【摘要】 目的:调查并分析北京市高危险年龄人群2型糖尿病患病的危险因素。方法:①于1997-08/1998-08采用随机整群抽样方法,横断面调查北京市城乡4个社区40岁以上常住居民2354人。均对调查项目知情同意。②依据“我国2型糖尿病流行病学研究操作手册”[卫生部老年卫生工作领导小组办公室编(1997)],调查纳入对象的性别、年龄、2型糖尿病家族史、2型糖尿病病史及有关干预治疗措施、糖尿病并发症发生情况、其它患病史、吸烟状况、饮酒状况、体力活动、强度、脑力活动强度、业余运动强度等。③用统一的方法测量纳入对象的身高、体质量、腰围、臀围、血压,计算体质量指数=体质量(kg)/身高(m)2。④采用世界卫生组织推荐的口服75g葡萄糖耐量试验,测定纳入对象的空腹血糖及餐后2h血糖。按照世界卫生组织1999年糖尿病的诊断标准确诊2型糖尿病和糖耐量低减。⑤计数和计量资料差异比较采用χ2和t检验,用非条件Logistic回归分析筛选与2型糖尿病密切相关的指标。结果:①共纳入2型糖尿病高危险年龄常住居民2354人,资料完整者2186人(2型糖尿病患者231人,糖尿病减低者268人,血糖正常者1687人)进入结果分析。②糖尿病和糖耐量低减患者年龄、腰围、臀围、体质量指数、腰臀比和收缩压明显高于血糖正常者(P≤0.05～0.01);体质量和舒张压差异不明显。③18个分析因素与2型糖尿病的关系的非条件Logistic回归分析结果,年龄、城乡、糖尿病家族史、体质量指数、腰围、收缩压、高血压和职业性体力劳动8个因素在糖尿病患者与血糖正常者间差异明显(P<0.05～0.01);其中职业性体力劳动OR=0.7262,为保护因素;其余7个因素OR=1.0116～2.7385,为危险因素。④18个分析因素与糖耐量低减的关系的非条件Logistic回归分析结果:年龄、腰围、收缩压、高血压、体质量指数5个因素在糖耐量低减患者与血糖正常者间差异明显(OR=1.226～1.896,P<0.05～0.01)。结论:北京市2型糖尿病高危险年龄人群中危险因素有7项,包括年龄增长、城市生活、糖尿病家族史、体质量指数、腰围、收缩压和高血压。因此有效地进行2型糖尿病高危人群的筛查,控制已知的2型糖尿病的危险因素,将会有利于预防和减少2型糖尿病的发生。更多还原

【Abstract】 AIM: To investigate and analyze the risk factors for type 2 diabetes mellitus(T2DM)in high-risk age population in Beijing. METHODS: ①A cross-sectional study was conducted on 2 354 residents older than 40 years living in 4 communities of Beijing rural and urban areas between August 1997 and August 1998 with randomized cluster sampling method, and all subjects signed the informed consent before participation.②According to the operation manual of epidemiologic research of T2DM in China (Compiled by Elderly Health Leading Group Office,Ministry of Health, 1997), each participant was interviewed for sex, age, family history and medical records of T2DM, interventional measures, complications of T2DM, other medical records, smoking, drinking, physical activities, intensity, intensity of brain work and exercise intensity in spare time etc.③The height, body mass, waist circumference, hip circumference and blood pressure were measured with unified method and the body mass index (BMI) was calculated as the body weight in kilograms divided by the square of the height.④Subjects were tested of the fasting blood glucose and the blood glucose at 2 hours after meal according to glucose tolerance test (GTT) of orally taking 75 g, which was recommended by World Health Organization (WHO). T2DM impaired glucose tolerance (IGT) in patients were diagnosed according to the diagnostic criteria of diabetes in 1999 published by WHO.⑤Differences in numeration and mmeasurement data were compared with t test and Chi square test, and non-conditional Logistic regression was used to screen the relevant indicators that closed related with T2DM. RESULTS: ①A total of 2 354 high-risk age residents of T2DM were enrolled, in which 2 186 subjects (231 patients with T2DM, and 268 patients with IGT, 1 687 subjects with normal blood glucose) were involved in the analysis of results, who had complete data.②Compared to subjects with normal plasma glucose, patients with T2DM and IGT were significantly higher in age, waistilne, hip circumference, BMI, systolic blood pressure and waist-to-hip ratio (WHR) (P ≤ 0.05-0.01), while there was no significant difference in weight and diastolic blood pressure between the 2 groups.③Analysis of relationship between 18 research factors and T2DM with non-conditional logistic regression showed that there were significant differences in age, city or country life, family history of DM, BMI, waistline, systolic blood pressure, hypertension and professional physical labor between DM patients and subjects with normal blood glucose (P < 0.05-0.01). Physical activity (OR=0.726 2) was a protective factor, and other 7 factors (OR=1.011 6-2.738 5) were risk factors.④Analysis of relationship between 18 research factors and IGT with non-conditional logistic regression represented that age, waistline, systolic blood pressure and hypertension and BMI in patients with IGT were obviously different from those in subjects of normal blood glucose (OR =1.226-1.896, P < 0.05-0.01). CONCLUSION: There are 7 risk factors for high-risk age population with T2DM in Beijing, including age, city life, family history of T2DM, BMI, waistline, systolic blood pressure and hypertension. Therefore, effective screening of high-risk population and control of known risk factors for T2DM are good to prevent and reduce T2DM.更多还原