南京市40~69岁社区居民糖尿病前期流行现状及影响因素分析-现代医学

南京市40~69岁社区居民糖尿病前期流行现状及影响因素分析

单位：1. 南京医科大学附属南京市疾病预防控制中心基本公共卫生服务指导办, 江苏南京 210003;
2. 南京医科大学附属南京市疾病预防控制中心慢性非传染病防制科, 江苏南京 210003

分类号：R587.1

出版年·卷·期（页码）：2025·53·第三期（371-378）

摘要：

目的：了解南京市40~69岁社区居民糖尿病前期(PDM)患病情况及其影响因素，为制定南京市中老年人PDM防控措施提供科学依据。方法：于2022年7~9月采用多阶段整群随机抽样方法抽取南京市3 203名40~69岁社区居民为研究对象。通过 χ²检验对PDM的流行特征进行描述性分析，使用多因素Logistic回归分析PDM的影响因素。结果：南京市40~69岁社区居民PDM的患病率为51.80%。Logistic回归分析结果显示，年龄50~59岁(OR=1.767，95%CI:1.477~2.115)、60~69岁(OR=2.321, 95%CI:1.926~2.798)、居住在郊区(OR=1.508，95%CI:1.304~1.743)、糖尿病家族史(OR=1.519，95%CI:1.234~1.871)、中心性肥胖(OR=1.270，95%CI:1.061~1.519)、冠心病(OR=1.866，95%CI:1.095~3.177)、血脂异常(OR=1.429，95%CI:1.092~1.871)是PDM发生的危险因素；有氧运动(OR=0.850，95%CI: 0.735~0.984)是PDM发生的保护因素。结论：南京市40~69岁社区居民PDM患病率处于较高水平，应当针对中老年、居住在郊区、中心性肥胖、冠心病、血脂异常等高危人群开展健康教育和生活方式干预，加强高危人群早期筛查和健康管理，进而降低PDM患病率。

Objective: To investigate the prevalence of prediabetes mellitus(PDM) and influencing factors among community residents aged 40-69 years in Nanjing, providing scientific basis for formulating prevention and control measures for PDM among middle-aged and elderly people in the Nanjing area. Methods: Using multistage cluster random sampling method to select 3 203 community residents aged 40-69 in Nanjing from July to September in 2022. The prevalence characterize of PDM was analyzed by χ² test and the influencing factors of PDM were analyzed by multivariate Logistic regression models. Results: The prevalence of PDM in community residents aged 40-69 years in Nanjing area was 51.80%. The results of Logistic regression analysis showed that aged 50-59 years(OR=1.767, 95%CI 1.477-2.115), 60-69 years(OR=2.321, 95%CI 1.926-2.798), living in the suburbs(OR=1.508, 95%CI 1.304-1.743), family history of diabetes(OR=1.519, 95%CI 1.234-1.871), central obesity(OR=1.270, 95%CI 1.061-1.519), coronary heart disease(OR=1.866, 95%CI 1.095-3.177), dyslipidemia(OR=1.429, 95%CI 1.092-1.871) were risk factors for PDM, while aerobic exercise(OR=0.850, 95%CI 0.735-0.984) was a protective factor. Conclusion: The prevalence of PDM in community residents aged 40 to 69 years in Nanjing is at a high level. Health education and lifestyle intervention should be carried out for middle-aged and elderly, living in suburban, central obesity, coronary heart disease and dyslipidemia people, early screening and health management should be strengthened to reduce the prevalence of PDM.

