北京市40～79岁居民糖尿病与空腹血糖受损流行病学现状及其危险因素研究
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摘要
背景流行病学调查显示我国成人2型糖尿病患病率不断攀升,加之庞大的人口基数及日益严重的老龄化趋势,预计未来糖尿病将造成沉重的疾病负担。年龄≥40岁是成人糖尿病的高危因素之一,有必要重视高危人群的糖尿病和空腹血糖受损的患病情况及其影响因素,有针对性地进行糖尿病的预防和控制。目的调查北京市40～79岁居民糖尿病、空腹血糖受损的流行病学现状并探讨其危险因素。方法选取2014年北京市40～79岁的常住居民(过去1年内在北京市累计居住6个月以上),采用多阶段分层随机抽样的方法,将北京市16个区作为调查点,共抽取36个乡镇/街道、180个社区中的19 815例常住居民。采用集中调查和入户调查相结合的方式对常住居民进行调查,调查内容包括问卷调查、体格检查和实验室检测3部分;问卷调查内容包括基本人口学特征、行为因素、个人疾病史;体格检查包括身高、体质量和血压;实验室检测包括空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)。采用多因素Logistic回归分析分析糖尿病、空腹血糖受损患病的影响因素。结果共纳入40～79岁居民11 889例,糖尿病患病率为12.11%,标化患病率为13.56%,男性糖尿病标化患病率高于女性(P<0.01)。糖尿病患病率随年龄增加而上升(χ~2趋势=317.38,P<0.01),男性、女性糖尿病患病率随年龄增加而上升(男性:χ~2趋势=78.05,P<0.01;女性:χ~2趋势=292.86,P<0.01)。城区糖尿病标化患病率高于郊区(P<0.01)。多因素Logistic回归分析结果显示,年龄、性别、居住地、饮酒、体质指数(BMI)、高血压和血脂异常是糖尿病患病的影响因素(P<0.05)。空腹血糖受损患病率5.22%,标化患病率为5.82%,男性空腹血糖受损标化患病率高于女性(P<0.01)。空腹血糖受损患病率随年龄增加而上升(χ~2趋势=75.84,P<0.01);男性、女性空腹血糖受损患病率随年龄增加而上升(男性:χ~2趋势=16.53,P<0.01;女性:χ~2趋势=70.18,P<0.01)。城区和郊区空腹血糖受损标化患病率比较,差异无统计学意义(χ~2=2.17,P=0.14)。多因素Logistic回归分析结果显示,年龄、性别、受教育程度、饮酒、BMI、高血压、血脂异常是空腹血糖受损患病的影响因素(P<0.05)。结论北京市40～79岁居民糖尿病患病率随年龄增大而升高,男性高于女性,城区高于郊区,空腹血糖受损患病率也呈类似趋势,但居住地差异不明显,高龄、男性、超重和肥胖、高血压和血脂异常均是糖尿病和空腹血糖受损的危险因素。
Background Epidemiological studies show that the prevalence of type 2 diabetes in adults in China is rising,coupled with the large population base and the increasing aging trend, it is expected that diabetes will cause a heavy disease burden in the future.Age ≥ 40 years is one of the high risk factors for adult diabetes.It is necessary to pay attention to the prevalence of diabetes mellitus and impaired fasting blood glucose among high-risk groups and their influencing factors.Thus targeted prevention and control of diabetes mellitus can be carried out.Objective To investigate the prevalence and risk factors of diabetes mellitus and impaired fasting glucose(IFG) among residents aged 40-79 years in Beijing.Methods A total of 19 815 residents aged 40 to 79 years with an accumulated period of residence of more than 6 months in Beijing as of the survey time in 2014 were selected from 180 communities of 36 towns or streets in 16 districts of Beijing by multi-stage stratified random cluster sampling.They participated in a centralized survey or household survey conducted by our research team,during which,all of them completed a self-administered questionnaire(consisting of basic demographic characteristics,behavioral factors,history of personal diseases),performed physical examination(including height,weight and blood pressure) and laboratory examination ﹝ including fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),lowdensity lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL-C) in peripheral blood ﹞.Risk factors of diabetes and IFG were analyzed using multivariate Logistic regression analysis.Results A total of 11 889 residents aged 40-79 were included in the final analysis.Diabetes prevalence was 12.11%.The prevalence of diabetes increased with age(χ~2 trend=317.38,P<0.01),and gender-specific prevalence increased with age(male: χ~2 trend=78.05,P<0.01;female: χ~2 trend=292.86,P<0.01).The age-standardized prevalence of diabetes was 13.56%.Males had a higher age-standardized prevalence of diabetes than females(P<0.01).The age-standardized prevalence of diabetes in urban residents was higher than that in suburban residents(P<0.01).Multivariate Logistic regression analysis showed that age,sex,location,drinking,BMI,hypertension and dyslipidemia were the influencing factors of diabetes mellitus(P<0.05).The prevalence of IFG was 5.22%.The prevalence of IFG increased with age(χ~2 trend=75.84,P<0.01),and gender-specific IFG prevalence increased with age(male:χ~2 trend=16.53,P<0.01;female:χ~2 trend=70.18,P<0.01).The age-standardized prevalence of IFG was 5.82%.Males showed higher age-standardized prevalence of IFG than females(P<0.01).There was no significant difference in agestandardized prevalence of IFG between urban and suburban residents(χ~2=2.17,P=0.14).Multivariate Logistic regression analysis demonstrated that age,sex,education level,drinking,BMI,hypertension and dyslipidemia were the influencing factors of IFG(P<0.05).Conclusion The prevalence of diabetes among Beijing residents aged 40-79 years increases with age.Males and living in urban areas are associated with higher prevalence.The prevalence of IFG also increases with age,but shows insignificant difference between urban and suburban residents.Elder age,male,overweight and obesity,hypertension and dyslipidemia are independent risk factors of diabetes and IFG.
