甘肃省糖尿病前期患病情况及相关因素分析

常星宇; 傅松波; 汤旭磊; 刘靖芳; 马承旭; 朱国贸; 井高静; 赵楠; 马丽华; 牛强龙; 焦彩虹; 郭强; 王晓林; 滕卫平; 单忠艳

doi:10.16462/j.cnki.zhjbkz.2022.04.021

文章导航 > 中华疾病控制杂志 > 2022 > 26(4): 483-489

常星宇, 傅松波, 汤旭磊, 刘靖芳, 马承旭, 朱国贸, 井高静, 赵楠, 马丽华, 牛强龙, 焦彩虹, 郭强, 王晓林, 滕卫平, 单忠艳. 甘肃省糖尿病前期患病情况及相关因素分析[J]. 中华疾病控制杂志, 2022, 26(4): 483-489. doi: 10.16462/j.cnki.zhjbkz.2022.04.021

引用本文:

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. Analysis of prevalence and related factors of pre-diabetes mellitus in Gansu Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(4): 483-489. doi: 10.16462/j.cnki.zhjbkz.2022.04.021

Citation:

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. Analysis of prevalence and related factors of pre-diabetes mellitus in Gansu Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(4): 483-489. doi: 10.16462/j.cnki.zhjbkz.2022.04.021

引用本文:

Citation:

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. Analysis of prevalence and related factors of pre-diabetes mellitus in Gansu Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(4): 483-489. doi: 10.16462/j.cnki.zhjbkz.2022.04.021

甘肃省糖尿病前期患病情况及相关因素分析

doi: 10.16462/j.cnki.zhjbkz.2022.04.021

1.
730000 兰州，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
2.
746000 陇南，甘肃省陇南市第一人民医院内分泌科
3.
730070 兰州，甘肃省宝石花医院内分泌科
4.
101100 沈阳，中国医科大学附属第一医院内分泌科

基金项目:

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

详细信息

通讯作者:
傅松波，E-mail: fusb@lzu.edu.cn

中图分类号: R181.1;R587.1
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- 被引次数: 0
出版历程
- 收稿日期: 2021-03-10
- 修回日期: 2021-06-11
- 网络出版日期: 2022-04-14
- 刊出日期: 2022-04-10

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

1.
Department of Endocrinology, the First Hospital of Lanzhou University, Gansu Provincial Endocrine Disease Clinical Medical Research Center, Lanzhou 730000, China
2.
Department of Endocrinology, No.1 Hospital of Longnan City, Gansu Province, Longnan 746000, China
3.
Department of Endocrinology, Gem Flower Hospital of Gansu Province, Lanzhou 730070, China
4.
Department of Endocrinology, First Affiliated Hospital of China Medical University, Shenyang 101100, China

Funds:

Center Leading Local Science and Technology Development Project (2020) 2020年

Public Welfare Industry Research Project of National Health and Family Planning Commission 201402005

The Program of Gansu Provincial Endocrine Disease Clinical Medical Research Center 20JR10FA667

Gansu Natural Science Foundation Project 20JR10RA681

Lanzhou Science and Technology Development guidance Program 2019-ZD-38

Innovative Entrepreneurship and Excellence Program for College students of Lanzhou University in 2021 20210060122

More Information

Corresponding author: FU Song-bo, E-mail: fusb@lzu.edu.cn

摘要

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2 866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χ²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。
- 糖尿病前期 /
- 糖耐量受损 /
- 空腹血糖受损 /
- 影响因素
Abstract: 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, 2 866 adult residents in Gansu Province were investigated, and the standardized prevalence rate was calculated by direct standardized method. χ² 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 out; people with thyroid nodules should be alert to abnormal glucose regulation status, pay attention to thyroid function status, and adjust diet and lifestyle to prevent PDM.
- Pre-diabetes mellitus /
- Impaired glucose tolerance /
- Impaired fasting blood glucose /
- Influencing factors

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表 1 不同年龄段PDM患病情况及性别差异[n (%)]

Table 1. PDM prevalence and gender differences in different ages [n (%)]

