血压偏高儿童青少年进行血糖筛查的重要性  

An importance of blood glucose screening in children and adolescents with high blood pressure

作　　者：马亚红[1,2] 徐志鑫[3] 杨金奎[1] 李淑波[3] 赵蕾[1] 

机构地区：[1]首都医科大学附属北京同仁医院内分泌科,100730 [2]北京市普仁医院内分泌科 [3]北京市昌平区疾病预防控制中心慢病科

出　　处：《中国糖尿病杂志》2008年第11期651-653,共3页Chinese Journal of Diabetes

摘　　要：目的对10～18岁儿童青少年进行T2DM筛查并评价美国糖尿病协会(ADA)推荐的儿童青少年T2DM筛查方案。方法采取分层整群随机抽样的方法,在北京市昌平区自然人群中抽取10～18岁在校中小学生3719人,对符合下列条件之一者进行血糖筛查:(1)超重/肥胖:BMI>同年龄、性别第85百分位数者;(2)血压偏高:血压≥同年龄、性别第90百分位数者。对FPG≥5.6mmol/L者行OGTT进行诊断,并按2008年ADA推荐的筛查方案进行评价。结果T2DM确诊率0.98/1000,IFG确诊率30.3/1000。IFG患者中超重/肥胖伴血压偏高者占51.6%,单纯超重/肥胖者占6.5%,单纯血压偏高者占41.9%。如按ADA建议不筛查单纯血压偏高者,将有近半数IFG患者漏诊。结论单纯血压偏高儿童青少年进行糖代谢检查十分必要。Objective To practice and evaluate T2DM screening in children and adolescents with high blood pressure and aged 10 to 18 years with the protocol based on the clinical practice recommendations （ADA 2008）. Methods General population from Changping District of Beijing was taken for stratified random sampling, accessing 3719 schoolchildren aged 10 to 18 years. Those who met one of the following conditions were taken for fasting blood glucose screening： （1） overweight/obesity： BMI 〉85th percentile for the age-sex stratification; （2） high blood pressure： a blood pressure≥ 90th percentile for age-sex stratification. Subjects with fasting blood glucose≥ 5.6 mmol/1 were then taken for OGTT. Results The final diagnosis rate was 0.98/1000 for DM and 30.3/1000 for IFG. Of the IFG subjects, 51.6 % had both overweight/obesity and high blood pressure,6.5 % had overweight/obesity and 41.9% had isolated high blood pressure without overweight/obesity. If not screening glucose of children and adolescents with isolated high blood pressure,near half of the patients with IFG would be missed. Conclusions It is very necessary to test glucose homeostasis in children and adolescents with high blood pressure.

关 键 词：儿童 青少年 糖调节受损 血压 

分 类 号：R179[医药卫生—妇幼卫生保健]