【作者】 梁爽；

【导师】 王桂侠；

【作者基本信息】 吉林大学 ， 临床医学硕士（专业学位）， 2017， 硕士

【摘要】 目的:对吉林省城乡18岁以上常住居民的糖尿病、糖尿病前期患病情况及相关危险因素进行分析,以了解吉林省糖尿病的流行情况及危险因素,从而对吉林省城乡居民的糖尿病防控策略及相关危险因素的干预措施提供科学指导。方法:本研究资料来源于甲状腺疾病和糖尿病全国调查-2014年(TIDE)的数据,采用现况流行病学研究方法,分层整群随机抽取吉林省部分城乡18岁以上2538名常住居民进行调查(城市1154名,农村1384名)。调查包括问卷调查、体格检查和实验室检测。对无糖尿病病史居民进行口服葡萄糖耐量试验(OGTT)。结果:(1)糖尿病(包括既往诊断的糖尿病和新诊断的糖尿病)患病率为15.3%(城市15.9%,农村14.8%),城乡患病率无明显差异;新诊断糖尿病占总糖尿病人数的43.2%;糖尿病前期患病率为14.1%(城市12.1%,农村15.7%),农村患病率明显高于城市。(2)在城市研究对象中,男性糖尿病患病率高于女性,差异有统计学意义(P=0.001)。(3)伴随年龄的增加(≤30岁、31-40岁、41-50岁、51-60岁、61-70岁、≥71岁),在城市研究对象中,糖尿病前期及糖尿病的患病率(分别为7%、6%、16%、15%、24%、15%;2%、8%、22%、24%、34%、41%)呈增加趋势,差异有统计学意义(P<0.001),在61-70岁组,糖尿病前期的患病率最高,为24%,而在≥71岁组,糖尿病的患病率最高,为41%;在农村研究对象中,糖尿病前期及糖尿病的患病率(分别为20%、15%、15%、13%、11%、14%;16%、18%、12%、14%、16%、14%)较平稳,无明显变化趋势,且患病率之间无统计学差异(P>0.05)。(4)在城市、农村研究对象中,随着体重指数(BMI)的升高,糖尿病前期、糖尿病的患病率(城市:分别为8%、15%、17%;6%、19%、33%,农村:分别为12%、18%、20%;9%、16%、28%)逐渐升高,差异均有统计学意义(P<0.01)。(5)在城市、农村研究对象中,有糖尿病家族史比无糖尿病家族史糖尿病患病率高(城市分别为:22%、12%;农村分别为:30%、12%),差异具有统计学意义(P<0.001)。(6)在城市、农村研究对象中,高血压组比正常血压组糖尿病前期、糖尿病患病率(城市分别为:18%、8%;27%、9%,农村分别为:20%、12%;21%、10%)均高,差异均具有统计学意义(P<0.001)。(7)在城市研究对象中,随着文化程度的升高,糖尿病前期、糖尿病的患病率(分别为25%、13%、10%;22%、23%、10%)有下降趋势,差异具有统计学意义(P<0.01);而在农村研究对象中,糖尿病前期、糖尿病的患病率无明显变化趋势,差异无统计学意义(P>0.05)。(8)在城市研究对象中,不同职业患病率不同,其中农民及家务的糖尿病前期、糖尿病患病率均明显高于其他组,学生的患病率最低,差异具有统计学意义(P<0.05);而在农村研究对象中,不同职业糖尿病前期和糖尿病的患病率无明显差异(P>0.05)。(9)在城市研究对象中,吸烟组比不吸烟组糖尿病患病率高,差异具有统计学意义(P<0.01)。(10)多因素回归分析结果显示生活在农村、超重、腰围大、心率快是糖尿病前期发生的危险因素(P<0.05,OR>1);年龄大于60岁、腰围大、甘油三酯(TG)高、心率快是糖尿病发生的危险因素(P<0.05,OR>1)。结论:(1)吉林省城乡18岁以上常住居民的糖尿病、糖尿病前期患病分别为15.3%(城市15.9%,农村14.8%)、14.1%(城市12.1%,农村15.7%),农村糖尿病前期患病率高于城市。(2)生活在农村、超重、腰围大、心率快是糖尿病前期发生的独立危险因素;年龄大于60岁、腰围大、TG高、心率快是糖尿病发生的独立危险因素。更多还原

