印度城市人口中糖尿病、空腹血糖受损及胰岛素抵抗综合征的患病率

Prevalence of diabetes, impaired fasting glucose and insulin resistance syndrome in an urban Indian population.

作者信息

Gupta Arvind, Gupta Rajeev, Sarna Mukesh, Rastogi Shweta, Gupta V P, Kothari Kunal

机构信息

Department of Medicine, Monilek Hospital and Research Centre, Jawahar Nagar, Jaipur 302004, India.

出版信息

Diabetes Res Clin Pract. 2003 Jul;61(1):69-76. doi: 10.1016/s0168-8227(03)00085-8.

DOI:10.1016/s0168-8227(03)00085-8

PMID:12849925

Abstract

OBJECTIVE

Epidemiological study among urban subjects in western India to determine prevalence of diabetes, insulin resistance syndrome (IRS) and their risk factors.

METHODS

Randomly selected adults > or =20 years were studied using stratified sampling. Target sample was 1,800 (men 960, women 840). 1123 subjects (response 62.4%) were evaluated and blood samples were available in 532 men and 559 women (n=1091, 60.6%). Measurement of anthropometric variables, blood pressure, fasting blood glucose and lipids was performed. Atherosclerosis risk factors were determined using current guidelines. Diabetes was diagnosed when the subject was a known diabetic or fasting blood glucose was > or =126 mg/dl, impaired fasting glucose (IFG) diagnosed when fasting glucose was 110-125 mg/dl. IRS was diagnosed when any three of-IFG, high triglycerides >150 mg/dl, low HDL cholesterol (men<40 mg/dl, women<50 mg/dl), central obesity (men>102 cm, women>88 cm), or high normal blood pressure (>130/>85 mmHg) or hypertension-were present.

RESULTS

Diabetes was present in 70 men (13.2%) and 64 women (11.5%). Age-adjusted prevalence of diabetes was 9.3% in men (95% confidence intervals (CI) 6.7-11.8), 8.1% in women (CI 5.8-10.4) and 8.6% overall (CI 6.9-10.3). IFG was in 28 men (5.3%) and 29 women (5.2%). IRS was present in 52 men (9.8%) and 114 women (20.4%) with age-adjusted prevalence of 7.9% in men (CI 6.7-9.1) and 17.5% in women (CI 14.4-20.6) with an overall prevalence of 12.8% (CI 10.8-14.8). Other metabolic abnormalities of IRS in men and women were high triglycerides in 32.1 and 28.6%, low HDL cholesterol in 54.9 and 90.2%; central obesity in 21.8 and 44.0%, and high normal blood pressure or hypertension in 35.5 and 32.4%. IFG subjects had similar atherosclerosis risk factor profile as normal subjects while those with IRS and diabetes had significantly greater prevalence of obesity, central obesity, hypertension, high triglycerides and low HDL (P<0.01).

CONCLUSIONS

There is s significant prevalence of diabetes and IRS in this urban Indian population. Subjects with diabetes as well as IRS have greater prevalence of obesity, central obesity, hypertension, hypertriglyceridemia and low HDL as compared with normal subjects.

摘要

目的

在印度西部城市人群中进行流行病学研究，以确定糖尿病、胰岛素抵抗综合征（IRS）的患病率及其危险因素。

方法

采用分层抽样对随机选取的年龄≥20岁的成年人进行研究。目标样本为1800人（男性960人，女性840人）。对1123名受试者（应答率62.4%）进行了评估，其中532名男性和559名女性（n = 1091，60.6%）有血样可供检测。测量了人体测量学变量、血压、空腹血糖和血脂。根据现行指南确定动脉粥样硬化危险因素。当受试者为已知糖尿病患者或空腹血糖≥126mg/dl时诊断为糖尿病，空腹血糖为110 - 125mg/dl时诊断为空腹血糖受损（IFG）。当出现以下任意三项时诊断为IRS：IFG、甘油三酯>150mg/dl、高密度脂蛋白胆固醇低（男性<40mg/dl，女性<50mg/dl）、中心性肥胖（男性>102cm，女性>88cm）、血压正常高值（>130/>85mmHg）或高血压。

结果

70名男性（13.2%）和64名女性（11.5%）患有糖尿病。年龄调整后的糖尿病患病率男性为9.3%（95%置信区间（CI）6.7 - 11.8），女性为8.1%（CI 5.8 - 10.4），总体为8.6%（CI 6.9 - 10.3）。28名男性（5.3%）和29名女性（5.2%）患有IFG。52名男性（9.8%）和114名女性（20.4%）患有IRS，年龄调整后的患病率男性为7.9%（CI 6.7 - 9.1），女性为17.5%（CI 14.4 - 20.6），总体患病率为12.8%（CI 10.8 - 14.8）。男性和女性IRS的其他代谢异常情况为：甘油三酯高分别为32.1%和28.6%，高密度脂蛋白胆固醇低分别为54.9%和90.2%；中心性肥胖分别为21.8%和44.0%，血压正常高值或高血压分别为35.5%和32.4%。IFG受试者的动脉粥样硬化危险因素谱与正常受试者相似，而患有IRS和糖尿病的受试者肥胖、中心性肥胖、高血压、甘油三酯高和高密度脂蛋白低的患病率显著更高（P<0.01）。