摘要
目的了解上海市35岁及以上人群未诊断糖尿病的特征,为调整糖尿病早发现策略提供依据。方法利用2013年上海市慢性病及其危险因素监测数据,以35岁及以上18736名常住居民为研究对象,进行问卷调查、体格检查和实验室检测。根据空腹血糖(FPG)和口服葡萄糖耐量试验(OGTT)2h血糖水平(2hPG),结合调查问卷中是否已诊断过糖尿病来鉴别未诊断糖尿病。采用SPSS17.0统计软件进行Rao-Scott χ^2检验、Pearson χ^2检验和logistic回归分析。结果35岁及以上人群的糖尿病患病率为17.57%,其中未诊断糖尿病患者所占比例为31.94%。在符合诊断标准的3795例糖尿病患者中,未诊断糖尿病的构成比在不同年龄段差异有统计学意义(P<0.05);城市、城乡结合地和农村的未诊断糖尿病构成比分别为26.56%、37.34%和45.04%,差异有统计学意义(P<0.01);不同医疗保险类型间未诊断糖尿病构成比差异有统计学意义(P<0.01)。未诊断糖尿病患者中以单纯OGTT2hPG升高为主要血糖异常形式,占49.80%,其次是FPG和OGTT2hPG两者都升高(26.50%)及单纯FPG升高(23.70%)。未诊断糖尿病患者血压和体质指数(BMI)未达标的比例分别为84.15%和64.69%,不经常体育锻炼率(77.74%)高于确诊糖尿病患者(72.47%),差异有统计学意义(P<0.05)。采用多因素非条件logistic回归调整年龄、性别后,不经常体育锻炼在两组间仍有差异(OR=0.772,95%CI:0.658~0.906,P<0.01)。结论上海市未诊断糖尿病中糖负荷后血糖升高比例高,未诊断糖尿病预后危险因素控制情况不乐观,改进初筛方法在重点人群中加强筛查,早期发现糖尿病,对糖尿病并发症的防治非常重要。
Objective To understand the characteristics of undiagnosed diabetes in residents (≥35 years old) in Shanghai,and to provide the basis for regulating the stratagem of early finding diabetes.Methods According to the Shanghai Chronic Disease and Risk Factors Surveillance data in 2013,18 736 permanent residents (≥35 years old) were served as the subjects,the investigation was performed with questionnaire,physical examination and laboratory test.Undiagnosed diabetes were identified based on fasting plasma glucose (FPG) and 2-hour glucose (2 h PG) after an oral glucose-tolerance test (OGTT),combined with the questions about whether diabetes had been previously diagnosed in the questionnaire.The Rao-Scott χ^2 test,Pearson χ^2 test and logistic regression were used to analyze the data.The used software was SPSS 17.0.Results The morbidity of diabetes in residents (≥35 years old) was 17.57%,the proportion of undiagnosed diabetes patients was 31.94%.In 3 795 cases diagnosed as diabetes,the proportions of undiagnosed diabetes were significantly different among different age groups (P<0.05);the proportions of undiagnosed diabetes in urban area,urban-rural area and rural area were 26.56%,37.34% and 45.04%,respectively(P<0.01);the proportions of undiagnosed diabetes among different health insurance types were significantly different (P<0.01).The proportions of only OGTT 2 h PG elevation,FPG plus OGTT 2 h PG elevation and only FPG elevation in undiagnosed diabetes patients were 49.80%,26.50% and 23.70%,respectively.In patients with undiagnosed diabetes,the proportions of blood pressure and BMI without standard-reach were 84.15% and 64.69%,respectively;the not frequent physical exercise rate (77.74%) in patients with undiagnosed diabetes was significantly higher than that (72.74%) in diagnosed diabetes patients (P<0.05).After adjusting age and gender,the multivariate logistic regression showed that not frequent physical exercise was different between two groups (OR=0.772,95%CI:0.658-0.906,P<0.01).Conclusion The proportion
作者
杨群娣
阮晔
刘丹妮
刘晓侠
郑杨
施燕
YANG Qun-di;RUAN Ye;LIU Dan-ni;LIU Xiao-xia;ZHENG Yang;SHI Yan(Department of Chronic Non-communicable Disease and Injury,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China)
出处
《中国慢性病预防与控制》
CAS
CSCD
北大核心
2019年第8期589-592,共4页
Chinese Journal of Prevention and Control of Chronic Diseases
关键词
未诊断糖尿病
患病率
空腹血糖
口服葡萄糖耐量试验
Undiagnosed diabetes
Morbidity
Fasting plasma glucose
Oral glucose tolerance test
