Łopatyński J, Mardarowicz G, Nicer T, Szcześniak G, Król H, Matej A, Szydłowski W, Paszkowski J, Dabek K, Zmurowska B, Szyprowska-Grzegorczyk E
Zakład Podstawowej Opieki Zdrowotncj Katedry Medycyny Rodzinnej Akademii Medycznej w Lublinie.
Pol Arch Med Wewn. 2001 Sep;106(3):781-6.
The prevalence of type 2 diabetes mellitus (DM 2) has increased dramatically in the last decade. Data relating to the number of undetected cases of diabetes are underestimated. The aim of the study was to evaluate the prevalence of DM 2, obesity, hypertension, and lipid disturbances in a representative group of urban and rural population in the Lublin region (Eastern Poland). The study was performed in 1998-2001. A two-layer draw was applied: two groups of 3000 people were drawn from the population of Lublin town and from the rural areas each comprising 100,000 inhabitants. In all subjects physical examination was performed and body weight, height, and blood pressure measurements were obtained. Blood samples were taken from the basilic vein to estimate: blood glucose, lipids and insulin concentration. Venous blood glucose concentration was measured using a Glucotrend glucometer. Oral glucose tolerance test (OGTT) after a 75 g-glucose load was performed in subjects without previously diagnosed diabetes mellitus and when the fasting blood glucose was < 8.0 mmol/l (144 mg/l). The LDL-cholesterol level was calculated according to Friedewald formula. DM 2 was identified according to the WHO criteria from 1985. Obesity and hypertension were diagnosed according to the new WHO criteria (Body Mass Index > or = 30 kg/m2, blood pressure > or = 140/90 mm Hg). 3782 subjects: 1809 in the rural area and 1973 in Lublin town were examined. The response rate among rural and urban population was 60.3% and 65.8% respectively. The prevalence of DM 2 was assessed in 17.6% of rural and in 14.1% of urban population. 75% of diabetics in the rural areas and 56% in the town were the newly diagnosed cases. We found impaired glucose tolerance in 30.3% of rural and in 21.6% of urban population, BMI > or = 30 kg/m2 in 30.8% and 30.1%, hypertension in 69.4% (29.2% newly diagnosed) and 68.6% (27.7% newly diagnosed), hypercholesterolaemia (total cholesterol > or = 5.2 mmol/l (200 mg/dl)) in 66.4% and 60%, hyper-LDL-cholesterolaemia (> or = 3.5 mmol/l (135 mg/dl)) in 57.3% and 52.6%, hypo-HDL--cholesterolaemia in 21.7% and 31.4%, hypertriglyceridemia (> or = 2.3 mmol/l (200 mg/dl)) in 15.1% and 22% respectively. This finding indicates the urgent need for introducing a national program for early diagnosis and prevention of DM 2 and concomitant metabolic disturbances.
在过去十年中，2型糖尿病（DM 2）的患病率急剧上升。与未被发现的糖尿病病例数量相关的数据被低估了。本研究的目的是评估波兰东部卢布林地区具有代表性的城乡人口群体中DM 2、肥胖、高血压和血脂紊乱的患病率。该研究于1998年至2001年进行。采用了两层抽样方法：从卢布林市和农村地区各有10万居民的人口中分别抽取两组3000人。对所有受试者进行了体格检查，并测量了体重、身高和血压。从贵要静脉采集血样以评估：血糖、血脂和胰岛素浓度。使用葡萄糖趋势血糖仪测量静脉血糖浓度。对先前未被诊断为糖尿病且空腹血糖<8.0 mmol/l（144 mg/l）的受试者进行75克葡萄糖负荷后的口服葡萄糖耐量试验（OGTT）。根据Friedewald公式计算低密度脂蛋白胆固醇水平。根据1985年世界卫生组织标准确定DM 2。根据世界卫生组织新的标准（体重指数≥30 kg/m2，血压≥140/90 mmHg）诊断肥胖和高血压。对3782名受试者进行了检查：农村地区1809名，卢布林市1973名。农村和城市人口的应答率分别为60.3%和65.8%。农村人口中DM 2的患病率评估为17.6%，城市人口中为14.1%。农村地区75%的糖尿病患者和城市地区56%的糖尿病患者为新诊断病例。我们发现农村人口中30.3%和城市人口中21.6%存在糖耐量受损，体重指数≥30 kg/m2的比例分别为30.8%和30.1%，高血压的比例分别为69.4%（新诊断的占29.2%）和68.6%（新诊断的占27.7%），高胆固醇血症（总胆固醇≥5.2 mmol/l（200 mg/dl））的比例分别为66.4%和60%，高LDL胆固醇血症（≥3.5 mmol/l（135 mg/dl））的比例分别为57.3%和52.6%，低HDL胆固醇血症的比例分别为21.7%和31.4%，高甘油三酯血症（≥2.3 mmol/l（200 mg/dl））的比例分别为15.1%和22%。这一发现表明迫切需要推行一项全国性计划，用于DM 2及相关代谢紊乱的早期诊断和预防。
