteria,the diabetes screening was conducted,then the single factor and Logistic to analysis were used to analyze the related risk factors.Results Among the 2125 subjects,there were 109 cases of diabetes,with the detection rate being5.13%.The single factor analysis showed that gender,age,marital status,occupation,cultural degree,living conditions,physical activity,alcohol consumption,BMI,systolic blood pressure,the mothers with diabetes were correlated with incidence of diabetes.Logistic regression analysis showed that gender [OR:1.339(1.154～1.553),age(OR:1.495(1.382～1.622) ]and BMI [OR:1.338(1.217～1.470) ],the mothers with diabetes [OR:1.860(1.392～2.487) ],occupation [OR:1.505(1.281～1.774) ],and physical activity [OR:1.497(1.302～1.823) ] were the independent risk factors of diabetes.Conclusion The incidence rate of diabetes is higher in middle and aged people in Nanjing urban area,there exist wide risk factors,therefore,it is necessary to intensify propaganda,advocate reasonable diet,control body weight,increase the movement,so as to prevent and reduce the incidence of diabetes.
引文
1王文,朱曼璐,王拥军,等.心血管病已成为我国重要的公共卫生问题---《中国心血管病报告2011》概要.中国循环杂志,2013,27:409-411.
2庞艳蕾,王增武,王馨,等.北方农村地区心血管病危险因素调查与高血压患病分析.中华疾病控制杂志,2015,19:327.
3 Pan C,Shang S,Wilhelm K,et al.Burden of diabetes in the adult Chinese population:A systematic literature review and future projections.International Journal of General Medicine,2010,3:173-179.
4 Mathur S,Zammitt NN,Frier BM.Optimal Glycaemic Control in Elderly People with Type 2 Diabetes:What Does the Evidence Say?Drug Saf,2015,38:17-32.
5 Prevalence of Diabetes among Men and Women in China.New England Journal of Medicine,2010,362:1090-1101.
6中华人民共和国卫生部疾病控制司主编.中国成人超重和肥胖症预防控制指南.北京:人民卫生出版社,2006.
7中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版).中国医学前沿杂志,2015,7:26-89.
8 Xue H,Wang C,Li Y,et al.Incidence of type 2 diabetes and number of events attributable to abdominal obesity in C hina:A cohort study:Journal of diabetes,2016,8:190-198.
9 Gow ML,Garnett SP,Baur LA,et al.The effectiveness of different diet strategies to reduce type 2 diabetes risk in youth.Nutrients,2016,8:486.
10 Simon D,de Pablos-Velasco P,Parhofer KG,et al.Hypoglycaemic episodes in patients with type 2 diabetes-risk factors and associations with patient-reported outcomes:The PANORAMA Study.Diabetes&metabolism,2015,41:470-479.
11 Yang W,Lu J,Weng J,et al.Prevalence of diabetes among men and women in China.New England Journal of Medicine,2010,362:1090-1101.
12林君英,蒋园园,葛阳,等.2014年杭州市萧山区18周岁及以上居民糖尿病患病情况及相关危险因素分析.实用预防医学,2017,24:141-144.
13祖平,施亮,施燕,等.上海市社区2型糖尿病患者生存质量及影响因素.环境与职业医学,2015,32:507-514.
14 Gepner Y,Golan R,Harman-Boehm I,et al.Effects of initiating moderate alcohol intake on cardiometabolic risk in adults with type 2diabetes:a 2-year randomized,controlled trial.Annals of internal medicine,2015,163:569-579.
15 Knott C,Bell S,Britton A.Alcohol consumption and the risk of type 2diabetes:a systematic review and dose-response meta-analysis of more than 1.9 million individuals from 38 observational studies.Diabetes care,2015,38:1804-1812.
16 Willi C,Bodenmann P,Ghali WA,et al.Active smoking and the risk of type 2 diabetes:a systematic review and meta-analysis.Jama,2007,298:2654-2664.
17付文萍,陶海兰.心理应激对2型糖尿病患者神经内分泌的影响.基层医学论坛,2011,15:997-999.
2庞艳蕾,王增武,王馨,等.北方农村地区心血管病危险因素调查与高血压患病分析.中华疾病控制杂志,2015,19:327.
3 Pan C,Shang S,Wilhelm K,et al.Burden of diabetes in the adult Chinese population:A systematic literature review and future projections.International Journal of General Medicine,2010,3:173-179.
4 Mathur S,Zammitt NN,Frier BM.Optimal Glycaemic Control in Elderly People with Type 2 Diabetes:What Does the Evidence Say?Drug Saf,2015,38:17-32.
5 Prevalence of Diabetes among Men and Women in China.New England Journal of Medicine,2010,362:1090-1101.
6中华人民共和国卫生部疾病控制司主编.中国成人超重和肥胖症预防控制指南.北京:人民卫生出版社,2006.
7中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版).中国医学前沿杂志,2015,7:26-89.
8 Xue H,Wang C,Li Y,et al.Incidence of type 2 diabetes and number of events attributable to abdominal obesity in C hina:A cohort study:Journal of diabetes,2016,8:190-198.
9 Gow ML,Garnett SP,Baur LA,et al.The effectiveness of different diet strategies to reduce type 2 diabetes risk in youth.Nutrients,2016,8:486.
10 Simon D,de Pablos-Velasco P,Parhofer KG,et al.Hypoglycaemic episodes in patients with type 2 diabetes-risk factors and associations with patient-reported outcomes:The PANORAMA Study.Diabetes&metabolism,2015,41:470-479.
11 Yang W,Lu J,Weng J,et al.Prevalence of diabetes among men and women in China.New England Journal of Medicine,2010,362:1090-1101.
12林君英,蒋园园,葛阳,等.2014年杭州市萧山区18周岁及以上居民糖尿病患病情况及相关危险因素分析.实用预防医学,2017,24:141-144.
13祖平,施亮,施燕,等.上海市社区2型糖尿病患者生存质量及影响因素.环境与职业医学,2015,32:507-514.
14 Gepner Y,Golan R,Harman-Boehm I,et al.Effects of initiating moderate alcohol intake on cardiometabolic risk in adults with type 2diabetes:a 2-year randomized,controlled trial.Annals of internal medicine,2015,163:569-579.
15 Knott C,Bell S,Britton A.Alcohol consumption and the risk of type 2diabetes:a systematic review and dose-response meta-analysis of more than 1.9 million individuals from 38 observational studies.Diabetes care,2015,38:1804-1812.
16 Willi C,Bodenmann P,Ghali WA,et al.Active smoking and the risk of type 2 diabetes:a systematic review and meta-analysis.Jama,2007,298:2654-2664.
17付文萍,陶海兰.心理应激对2型糖尿病患者神经内分泌的影响.基层医学论坛,2011,15:997-999.