【Abstract】 Objective:To investigate the prevalence and the risk factors of diabetes mellitus and prediabetes through analyzing among the urban and rural residents aged over 18 years old in Jilin province.Thereby,to provide scientific guidance for controlling the diabetes mellitus and intervening risk factors of urban and rural residents in Jilin province.Methods:The research material data of this study was derived from the National Survey of Thyroid Diseases and Diabetes-the year of 2014(TIDE).Using the current epidemiological investigation method,stratified random cluster sampling was performed to recruit the urban and rural residents of Jilin province for more than 18 years old(total individuals 2538 including 1154 urban objects and 1384 rural objects).The survey included questionnaires,physical examinations and laboratory tests.Oral Glucose Tolerance Test(OGTT)was performed on residents without history of diabetes mellitus.Result:(1)The prevalence of total diabetes(previously diagnosed and newly diagnosed)was 15.3%(15.9% in urban objects,and 14.8% in rural objects),and there was no significant difference between urban and rural areas;43.2% of the diabetes were newly diagnosed;the prevalence of prediabetes was 14.1%(12.1% in urban objects,and 15.7% in rural objects),and the prevalence of prediabetes in rural area was significantly higher than that in urban area.(2)In the urban objects,the prevalence of diabetes in male was significantly higher than in female(P=0.001).(3)In the urban objects,the prevalence rates of diabetes mellitus and prediabetes were increased with age(7%,6%,16%,15%,24% and 15% for diabetes,2%,8%,22%,24%,34% and 41% for prediabetes aged ≤30,31-40,41-50,51-60,61-70 and ≥70,respectively),thus there were differences among different ages(P <0.001).The highest prevalence rate of prediabetes(24%)was in the group(age of 61-70),while the highest prevalence rate of diabetes(41%)was in the group(age over 70).However,in the rural objects,the prevalence rates of diabetes mellitus and prediabetes varied smoothly(20%,15%,15%,13%,11% and 14% for diabetes,16%,18%,12%,14%,16% and 14% for prediabetes aged ≤30,31-40,41-50,51-60,61-70 and ≥70,respectively),thus there were no differences among different ages(P >0.05).(4)In both urban and rural objects,the prevalence rates of prediabetes and diabetes mellitus were increased with BMI(urban objects: 8%,15% and17%,and rural objects: 9%,16%,and 28%,respectively).Thus for both urban and rural objects,there were no differences in prevalence among different BMI indices(P<0.01).(5)The prevalence of diabetes in people with a family history of diabetes was significantly higher than in those without a family history for both urban and rural objects(urban objects: 22%,12%;rural objects: 30%,12%).There was a statistically difference in prevalence between different people with and without a family history of diabetes(P <0.001).(6)The prevalence of prediabetes and diabetes in hypertension group were higher than normal blood pressure group(P <0.001)for both urban and rural objects(urban objects: 18%,8%;27%,9%,and rural objects: 20%.12%;21%,10%).(7)In urban objects,the prevalence of prediabetes and diabetes had a download trend with increasing degrees of education(25%,13%,10%;22%,23%,10%),while there was no significant change trend in rural objects.Thus there were differences between different degrees of education in urban objects(P <0.01);however,there was no difference in rural objects yet(P >0.05).(8)The prevalence in urban objects differed from different occupations.The prevalence of prediabetes and diabetes for farmers and those running the home were significantly higher than other occupations,and the prevalence of students were lowest in urban objects rather than rural objects.Thus for different occupations,there were differences between prediabetes and diabetes in urban objects(P <0.05)rather than rural objects(P >0.05).(9)In urban objects,the prevalence of diabetes for smokers was higher than non-smokers(P <0.01).(10)The multivariable regression analysis results showed living in rural area,overweight,high waist circumference and rapid heart rate were risk factors for pre diabetes(P<0.05,OR>1).Age greater than 60,high waist circumference,high TG and rapid heart rate were risk factors for diabetes(P<0.05,OR>1).Conclusion:(1)The prevalence of diabetes and prediabetes for residents of Jilin province for more than 18 years old were 15.3%(in urban objects: 15.9%,and in rural objects: 14.8%),14.1%(in urban objects: 12.1%,and in rural objects: 15.7%).The prevalence of prediabetes in rural objects was higher than rural objects.(2)Living in rural area,overweight,high waist circumference and rapid heart rate were risk factors for pre diabetes.Age greater than 60,high waist circumference,high TG and rapid heart rate were independent risk factors for diabetes.更多还原