Institute of Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.
Diabet Med. 2009 Dec;26(12):1212-9. doi: 10.1111/j.1464-5491.2009.02863.x.
To determine the incidence of Type 2 diabetes in an elderly population in Germany and its association with clinical and lifestyle factors.
Oral glucose tolerance tests (OGTT, World Health Organization criteria) were carried out in a random sample of 1353 subjects (age group 55-74 years; 62% response) in Augsburg (Southern Germany) (1999-2001). The cohort was re-investigated in 2006-2008. Of those individuals without diabetes (baseline), 887 (74%) participated in the follow-up.
Ninety-three (10.5%) developed diabetes during the 7-year follow-up period {standardized incidence rates [95% confidence interval (CI)] per 1000 person-years: total 15.5; 12.6, 19.1; men 20.2; 15.6, 26.1; women 11.3; 7.9, 16.1}. In both sexes, those who developed diabetes were slightly older, were more obese, had a more adverse metabolic profile (higher glucose values, HbA(1c), fasting insulin, uric acid, and triglycerides) and were more likely to have hypertension at baseline than were participants remaining free of diabetes (P < 0.05). On stepwise logistic regression, age, parental diabetes, body mass index, uric acid, current smoking, HbA(1c) and fasting and 2-h glucose (OGTT) were strong predictors of diabetes incidence. The risk of diabetes was higher in subjects with isolated impaired glucose tolerance (odds ratio 8.8; 95% CI 5.0, 15.6) than in isolated impaired fasting glucose (4.7; 2.2, 10.0), although the difference did not reach statistical significance.
For the first time, we have estimated the incidence of Type 2 diabetes in an elderly German cohort and demonstrated that it is among the highest in Europe. The OGTT appears to be useful in identifying individuals with high Type 2 diabetes risk. Our results support a role of smoking in the progression to diabetes.
确定德国老年人群中 2 型糖尿病的发病率及其与临床和生活方式因素的关系。
在德国奥格斯堡（南部）进行了一项随机抽样的 1353 名受试者（年龄组为 55-74 岁；应答率为 62%）的口服葡萄糖耐量试验（OGTT，世界卫生组织标准）（1999-2001 年）。该队列在 2006-2008 年进行了重新调查。在那些没有糖尿病的个体中（基线），887 名（74%）参加了随访。
在 7 年的随访期间，93 名（10.5%）患者发生了糖尿病{标准化发病率[95%置信区间（CI）]每 1000 人年：总 15.5；12.6，19.1；男性 20.2；15.6，26.1；女性 11.3；7.9，16.1}。在两性中，发生糖尿病的患者年龄稍大，更肥胖，代谢谱更差（血糖值、HbA1c、空腹胰岛素、尿酸和甘油三酯更高），且在基线时高血压的可能性更高，而与未发生糖尿病的参与者相比（P<0.05）。在逐步逻辑回归中，年龄、父母糖尿病、体重指数、尿酸、当前吸烟、HbA1c 以及空腹和 2 小时血糖（OGTT）是糖尿病发病的强预测因素。与单纯空腹血糖受损相比，单纯糖耐量受损患者的糖尿病风险更高（比值比 8.8；95%CI 5.0，15.6），尽管差异无统计学意义（4.7；2.2，10.0）。
我们首次估计了德国老年队列中 2 型糖尿病的发病率，并证明其发病率在欧洲处于较高水平。OGTT 似乎可用于识别 2 型糖尿病高危人群。我们的结果支持吸烟在糖尿病进展中的作用。