Background Epidemiological studies show that the prevalence of type 2 diabetes in adults in China is rising,coupled with the large population base and the increasing aging trend, it is expected that diabetes will cause a heavy disease burden in the future.Age ≥ 40 years is one of the high risk factors for adult diabetes.It is necessary to pay attention to the prevalence of diabetes mellitus and impaired fasting blood glucose among high-risk groups and their influencing factors.Thus targeted prevention and control of diabetes mellitus can be carried out.Objective To investigate the prevalence and risk factors of diabetes mellitus and impaired fasting glucose(IFG) among residents aged 40-79 years in Beijing.Methods A total of 19 815 residents aged 40 to 79 years with an accumulated period of residence of more than 6 months in Beijing as of the survey time in 2014 were selected from 180 communities of 36 towns or streets in 16 districts of Beijing by multi-stage stratified random cluster sampling.They participated in a centralized survey or household survey conducted by our research team,during which,all of them completed a self-administered questionnaire(consisting of basic demographic characteristics,behavioral factors,history of personal diseases),performed physical examination(including height,weight and blood pressure) and laboratory examination ﹝ including fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),lowdensity lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL-C) in peripheral blood ﹞.Risk factors of diabetes and IFG were analyzed using multivariate Logistic regression analysis.Results A total of 11 889 residents aged 40-79 were included in the final analysis.Diabetes prevalence was 12.11%.The prevalence of diabetes increased with age(χ~2 trend=317.38,P<0.01),and gender-specific prevalence increased with age(male: χ~2 trend=78.05,P<0.01;female: χ~2 trend=292.86,P<0.01).The age-standardized prevalence of diabetes was 13.56%.Males had a higher age-standardized prevalence of diabetes than females(P<0.01).The age-standardized prevalence of diabetes in urban residents was higher than that in suburban residents(P<0.01).Multivariate Logistic regression analysis showed that age,sex,location,drinking,BMI,hypertension and dyslipidemia were the influencing factors of diabetes mellitus(P<0.05).The prevalence of IFG was 5.22%.The prevalence of IFG increased with age(χ~2 trend=75.84,P<0.01),and gender-specific IFG prevalence increased with age(male:χ~2 trend=16.53,P<0.01;female:χ~2 trend=70.18,P<0.01).The age-standardized prevalence of IFG was 5.82%.Males showed higher age-standardized prevalence of IFG than females(P<0.01).There was no significant difference in agestandardized prevalence of IFG between urban and suburban residents(χ~2=2.17,P=0.14).Multivariate Logistic regression analysis demonstrated that age,sex,education level,drinking,BMI,hypertension and dyslipidemia were the influencing factors of IFG(P<0.05).Conclusion The prevalence of diabetes among Beijing residents aged 40-79 years increases with age.Males and living in urban areas are associated with higher prevalence.The prevalence of IFG also increases with age,but shows insignificant difference between urban and suburban residents.Elder age,male,overweight and obesity,hypertension and dyslipidemia are independent risk factors of diabetes and IFG.
引文
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[6]中国成人血脂异常防治指南制订联合委员会.中国成人血脂异常防治指南[J].中华心血管病杂志,2007,35(5):390-419.DOI:10.3760/j.issn.0253-3758.2007.05.003.Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults.Chinese guidelines on prevention and treatment of dyslipidemia in adults[J].Chinese Journal of Cardiology,2007,35(5):390-419.DOI:10.3760/j.issn.0253-3758.2007.05.003.
[7]中国肥胖问题工作组.中国成人超重与肥胖症预防与控制指南(节录)[J].营养学报,2004,26(1):1-4.DOI:10.3321/j.issn.0512-7955.2004.01.001.Working Group of Obesity in China.Guidelines for prevention and control of overweight and obesity in Chinese adults[J].Acta Nutrimenta Sinica,2004,26(1):1-4.DOI:10.3321/j.issn.0512-7955.2004.01.001.
[8]王燕,康晓平.卫生统计学教程[M].北京:北京大学医学出版社,2006:30-33.WANG Y,KANG X P.Course on health statistics[M].Beijing:Peking University Medical Publishing House,2006:30-33.
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