基于三级网络体系的糖尿病前期人群流行病学研究

发布时间：2018-04-05 12:22

本文选题：糖尿病前期　切入点：糖尿病　出处：《宁波大学》2015年硕士论文

【摘要】：目的:基于三级网络体系,进行社区成年人群糖尿病筛查,掌握糖尿病前期人群和无症状糖尿病者的流行情况;探索社区人群糖尿病筛查模式;分析不同糖代谢状况与其他代谢指标的关系;了解不同糖尿病前期状态的生化指标差异;为糖尿病的早期防治提供依据。方法:采用分层整群随机抽样方法,抽取鄞州区6个乡镇,将20岁及以上的本地常住居民作为研究对象,结合新农合体检增加糖耐量试验,分析糖尿病前期和糖尿病的流行情况。选取鄞州区姜山镇,横断面分析不同糖代谢状况与其他代谢指标的关系。对筛查出的20~64岁糖尿病前期人群,分析不同糖尿病前期状态的生化指标差异。收集和清理数据,用PASW Statistics和EXCEL2003等软件进行统计分析。结果:1、糖尿病粗检出率为6.68%。按照2012年宁波市平均人口数调整计算后,糖尿病调整检出率为4.67%。性别间差异无统计学意义(χ2=2.68,P=0.101)。从年龄别看,糖尿病粗检出率波动在0~13.44%之间,随着年龄增长而上升(趋势χ2=141.21,P=0.000)。2、糖尿病前期的粗检出率为19.13%,调整检出率为13.52%。性别间差异有统计学意义(χ2=4.27,P=0.039)。糖尿病前期粗检出率波动在3.65%~30.07%之间,随着年龄增长而上升(趋势χ2=273.44,P=0.000)。3、不同糖尿病前期状态中,单纯性糖耐量受损最多(占糖尿病前期的64.93%);其次为单纯性空腹血糖受损(占19.45%);最少为空腹血糖受损合并糖耐量受损(占15.62%)。空腹血糖和糖耐量2h血糖检测结果的一致性较差(Kappa=0.25,P=0.000)。4、体质指数、空腹血糖、糖耐量2h血糖、收缩压、舒张压和甘油三酯在正常血糖组、糖尿病前期组、糖尿病组3组间差异有统计学意义,糖尿病前期组和糖尿病组均高于正常血糖组。多分类无序Logistic回归分析结果显示,除性别外,年龄、超重和(或)肥胖、高血压和血脂紊乱均表现为糖尿病和糖尿病前期的危险因素。5、在总胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白、空腹胰岛素、胰岛素抵抗HOMA-IR指数方面,空腹血糖受损合并糖耐量受损和(或)单纯性糖耐量受损2组的危险程度高于单纯性空腹血糖受损。结论:1、本次筛查显示糖尿病调整检出率为4.67%,糖尿病前期的调整检出率为13.52%。2、单纯性糖耐量受损是最多的糖尿病前期状态的亚型。若仅进行空腹血糖检测,将遗漏多于半数的糖尿病和糖尿病前期。3、将糖耐量2h检测纳入体检流程,实践证明可行。4、年龄、超重和(或)肥胖、高血压和血脂紊乱为糖尿病和糖尿病前期的危险因素。5、相比单纯性空腹血糖受损,空腹血糖受损合并糖耐量受损、单纯性糖耐量受损在某些指标方面具有较高的危险水平。
[Abstract]:Objective: based on the three-level network system, to screen diabetes in community adult population, to understand the prevalence of pre-diabetes and asymptomatic diabetes, and to explore the screening model of diabetes in community.To analyze the relationship between different glucose metabolism status and other metabolic indexes, to understand the difference of biochemical indexes of different pre-diabetic states, and to provide the basis for early prevention and treatment of diabetes mellitus.Methods: using stratified cluster random sampling method, 6 villages and towns in Yinzhou district were selected. The residents aged 20 and above were selected as the research objects, and the test of increasing glucose tolerance was carried out in combination with the physical examination of Xinrong Medical College.To analyze the prediabetes and the prevalence of diabetes.Jiangshan Town, Yinzhou District, was selected to analyze the relationship between different glucose metabolism and other metabolic indexes.The biochemical indexes of different pre-diabetic states were analyzed among 20-64-year-old prediabetic population.Collect and clean the data, use PASW Statistics and EXCEL2003 to do statistical analysis.Results the crude detection rate of diabetes was 6.68%.According to the average population of Ningbo in 2012, the adjusted rate of diabetes was 4.67.There was no statistical difference between the two sexes (蠂 2 / 2.68 P = 0.101).The crude detection rate of diabetes mellitus fluctuated between 0 ~ 13.44% and increased with age (蠂 ~ (2) ~ (2)) 141.21 ~ (1) P ~ (0.000) ~ (0.000). 2. The crude detection rate of diabetes was 19.13%, and the adjusted rate was 13.52%.The sex difference was statistically significant (蠂 2 = 4.27, P < 0.039).The crude detection rate of prediabetic patients fluctuated between 3.65% and 30.07%, which increased with age (蠂 ~ 2 273.44) 0.000. 3.Simple glucose tolerance impairment was the most (64.93% of prediabetes mellitus) followed by simple fasting glucose impairment (19.45%) and fasting glucose impairment with impaired glucose tolerance (15.62%).The consistency of fasting blood glucose and glucose tolerance 2 h blood glucose was poor. The body mass index, body mass index, fasting blood glucose, glucose tolerance 2 hours blood glucose, systolic blood pressure, diastolic blood pressure and triglyceride were measured in normal blood glucose group and prediabetic group.There was significant difference among the three groups. The prediabetic group and the diabetic group were higher than the normal blood glucose group.Multiple disordered Logistic regression analysis showed that age, overweight and / or obesity, hypertension and dyslipidemia were all the risk factors of diabetes and prediabetes, in total cholesterol, low density lipoprotein cholesterol, and low density lipoprotein cholesterol, in addition to sex, age, overweight and / or obesity, hypertension and dyslipidemia were the risk factors of diabetes and prediabetes.The risk of glycosylated hemoglobin, fasting insulin, HOMA-IR index of insulin resistance, impaired fasting blood glucose with impaired glucose tolerance and / or simple impaired glucose tolerance was higher than that of simple impaired fasting blood glucose.ConclusionThe adjusted rate of diabetes was 4.67 and 13.52 in prediabetes. Simple impaired glucose tolerance was the most subtype of pre-diabetes.If only fasting blood glucose was measured, more than half of the diabetes mellitus and prediabetes patients were left out, and 2 hours glucose tolerance test was included in the physical examination process. The practice proved feasible: age, overweight and / or obesity.Hypertension and dyslipidemia were risk factors of diabetes and prediabetes. Compared with simple fasting blood glucose, impaired fasting blood glucose with impaired glucose tolerance and simple glucose tolerance had higher risk level in some indexes.
【学位授予单位】：宁波大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1

【相似文献】