年龄(岁)	总计		男性		女性		χ²值	P值
年龄(岁)	例数	PDM	例数	PDM	例数	PDM	χ²值	P值
18~ < 31	764	31(4.06)	408	17(4.17)	356	14(3.93)	0.027	0.870
31~ < 41	626	56(8.95)	316	39(12.34)	310	17(5.48)	9.035	0.003
41~ < 51	627	109(17.38)	308	45(14.61)	319	64(20.06)	3.243	0.072
51~ < 61	436	122(27.98)	220	65(29.55)	216	57(26.39)	0.539	0.463
≥61	413	114(27.60)	208	62(29.81)	205	52(25.37)	1.019	0.313
合计	2 866	432(15.07)	1 460	228(15.62)	1 406	204(14.51)	0.686	0.408

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表 2 PDM亚型患病率及构成比情况[n (%)] ^a

Table 2. Prevalence and composition of PDM subtypes [n (%)] ^a

性别	IFG		IGT		IFG+IGT		合计
性别	例数	构成比(%)	例数	构成比(%)	例数	构成比(%)	例数	构成比(%)
男	44(1.54)	19.30	149(5.20)	65.35	35(1.22)	15.35	228(7.96)	100.00
女	43(1.50)	21.08	137(4.78)	67.16	24(0.84)	11.76	204(7.12)	100.00
合计	87(3.04)	20.14	286(9.98)	66.20	59(2.06)	13.66	432(15.07)	100.00
注：^a n为患病例数，(%)为患病率。

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表 3 PDM亚型患病率及构成比情况(x±s)

Table 3. Prevalence and composition of PDM subtypes (x±s)

变量	合计				男性		女性
变量	PDM组	正常组	t/Z值	P值	PDM组	正常组	PDM组	正常组
年龄(岁)	52.01±13.70	39.45±13.55	17.59	< 0.001	51.89±14.17	39.07±13.53 ^a	52.14±13.18	39.84±13.56 ^a
BMI(kg/m²)	24.86±3.20	23.57±12.08	4.33	< 0.001	25.36±3.27	24.24±7.52 ^a	24.31±3.04	22.88±15.34 ^b
SBP(mm Hg)	134.74±18.57	122.84±16.39	12.41	< 0.001	134.90±15.73	124.24±14.18 ^a	134.56±21.33	121.44±18.25 ^a
DBP(mm Hg)	81.57±11.83	76.99±23.16	6.09	< 0.001	83.61±10.99	79.66±30.63 ^a	79.28±12.33	74.29±10.85 ^a
腰围(cm)	86.48±9.56	82.81±20.43	5.79	< 0.001	90.02±8.99	87.19±26.73 ^b	82.51±8.59	78.40±8.93 ^a
TG(mmol/L)	1.86±1.36	1.41±1.00	6.57	< 0.001	1.97±1.15	1.56±1.11 ^a	1.73±1.56	1.25±0.85 ^a
TC(mmol/L)	4.69±0.96	4.31±0.92	7.64	< 0.001	4.64±0.93	4.32±0.91 ^a	4.75±0.99	4.30±0.94 ^a
LDL-C(mmol/L)	2.89±0.71	2.49±0.73	10.56	< 0.001	2.89±0.72	2.57±0.71 ^a	2.89±0.70	2.42±0.75 ^a
HDL-C (mmol/L)	2.22±15.76	1.99±12.51	0.33	0.738	2.81±21.70	2.31±17.65	1.56±0.34	1.66±0.36 ^a
UA(mol/L)	291.14±96.39	276.28±130.73	2.75	0.006	333.62±93.05	326.91±159.95	243.67±75.84	225.29±58.00 ^a
UIC[M(P₂₅, P₇₅), g/L]	267.89 (145.30, 295.80)	342.57 (158.60, 320.03)	-2.97 ^c	0.003	245.51 (154.48, 294.43)	381.32 (162.45, 310.05) ^b	293.02 (136.20, 296.60)	303.54 (156.05, 336.90) ^b
ALT(U/L)	25.34±23.28	22.61±16.45	2.93	0.003	27.32±23.00	24.65±17.41 ^b	23.14±23.45	20.55±15.16 ^b
AST(U/L)	30.85±22.25	24.76±13.36	5.51	< 0.001	31.32±20.65	25.32±13.20 ^a	30.33±23.94	24.19±13.50 ^a
血钙(mmol/L)	2.19±0.14	2.20±0.14	-0.87	0.386	2.19±0.17	2.22±0.16 ^b	2.20±0.09	2.18±0.11
血磷(mmol/L)	1.01±0.17	1.01±0.16	-0.70	0.484	0.94±0.15	0.96±0.16	1.08±0.16	1.06±0.14
维生素D(ng/ml)	13.71±5.92	14.42±6.01	-2.28	0.023	15.06±5.88	15.84±6.11	12.20±5.60	12.99±5.55
注：^a正常组与PDM相比P < 0.001;^b正常组与PDM组相比P < 0.05;^c为Z值。