参考文献：

[1] Diabetes Canada Clinical Practice Guidelines Expert Committee.Diabetes Canada 2018 clinical practice guidelines for the prevention and management of diabetes in Canada[J].Can J Diabetes,2018,42(Suppl 1):S1-325.
[2] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)(上)[J].中国实用内科杂志,2021,41(8):668-695.
[3] WANG L，PENG W，ZHAO Z，et al.Prevalence and treatment of diabetes in China，2013—2018[J].JAMA，2021,326(24):2498-2506.
[4] LI G，ZHANG P，WANG J，et al.The long-term effect of lifestyle interventions to prevent diabetes in the China DaQing diabetes prevention study:a 20-year follow-up study[J].Lancet，2008,371(9626):1783-1789.
[5] LINDSTRÖM J，PELTONEN M，ERIKSSON J G，et al.Improved lifestyle and decreased diabetes risk over 13 years:long-term follow-up of the randomised finnish diabetes prevention study(DPS)[J].Diabetologia，2013，56(2):284-293.
[6] 姜傥.糖尿病的实验室诊断管理专家共识[J].临床检验杂志,2020,38(7):481-487.
[7] PIERCY K L，TROIANO R P，BALLARD R M，et al.The physical activity guidelines for Americans[J].JAMA,2018,320(19):2020-2028.
[8] 中国肥胖问题工作组.中国成人超重和肥胖症预防与控制指南(节录)[J].营养学报,2004(1):1-4.
[9] 中国营养学会肥胖防控分会,中国营养学会临床营养分会,中华预防医学会行为健康分会,等.中国居民肥胖防治专家共识[J].中华流行病学杂志,2022,43(5):609-626.
[10] 诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-953.
[11] 中国高血压防治指南修订委员会,高血压联盟(中国),中华医学会心血管病学分会,等.中国高血压防治指南(2018年修订版)[J].中国心血管杂志,2019,24(1):24-56.
[12] 毛涛,曲晨,何楚,等.江苏省18～65岁社区居民新发糖尿病和糖尿病前期不同诊断标准检出分析[J].江苏预防医学,2019,30(4):401-404,413.
[13] 国家卫生健康委疾病预防控制局.中国居民营养与慢性病状况报告 [M].北京:人民卫生出版社，2021:98-99.
[14] 赵惠.中国45～79岁人群糖尿病前期、糖尿病患病及影响因素研究[D].北京：中国疾病预防控制中心,2021.
[15] 李贤,王惠群,吴延莉,等.贵州省2型糖尿病和糖尿病前期流行现状及影响因素分析[J].中国慢性病预防与控制,2021,29(5):373-376.
[16] 沈宇航.吉林省居民糖尿病前期检出情况及影响因素分析[D].长春：吉林大学,2020.
[17] 刘少博.10省市队列人群糖尿病前期与糖尿病发病状况及影响因素研究[D].北京：中国疾病预防控制中心,2021.
[18] KALRA S，ANJANA R M，VERMA M，et al.Urban-Rural differences in the prevalence of diabetes among adults in Haryana，India:the ICMR-INDIAB study(ICMR-INDIAB-18)[J].Diabetes Ther，2024，15(7):1597-1613.
[19] ZHAO Y，LI H F，WU X，et al.Rural-urban differentials of prevalence and lifestyle determinants of pre-diabetes and diabetes among the elderly in southwest China[J].BMC Public Health，2023，23(1):603.
[20] 张辉映,袁旻健,娄灵芝,等.糖尿病前期人群血糖水平的影响因素分析[J].上海预防医学,2011,23(5):207-209.
[21] 叶鹏,陈霞,魏东,等.肥胖指标和甘油三酯对中老年人群糖代谢异常的预测价值[J].实用医院临床杂志,2022,19(4):22-26.
[22] 卢露,景翔,王亚丽,等.山东省≥60岁老年人超重、肥胖和腹型肥胖流行现状及其影响因素分析[J].中国公共卫生,2020,36(4):566-569.
[23] 丁有红,吴洵,覃玉,等.中老年人群脂质蓄积指数与糖尿病发生风险关系研究[J].现代医学,2024,52(4):515-522.
[24] TAO L X，YANG K，HUANG F F，et al.Association of waist circumference gain and incident prediabetes defined by fasting glucose:a seven-year longitudinal study in Beijing，China[J].Int J Environ Res Public Health，2017,14(10):1208.
[25] 张扬,王明杰,刘鑫,等.吉林省成年居民糖尿病前期患病情况及其危险因素分析[J].中国公共卫生,2018,34(7):977-981.
[26] 吴春香,于杰.上海市普陀区糖尿病高危人群筛查情况分析[J].中国全科医学,2019,22(10):1203-1208.
[27] 张皓,王志勇,胡彩红,等.血脂异常对南京市社区2型糖尿病患者血糖控制的影响[J].现代医学,2024,52(2):265-271.
[28] 杨杰,周玉杰,马越,等.糖尿病前期与动脉粥样硬化性心血管疾病的相关性研究进展[J].心肺血管病杂志,2019,38(8):879-881.
[29] PAN X R，LI G W，HU Y H，et al.Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance.The DaQing IGT and diabetes study[J].Diabetes Care,1997,20(4):537-544.
[30] ECHOUFFO-TCHEUGUI J B，PERREAULT L，JI L，et al.Diagnosis and management of prediabetes:a review[J].JAMA，2023,329(14):1206-1216.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录