Deepa M, Pradeepa R, Rema M, Mohan Anjana, Deepa R, Shanthirani S, Mohan V
Madras Diabetes Research Foundation, Gopalapuram, Chennai, India.
J Assoc Physicians India. 2003 Sep;51:863-70.
The report of World Health Organization (WHO) shows that India tops the world with the largest number of diabetic subjects. This increase is attributed to the rapid epidemiological transition accompanied by urbanization, which is occurring in India. There is very little data regarding the influence of affluence on the prevalence of diabetes and its complications particularly retinopathy in the Indian population. Furthermore, there are very few studies comparing the urban/rural prevalence of diabetes and its complications. The Chennai Urban Rural Epidemiology Study (CURES) is designed to answer the above questions. CURES is initially planned as a cross-sectional study to evolve later into a longitudinal study. Subjects for the urban component of the CURES have been recruited from within the corporation limits of Chennai City. Chennai (formerly Madras), the largest city in Southern India and the fourth largest in India has been divided into 10 zones and 155 wards. 46 wards were selected by a systematic random sampling method to represent the whole of Chennai. Twenty thousand and one individuals were recruited for the study, this number being derived based on a sample size calculation. The study has three phases. Phase one is a door to door survey which includes a questionnaire, anthropometric, fasting capillary blood glucose and blood pressure measurements. Phase two focussed on the prevalence of diabetic complications particularly retinopathy using standardized techniques like retinal photography etc. Diabetic subjects identified in phase one and age and sex matched non-diabetic subjects will participate in these studies. Phase three will include more detailed studies like clinical, biochemical and vascular studies on a sub-sample of the study subjects selected on a stratified basis from phase one. CURES is perhaps one of the largest systematic population based studies to be done in India in the field of diabetes and its complications like retinopathy, nephropathy and neuropathy.
世界卫生组织(WHO)的报告显示,印度糖尿病患者数量位居世界之首。这种增长归因于印度正在发生的、伴随着城市化的快速流行病学转变。关于富裕程度对印度人群糖尿病患病率及其并发症(尤其是视网膜病变)的影响,相关数据非常少。此外,很少有研究比较糖尿病及其并发症在城市/农村的患病率。金奈城乡流行病学研究(CURES)旨在回答上述问题。CURES最初计划作为一项横断面研究,随后发展为纵向研究。CURES城市部分的研究对象是从金奈市的公司范围内招募的。金奈(原马德拉斯)是印度南部最大的城市,也是印度第四大城市,已被划分为10个区和155个病房。通过系统随机抽样方法选取了46个病房来代表整个金奈。该研究招募了20001名个体,这个数字是根据样本量计算得出的。该研究分为三个阶段。第一阶段是挨家挨户的调查,包括问卷调查、人体测量、空腹毛细血管血糖和血压测量。第二阶段重点关注糖尿病并发症(尤其是视网膜病变)的患病率,采用视网膜摄影等标准化技术。在第一阶段确定的糖尿病患者以及年龄和性别匹配的非糖尿病患者将参与这些研究。第三阶段将包括更详细的研究,如对从第一阶段分层选取的研究对象子样本进行临床、生化和血管研究。CURES可能是印度在糖尿病及其并发症(如视网膜病变、肾病和神经病变)领域进行的最大规模的系统性人群研究之一。