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表 4 PDM人群FPG和2 h PBG水平相关性分析

Table 4. Correlation analysis of FPG and 2 h PBG levels in PDM population

变量	FPG		2 h PBG
变量	r值	P值	r值	P值
年龄(岁)	0.38	< 0.001	0.37	< 0.001
BMI(kg/m²)	0.04	0.037	0.05	0.006
SBP(mm Hg)	0.33	< 0.001	0.27	< 0.001
DBP(mm Hg)	0.13	< 0.001	0.08	< 0.001
腰围(cm)	0.08	< 0.001	0.11	< 0.001
TG(mmol/L)	0.14	< 0.001	0.19	< 0.001
TC(mmol/L)	0.25	< 0.001	0.14	< 0.001
LDL-C(mmol/L)	0.22	< 0.001	0.22	< 0.001
HDL-C(mmol/L)	-0.04	0.027	0.01	0.464
UA(mol/L)	0.05	0.022	0.05	0.008
ALT(U/L)	0.13	< 0.001	0.04	0.035
AST(U/L)	0.21	< 0.001	0.17	< 0.001
血钙(mmol/L)	-0.09	< 0.001	-0.01	0.612
血磷(mmol/L)	0.01	0.674	-0.01	0.633
维生素D(ng/ml)	-0.07	0.001	-0.05	0.005

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表 5 PDM人群患病危险因素Logistic回归分析模型分析

Table 5. Logistic regression analysis of disease risk factors in PDM population

变量	PDM		IFG		IGT		IFG+IGT
变量	OR值	(95%CI)值	OR值	(95%CI)值	OR值	(95%CI)值	OR值	(95%CI)值
年龄(岁)	1.98	1.39~2.62 ^a	1.04	1.02~1.06 ^a	1.05	1.04~1.07 ^a	1.07	1.05~1.10 ^a
BMI(kg/m²)	1.83	1.23~2.74 ^a	1.01	0.98~1.02	1.73	1.29~2.66 ^a	1.41	0.98~1.92
SBP(mm Hg)	1.45	1.12~1.72 ^a	1.02	1.00~1.03	1.01	1.00~1.02 ^a	1.02	1.00~1.04 ^a
TG(mm Hg)	2.23	1.84~3.20 ^a	0.99	0.79~1.22	1.29	1.16~1.43 ^a	1.13	0.98~1.33
TC(mm Hg)	1.74	1.38~2.19 ^a	1.64	1.02~2.63 ^a	1.03	0.89~1.89	1.36	1.04~1.78 ^a
HDL-C(mm Hg)	0.67	0.35~0.84 ^a	1.01	0.98~1.08	0.76	0.43~0.83 ^a	0.36	0.15~0.88 ^a
UA(mol/L)	1.24	1.10~1.54 ^a	1.01	1.00~1.04	1.12	1.06~1.54 ^a	1.01	0.99~1.07
维生素D(ng/ml)	0.99	0.96~1.03	0.95	0.90~0.99 ^a	1.01	0.98~1.06	1.01	0.79~1.32
TSH(mIU/L)	0.97	0.93~0.99 ^a	0.99	0.91~1.12	0.95	0.91~0.99 ^a	0.95	0.89~1.54
患有甲状腺结节	2.21	1.79~2.89 ^a	1.91	1.65~2.77 ^a	2.01	1.57~2.45 ^a	2.98	1.67~4.01 ^a
注：^a P＜0.05。

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