汶川地震重灾区居民糖尿病患病率调查及特点分析
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摘要
目的了解四川汶川地震后重灾区板房居住人群DM和糖调节受损(IGR)的患病率及伴发特点,探讨其流行特征和相关危险因素。方法采取横断面随机整群抽样的方法 ,在汶川地震发生1年后对重灾区移居板房居住人群3230名进行了筛查,对指尖FBG≥5.0mmol/L或血压≥140/90mmHg者,给予75g OGTT,并行问卷调查、SAS评分及血液生化指标监测。结果确诊DM者326例,患病率为10.09%,标化率4.63%;IGR者200例,患病率6.19%,标化率2.50%;其中新诊断DM为206例,占本次调查63.19%,新诊断IGR为170例,占本次调查85%。地震重灾区居民DM患病率较全国2008年全国DM调查的结果无明显升高,但是其新诊断率增高(63.1%vs.47.6%),IGR者增高(85%vs.69%),新诊断DM(59.7%vs.35.0%)和IGR者(56.5%vs.37%)合并高血压的发生率较其他地区有明显增加,Logistic回归分析表明,年龄、文化程度、家族史、向心性肥胖、BMI、SBP及精神压力与DM发生明显相关。结论汶川地震后重灾区移居板房居民DM与IGR的患病率与我省2008年调查结果无明显差异,但是DM的新诊断率增高,新诊断DM和IGR者合并高血压的发生率较其他地区有明显增加。除了已经被证实的年龄、文化程度、家族史、向心性肥胖、BMI、SBP因素外,严重自然灾害引起的精神压力可能与新诊断DM合并高血压率显著相关。
Objective To investigation of the prevalence and characteristics of newly diagnosed diabetes and IGR in the population of disaster areas of Wenchuan earthquake.Methods We investigated 3,230 refugees created by Wenchuan carthquake in Sichuan province,China one year after the earthquake. Subjects with fingertips fasting glucose > 5.0mmol/L or BP>140/90mmHg were given 75g OGTT, questionnaire investigation,SAS scoring and blood biochemical test.Results The study showed that the prevalence was 10.1%(326/3230,STD rate 4.6%) for diabetes mellitus(DM) and 6.2%(200/3230, STD rate 2.5%) for IGR respectively,among which newly diagnosed DM and IGR accounted for 63.2% (206/326) being higher than 47.6%of National-2008 value,and 85%(170/200) being higher than 69% of National-2008 value.In the earthquake year versus National 2008 year,the newly diagnosed incidence rates were increased for DM(63.2%vs 47.6%,P<0.05),and for IGR(8.5%vs,69%,P<0.05).In the earthquake area versus non-earthquake area,the incidence rates were increased for DM plus hypertension(59.7%to 35.0%) and for IGR plus hypertension(56.5%to 37.0%)(all P<0.05). Logistic analysis showed the significant correlations of DM/IGR development with age,education degree, family history of DM,central obesity,BMI,SBP,and depression and/or anxiety form earthquake. Conclusion Depression and anxiety from earthquake may have significant influence on newly diagnosed diabetes morbidities,and most of these diabetes patients are complicated with hypertension.
Objective To investigation of the prevalence and characteristics of newly diagnosed diabetes and IGR in the population of disaster areas of Wenchuan earthquake.Methods We investigated 3,230 refugees created by Wenchuan carthquake in Sichuan province,China one year after the earthquake. Subjects with fingertips fasting glucose > 5.0mmol/L or BP>140/90mmHg were given 75g OGTT, questionnaire investigation,SAS scoring and blood biochemical test.Results The study showed that the prevalence was 10.1%(326/3230,STD rate 4.6%) for diabetes mellitus(DM) and 6.2%(200/3230, STD rate 2.5%) for IGR respectively,among which newly diagnosed DM and IGR accounted for 63.2% (206/326) being higher than 47.6%of National-2008 value,and 85%(170/200) being higher than 69% of National-2008 value.In the earthquake year versus National 2008 year,the newly diagnosed incidence rates were increased for DM(63.2%vs 47.6%,P<0.05),and for IGR(8.5%vs,69%,P<0.05).In the earthquake area versus non-earthquake area,the incidence rates were increased for DM plus hypertension(59.7%to 35.0%) and for IGR plus hypertension(56.5%to 37.0%)(all P<0.05). Logistic analysis showed the significant correlations of DM/IGR development with age,education degree, family history of DM,central obesity,BMI,SBP,and depression and/or anxiety form earthquake. Conclusion Depression and anxiety from earthquake may have significant influence on newly diagnosed diabetes morbidities,and most of these diabetes patients are complicated with hypertension.
引文
[1]张坚,李卫东,向红丁,等.2002年中国城市居民糖尿病流行状况分析.中华预防医学杂志,2007,41:4-7.
[2]谭志学.聚焦2007～2008年全国糖尿病流行病学调查.药品评价,2009,1:4-6.
[3]李锐,卢伟,贾伟平,等,上海市2型糖尿病患病情况现状调查.中华医学杂志,2006,24:1675-1680.
[4]University of Edinburgh UK,Stress Affects Brain Function in Older People with Type 2 Diabetes,Diabetes Care,2010.
[5]杨泽.中国中老年人糖尿病和糖耐量异常的流行病学研究.中华流行病学杂志,2003,24:410-413.
[6]国家“九五”攻关计划糖尿病研究协作组.中国12个地区中老年人糖尿病患病率调查.中华内分泌代谢杂志,2002,18:
[7]Pouwer F,Kupper N,Adriaanse MC.Does emotional stress cause type 2 diabetes mellitus? A review from the european depression in diabetes(EDID) research consortium.Discov Med, 2010,45:112-118.
[2]谭志学.聚焦2007～2008年全国糖尿病流行病学调查.药品评价,2009,1:4-6.
[3]李锐,卢伟,贾伟平,等,上海市2型糖尿病患病情况现状调查.中华医学杂志,2006,24:1675-1680.
[4]University of Edinburgh UK,Stress Affects Brain Function in Older People with Type 2 Diabetes,Diabetes Care,2010.
[5]杨泽.中国中老年人糖尿病和糖耐量异常的流行病学研究.中华流行病学杂志,2003,24:410-413.
[6]国家“九五”攻关计划糖尿病研究协作组.中国12个地区中老年人糖尿病患病率调查.中华内分泌代谢杂志,2002,18:
[7]Pouwer F,Kupper N,Adriaanse MC.Does emotional stress cause type 2 diabetes mellitus? A review from the european depression in diabetes(EDID) research consortium.Discov Med, 2010,45:112-118.
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