Lima-Costa Maria Fernanda, Peixoto Sérgio Viana, Firmo Josélia Oliveira Araújo, Uchoa Elizabeth
Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Rev Saude Publica. 2007 Dec;41(6):947-53. doi: 10.1590/s0034-89102007000600009.
To assess the validity of self-reported diabetes and its determinants in the elderly.
Cross-sectional study including 1,492 subjects aged >or= 60 years, which corresponds to 86% of all residents in this age group living in the municipality of Bambuí, Southeastern Brazil, in 1997. The validity of self-reported diabetes was assessed comparing to diabetes mellitus defined by medical criteria (fasting glucose > 126 mg/dl or current treatment). Multivariate analysis was carried out to assess factors independently associated with sensitivity and specificity.
The prevalence of diabetes mellitus and self-reported diabetes were 14.5% and 11.7%, respectively. Sensitivity and specificity of self-reported diabetes were 57.1% (95% CI: 50.3;63.8) and 96.9% (95% CI: 94.7;97.0), respectively. Medical visits in the previous two years (PR=3.78), as well as 1-3 (PR=1.90) and > 4 years (PR=1.55) of schooling were positively and independently associated with sensitivity. Medical visits in the previous two years (PR= 0.96) and female sex (PR = 0.97) were negatively and independently associated with specificity.
The study results indicated that self-reported diabetes should not be either used to estimate the prevalence of diabetes mellitus or to identify individuals with the disease in the study population. Schooling and medical visits were determinants of the elderly awareness of being diabetics, indicating that these modifiable characteristics may play a role in secondary and tertiary prevention.
评估老年人自我报告的糖尿病及其决定因素的有效性。
横断面研究纳入了1492名年龄≥60岁的受试者,这相当于1997年巴西东南部班布伊市该年龄组所有居民的86%。通过与根据医学标准定义的糖尿病(空腹血糖>126mg/dl或正在接受治疗)进行比较,评估自我报告糖尿病的有效性。进行多变量分析以评估与敏感性和特异性独立相关的因素。
糖尿病和自我报告糖尿病的患病率分别为14.5%和11.7%。自我报告糖尿病的敏感性和特异性分别为57.1%(95%CI:50.3;63.8)和96.9%(95%CI:94.7;97.0)。过去两年内的就诊次数(PR=3.78)以及受教育1 - 3年(PR=1.90)和超过4年(PR=1.55)与敏感性呈正相关且独立相关。过去两年内的就诊次数(PR=0.96)和女性性别(PR = 0.97)与特异性呈负相关且独立相关。
研究结果表明,自我报告的糖尿病既不应被用于估计糖尿病的患病率,也不应被用于识别研究人群中的糖尿病患者。受教育程度和就诊次数是老年人糖尿病知晓情况的决定因素,表明这些可改变的特征可能在二级和三级预防中发挥作用。