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目的了解上海市闸北区45岁及以上居民糖尿病高危人群的特征,并研究其危险因素,为辖区糖尿病预防工作前移提供依据。方法于2009年1-6月采用随机整群抽样的方法,以居委会为单位,按5%的比例从闸北区常住人口中抽取16151非糖尿病患者,参考《上海市社区糖尿病防治指南》将其分为糖尿病高危人群和非高危人群,并对其进行问卷调查、体格检查和生化指标测定。采用非条件logistic回归分析糖尿病高危人群的危险因素。结果筛选出糖尿病高危人群11323人,占70.1%。糖尿病高危人群的年龄、男性比例、颈围、体重、体质指数、腰臀比、血压值、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、肝功能指标、癌胚抗原、大便隐血阳性比例、是否吸烟、是否饮酒等指标均明显高于非高危人群,高密度脂蛋白胆固醇水平和每日睡眠时间低于非高危人群,差异均有统计学意义(P<0.01)。非条件logistic回归分析结果显示,腰臀比(OR=90.969,95%CI=48.032～172.291)、甘油三酯(OR=2.142,95%CI=2.006～2.288)、空腹血糖(OR=1.328,95%CI=1.251～1.409)、舒张压(OR=1.065,95%CI=1.058～1.072)、收缩压(OR=1.045,95%CI=1.040～1.049)、血清丙氨酸转氨酶(OR=1.020,95%CI=1.015～1.025)和血尿酸(OR=1.004,95%CI=1.003～1.004)水平越高,年龄(OR=1.017,95%CI=1.013～1.022)越大,越容易成为糖尿病高危人群,同时女性(OR=1.772,95%CI=1.607～1.953)比男性更容易成为糖尿病高危人群。而血清天冬氨酸转氨酶(OR=0.979,95%CI=0.973～0.985)水平越高,则越不容易成为糖尿病高危人群。结论闸北区糖尿病高危人群比例较大,健康状况低于非高危人群。应将预防控制策略前移,通过改善糖尿病高危人群的生活方式达到预防糖尿病的目的 。
Objective To understand the characteristics of high risk population of diabetes in Zhabei District, Shanghai, population aged 45 and over, and to study the risk factors for the prevention of diabetes in advance. Methods From January to June 2009, a random cluster sampling method was used to collect 16,151 non-diabetic patients from the resident population of Zhabei District at a rate of 5% based on neighborhood committees. Refer to the Shanghai Community Diabetes Prevention and Treatment Guidelines For the high-risk groups of diabetes and non-high-risk groups, and its questionnaires, physical examination and biochemical indicators. Non-conditional logistic regression was used to analyze the risk factors of diabetes at high risk. Results A total of 11,323 people were screened at high risk of diabetes, accounting for 70.1%. Age, male ratio, neck circumference, body weight, body mass index, waist-hip ratio, blood pressure, fasting blood glucose, total cholesterol, triglycerides, LDL cholesterol, liver function, carcinoembryonic antigen, fecal occult blood The positive rate, smoking rate, drinking and other indicators were significantly higher than those in non-high risk population. The levels of HDL cholesterol and daily sleep were lower than those in non-high risk group (P <0.01). The results of unconditional logistic regression analysis showed that WHR (OR = 90.969, 95% CI = 48.032-172.291), triglyceride (OR = 2.142, 95% CI = 2.006-2.88), fasting blood glucose (OR = 1.065, 95% CI = 1.058-1.072), systolic blood pressure (OR = 1.045, 95% CI = 1.040-1.049), serum alanine aminotransferase (OR = 1.020, (OR = 1.017, 95% CI = 1.013 ~ 1.022), the higher the level of serum uric acid (OR = 1.004, 95% CI = 1.003-1.004) People, meanwhile, women (OR = 1.772, 95% CI = 1.607-1.9515) were more likely than men to become diabetic at high risk. Serum aspartate aminotransferase (OR = 0.979, 95% CI = 0.973 ~ 0.985) the higher the level, the less likely to be at high risk of diabetes. Conclusion Zhabei District, a high proportion of diabetic high risk population, health status is lower than non-high risk population. Preventive and control strategies should be moved forward to prevent diabetes by improving the lifestyle of people at risk of diabetes.