Rahim M A, Vaaler S, Keramat Ali S M, Khan A K A, Hussain A, Nahar Q
Deptt. of Community Medicine, National Institute of Preventive and Social Medicine, Dhaka.
Bangladesh Med Res Counc Bull. 2004 Aug;30(2):60-70.
This cross-sectional study was conducted to estimate the prevalence of type 2 diabetes along with its risk factors in urban slum population of Dhaka, Bangladesh. A random sample of 1555 slum dwellers of Dhaka city (age > or = 20 years) were included in the study. Capillary blood glucose levels, fasting and 2-h after 75g oral glucose load (for a selected subjects, n = 476), were measured. Height, weight, waist and hip circumferences, blood pressure and some other important socio-demographic information on age, sex, education, income, and occupation status were collected. The overall prevalence of type 2 diabetes was found to be 8.1 percent, and the prevalence for men and women were 7.7 percent and 8.5 percent respectively. Prevalence of diabetes was found to be lower following 2-h glucose values in the selected population compared to the FBG procedure. Age, sex, literacy and waist to hip ratio for men were found as significant risk factors following both fasting blood glucose and 2-h post glucose values adjusted for a number of confounding variables. Poor to moderate agreement was observed between fasting blood glucose and 2-h glucose (kappa 0.41, p < 0.001). The agreement was even poorer between impaired fasting glucose and impaired glucose tolerance. Poor agreement between FBG and 2-h BG may raise concern for the dependability of diagnostic procedures. Higher prevalence of type 2 diabetes in the urban slum may indicate an epidemiological transition due to fast urban migration and possibly urbanization. However, this issue needs further exploration.
本横断面研究旨在估计孟加拉国达卡市城市贫民窟人群中2型糖尿病的患病率及其危险因素。研究纳入了达卡市1555名年龄≥20岁的贫民窟居民的随机样本。测量了毛细血管血糖水平、空腹血糖以及75克口服葡萄糖负荷后2小时血糖(针对部分选定受试者,n = 476)。收集了身高、体重、腰围和臀围、血压以及一些其他重要的社会人口学信息,包括年龄、性别、教育程度、收入和职业状况。结果发现2型糖尿病的总体患病率为8.1%,男性患病率为7.7%,女性患病率为8.5%。在选定人群中,与空腹血糖检测方法相比,2小时血糖值检测出的糖尿病患病率较低。在对多个混杂变量进行校正后,年龄、性别、男性的识字率和腰臀比被发现是空腹血糖和葡萄糖负荷后2小时血糖值的显著危险因素。空腹血糖和2小时血糖之间的一致性较差(kappa值为0.41,p < 0.001)。空腹血糖受损和糖耐量受损之间的一致性更差。空腹血糖和2小时血糖之间的一致性较差可能会引发对诊断程序可靠性的担忧。城市贫民窟中2型糖尿病的较高患病率可能表明由于快速的城市迁移以及可能的城市化导致了流行病学转变。然而,这个问题需要进一步探讨。