甘肃省糖尿病前期患病情况及相关因素分析  

Analysis of prevalence and related factors of pre-diabetes mellitus in Gansu Province

作　　者：常星宇 傅松波[1] 汤旭磊[1] 刘靖芳[1] 马承旭 朱国贸 井高静 赵楠[1] 马丽华[1] 牛强龙 焦彩虹 郭强 王晓林 滕卫平[4] 单忠艳[4] CHANG Xing-yu;FU Song-bo;TANG Xu-lei;LIU Jing-fang;MA Cheng-xu;ZHU Guo-mao;JING Gao-jing;ZHAO Nan;MA Li-hua;NIU Qiang-long;JIAO Cai-hong;GUO Qiang;WANG Xiao-lin;TENG Wei-ping;SHAN Zhong-yan(Department of Endocrinology,the First Hospital of Lanzhou University,Gansu Provincial Endocrine Disease Clinical Medical Research Center,Lanzhou 730000,China;Department of Endocrinology,No.1 Hospital of Longnan City,Gansu Province,Longnan 746000,China;Department of Endocrinology,Gem Flower Hospital of Gansu Province,Lanzhou 730070,China;Department of Endocrinology,First Affiliated Hospital of China Medical University,Shenyang 101100,China)

机构地区：[1]兰州大学第一医院内分泌科,甘肃省内分泌疾病临床医学研究中心,兰州730000 [2]甘肃省陇南市第一人民医院内分泌科,陇南746000 [3]甘肃省宝石花医院内分泌科,兰州730070 [4]中国医科大学附属第一医院内分泌科,沈阳101100

出　　处：《中华疾病控制杂志》2022年第4期483-489,共7页Chinese Journal of Disease Control & Prevention

基　　金：中央引导地方科技发展专项(2020年);国家卫计委公益性行业科研专项(201402005);甘肃省内分泌疾病临床医学研究中心建设方案(20JR10FA667);甘肃省自然科学基金(20JR10RA681);兰州市科技发展指导性计划项目(2019-ZD-38);兰州大学2021年大学生创新创业项目(20210060122)。

摘　　要：目的探讨甘肃省糖尿病前期(pre-diabetes mellitus,PDM)患病情况及相关影响因素。方法通过多阶段分层整群随机抽样的方法选取甘肃省内2866名成年居民进行调查,使用直接标化法计算标化患病率。通过χ^(2)检验分析PDM患病率差异,采用Pearson相关性分析探讨FPG及口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)负荷后2 h血糖(2 h postprandial blood glucose,2 h PBG)相关影响因素,采用Logistic回归分析模型分析PDM人群患病危险因素。结果甘肃省PDM总患病率为15.07%,其中糖耐量受损(impaired glucose tolerance,IGT)患病率最高,且不同年龄组间PDM患病率差异均有统计学意义(均有P<0.05)。PDM组年龄、BMI、SBP、DBP、腰围、TC、TG、LDL-C、尿酸(uric acid,UA)高于正常组,维生素D和尿碘低于正常组(均有P<0.05)。PDM人群FPG水平与年龄、BMI、SBP、DBP、腰围、TG、TC、LDL-C、UA呈正相关,与HDL-C、血钙、维生素D呈负相关(均有P<0.05);2 h PBG与年龄、BMI、SBP、DBP、腰围、TG、TC、LDL-C、UA呈正相关,与维生素D呈负相关(均有P<0.05),通过Logistic回归分析模型分析得出PDM的危险因素有年龄增长、高BMI、高SBP、高TG、高TC、高UA和患有甲状腺结节,而适宜水平的HDL-C和促甲状腺激素(thyroid-stimulating hormone,TSH)为保护因素。结论甘肃地区PDM中老年人群患病率相对较高,要重视对PDM高危人群糖耐量水平的监测;PDM人群要提高对UA水平和维生素D水平的关注度,及时进行相应调控干预;甲状腺结节患病人群要警惕糖调节状态异常,注意甲状腺功能状况,通过调整饮食结构和生活方式来预防PDM。Objective To investigate the prevalence and related influencing factors of pre-diabetes mellitus(PDM)patients in Gansu Province.Methods By using the method of multi-stage stratified cluster random sampling,2866 adult residents in Gansu Province were investigated,and the standardized prevalence rate was calculated by direct standardized method.χ^(2)test was used to analyze the prevalence difference of PDM.Pearson correlation analysis were used to analyze the fasting blood glucose(FPG)and oral glucose tolerance test(OTGG)2 h blood glucose(2 h PBG)related influencing factors.Logistic regression analysis was used to analyze the risk factors of PDM population.Results The total prevalence rate of PDM in Gansu Province was 15.07%,among which the prevalence rate of impaired glucose tolerance(IGT)was the highest,and there was a statistically significant difference in the prevalence rate of PDM among different age groups(all P<0.05).Age,BMI,SBP,DBP,waist circumference,TC,TG,LDL-C and uric acid(UA)in PDM group were higher than those in normal group,while Vitamin D and urinary iodine were lower than those in normal group(all P<0.05).The level of FPG in PDM population was positively correlated with age,BMI,SBP,DBP,waist circumference,TG,TC,LDL-C and UA,but negatively correlated with HDL-C,serum calcium and Vitamin D(all P<0.05).The 2 h PBG was positively correlated with age,BMI,SBP,DBP,waist circumference,TG,TC,LDL-C and UA,but negatively correlated with Vitamin D(all P<0.05).Logistic regression analysis showed that the risk factors of PDM were aging,high level of BMI,SBP,TG,TC,UA and thyroid nodules,while the appropriate levels of HDL-C and thyroid-stimulating hormone(TSH)were protective factors.Conclusions The prevalence rate of PDM in middle-aged and elderly people in Gansu area is relatively high,so attention should be paid to the monitoring of glucose tolerance level of PDM high-risk population;PDM people should pay more attention to UA level and Vitamin D level,and timely regulation and intervention should be carried o

关 键 词：糖尿病前期 糖耐量受损 空腹血糖受损 影响因素 

分 类 号：R181.1[医药卫生—流行病学] R587.1[医药卫生—公共卫生与预防医学]