“中国糖尿病风险评分表”在内蒙古乌海市糖尿病筛查中的应用及其改进  

Application and improvement of Chinese Diabetes Risk Score on screening type 2 diabetes mellitus in Wuhai City,Inner Mongolia

作　　者：何婷超 刘爱萍[1] 王东平[2] 伍思佳 宋菲[1] 王浩杰[2] 宋阳[2] 王培玉[1] He Tingchao Liu Aiping Wang Dongping Wu Sijia Song Fei Wang Haojie Song Yang Wang Peiyu(School of Public Health, Peking University, Beijing 100191, China)

机构地区：[1]北京大学公共卫生学院,北京100191 [2]乌海市疾病预防控制中心

出　　处：《卫生研究》2017年第1期46-51,56,共7页Journal of Hygiene Research

摘　　要：目的探究"中国糖尿病风险评分表"在内蒙古乌海市糖尿病筛查中的应用效果及其改进。方法采用多阶段系统抽样,抽取乌海市6978名成人进行问卷调查,并进行体格测量(身高、体重、腰围、血压)、空腹血糖和糖化血红蛋白检测,在"中国糖尿病风险评分表"中新纳入膳食摄入构建新评分表。结果多因素分析发现,谷物摄入适宜和较多者糖尿病患病风险均增高,OR值分别为1.263(95%CI 1.045~1.526)和1.309(95%CI 1.044~1.643),水果摄入较多者糖尿病患病风险显著降低,OR=0.685(95%CI 0.481~0.974)。纳入谷类和水果摄入构建新评分表,新旧评分表曲线下面积分别为0.783(95%CI 0.766~0.799)和0.770(95%CI 0.753~0.786),差异有统计学意义(P<0.01)。原评分表在推荐切点(25分)的灵敏度和特异度分别为85.8%和54.0%,新评分表在最佳切点(27分)的灵敏度和特异度分别为85.5%和57.7%。结论中国糖尿病风险评分表可作为中国糖尿病的一线筛查工具,纳入生活方式评分将提高其筛查效果。Objective To explore the application and improvement of ＂Chinese Diabetes Risk Score ＂ on screening type 2 diabetes mellitus in Wuhai City, Inner Mongolia. Methods Using multi-stage systematic sampling,6987 adults were selected to be administered questionnaire and to finish anthropological measurements（ height,weight,waist circumference,and blood pressure） and blood tests for fasting plasma glucose and glycosylated hemoglobin. According to Chinese Diabetes Risk Score（ DRS-1）,some new lifestyle factors associated with diabetes risk were add to the construction of New Diabetes Risk Score（ DRS-3）. Results Multi-logistic regression analysis showed a statistically significant positive association between cereals intake and diabetes risk（ P〈0. 05）. In contrast,consumption of fruits was significantly,inversely associated with diabetes risk after adjustment of potential confounders（ P〈0. 05）. The AUC of the newrisk score（ DRS-3）,which were constructed by cereals and fruits intake and some other factors,significantly higher when compared with the AUC of the original risk score（ DRS-1）（ 0. 770 and 0. 783,respectively）. The sensitivity and specificity of DRS-1 were 85. 8% and 54. 0% respectively when using the cutoff value recommended（ 25 scores）.While the sensitivity and specificity of DRS-3 were 85. 5% and 57. 7% respectively when using the optimal cutoff value（ 27 scores）. Conclusion Chinese Diabetes Risk Score can be used as a primary screening tool for diabetes,and it is necessary to include some lifestyle factors for the improvement of its screening ability.

关 键 词：糖尿病 中国糖尿病风险评分表 筛查 受试者工作特征曲线 

分 类 号：R587.1[医药卫生—内分泌]