大连獐子岛地区2型糖尿病及糖调节受损的流行特征分析

发布时间：2018-09-17 14:57

【摘要】： 目的:研究大连獐子岛地区2型糖尿病及糖调节受损的患病情况及危险因素,为制定适宜的干预措施提供依据。方法:采用整群随机抽样的方法抽取大连獐子岛18岁以上的常住居民907人,采取自制的问卷进行一般状况,生活方式及行为、疾病史的调查,同时进行体格检查和相关的生化指标检测。所有人进行口服75g葡萄糖耐量(OGTT)试验,测空腹血糖(FPG)、OGTT2小时血糖(2hPG)、空腹胰岛素(FINS)、血清总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、血尿酸(UA)。计算胰岛素抵抗指数(IRI),HOMA稳态模型β细胞功能指数(HOMA-β)及胰岛素敏感性指数(ISI)。分析研究对象的流行病学特征,研究对象主要分为正常糖耐量(NGT)、糖调节受损(IGR)、糖尿病(DM),比较各组间的临床特征,并分析影响糖调节受损和糖尿病的危险因素。应用SPSS11.5软件进行统计学分析。结果:1.大连獐子岛地区2型糖尿病及糖调节受损的患病率分别为11.4%、37.4%,其中男性分别为10.4%及36.4%,女性分别为12.2%及38.3%,(χ2=0.87,P 0.05 vsχ2=0.24,P 0.05)。而糖尿病患病的知晓率仅为29.13%。2型糖尿病和糖调节受损的患病率均随年龄的增长而增加(P 0.01)。2.DM、IGR与NGT比较,从NGT到IGR再到DM的发展过程中,TC、LDL、BMI、腰围、收缩压、舒张压、IRI、HOMA-β、ISI、FPG及FINS几种相关临床指标的数值显著性升高,三组间差距有统计学意义。TG在最终发展为糖尿病时也产生了显著性差异,但HDL和UA无差异性。同时胰岛素敏感性不断下降,IR不断加重,胰岛素β细胞功能衰退,发展到糖尿病阶段更为严重。而血糖浓度在一定范围内时,血浆胰岛素水平是随血糖浓度升高而增高的。3.多因素非条件Logistic回归分析结果显示:年龄、文化程度、饮酒和高TC血症与糖调节受损的发生有关;而年龄、文化程度、高TG血症、高TC血症、BMI和高血压可增加2型糖尿病的危险性。结论:大连獐子岛地区2型糖尿病和糖调节受损的患病率较高,而糖尿病的知晓率低,疾病的发生与多种因素有关,应采取综合性措施进行防治,以降低患病率。
[Abstract]:Objective: to study the prevalence and risk factors of type 2 diabetes mellitus and impaired glucose regulation in Swertia Island, Dalian. Methods: 907 residents over 18 years old in Swertia Island, Dalian were selected by cluster random sampling, and self-made questionnaire was used to investigate the general condition, life style, behavior and disease history. At the same time, physical examination and related biochemical indicators were performed. 75 g glucose tolerance (OGTT) test was performed on all subjects. Fasting blood glucose (FPG), OGT T 2 hour glucose (2hPG), fasting insulin (FINS), total cholesterol, (TC), low density lipoprotein (TG), high density lipoprotein (LDL), high density lipoprotein (HDL),) were measured. Calculation of insulin resistance index (IRI) and homeostasis model 尾 cell function index (HOMA- 尾) and insulin sensitivity index (ISI).) The epidemiological characteristics of the subjects were analyzed. The subjects were divided into normal glucose tolerance (NGT), impaired glucose regulation (IGR),) and diabetes mellitus (IGR),). The clinical characteristics of each group were compared, and the risk factors affecting impaired glucose regulation and diabetes mellitus were analyzed. SPSS11.5 software was used for statistical analysis. The result is 1: 1. The prevalence rates of type 2 diabetes mellitus and impaired glucose regulation in Swertia davidii area were 11.4m 37.4%, 10.4% and 36.4% in males and 12.2% and 38.3% in females, respectively (蠂 ~ 2 0.87 P 0.05 vs 蠂 ~ (0.24) P 0.05). However, the awareness rate of diabetes mellitus was 29.13.2% and the prevalence of impaired glucose regulation increased with age (P0.01) .2.DMIGR was compared with NGT. During the development from NGT to IGR to DM, TCC LDLBMI, waist circumference, systolic blood pressure (SBP). The clinical values of FINS and FPG were significantly increased, and the difference between the three groups was statistically significant. TG also had significant difference in the development of diabetes mellitus, but there was no difference between HDL and UA. At the same time, the insulin sensitivity decreased and IR increased, the function of insulin 尾-cells declined, and it became more serious in the stage of diabetes. When blood glucose concentration is in a certain range, plasma insulin level is increased with the increase of blood glucose concentration. Multivariate conditional Logistic regression analysis showed that age, education, alcohol consumption and hyperglycemia were associated with impaired glucose regulation, while age, education, and hyperglycemia were associated with hyperglycemia. High TC and hypertension may increase the risk of type 2 diabetes. Conclusion: the prevalence of type 2 diabetes mellitus and impaired glucose regulation in Swertia davidiana area is higher, but the awareness rate of diabetes mellitus is low, the occurrence of disease is related to many factors, comprehensive measures should be taken to prevent and cure the disease in order to reduce the prevalence rate.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R587.1;R181.3

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