Institute for Nutritional Sciences, Shanghai Institute for Biological Sciences, Chinese Academy of Sciences, Shanghai, China.
BMC Public Health. 2010 Nov 9;10:683. doi: 10.1186/1471-2458-10-683.
Type 2 diabetes is becoming an epidemic in China. To evaluate the prevalence, clustering of metabolic risk factors and their impact on type 2 diabetes, we conducted a population-based study in Shanghai, China's largest metropolitan area.
From 2006 to 2007, 2,113 type 2 diabetes cases and 2,458 comparable controls of adults aged 40 to 79 years were enrolled. Demographic, lifestyle, and dietary factors were assessed via standardized questionnaires. Plasma, red and white blood cells were collected and stored for future studies. Anthropometric indices and biochemical intermediates (including blood pressure, fasting glucose, glycosylated hemoglobin, and blood lipids) were measured. The prevalence of metabolic syndrome were also compared following two criteria recommended by the Chinese Diabetes Society (CDS, 2004) and the National Cholesterol Education Program's Adult Treatment Panel III (ATP III, 2002).
Prevalence of metabolic syndrome (62% vs. 15% using CDS criteria) and its individual components, including obesity (51% vs. 42%), hypertension (54% vs. 41%), hypertriglyceridemia (42% vs. 32%), and low high-density lipoprotein-cholesterol (HDL) levels (36% vs. 25%) were higher in diabetes cases than controls. Regardless of criteria used, those with impaired fasting glucose (IFG) had similarly high prevalence of metabolic syndrome as did diabetes cases. In a multiple logistic regression model adjusted for demographics and lifestyle risk factors, the odds ratios of diabetes (95% CI) were 1.23 (1.04-1.45) for overweight (28 >= BMI >= 24), 1.81 (1.45-2.25) for obesity (BMI > 28), 1.53 (1.30-1.80) for central obesity (waist circumference > 80 cm for woman or waist circumference > 85 cm for man), 1.36 (1.17-1.59) for hypertension (sbp/dbp >= 140/90 mmHg), 1.55 (1.32-1.82) for high triglycerides (triglycerides > 1.70 mmol/l) and 1.52 (1.23-1.79) for low HDL-C (HDL-C < 1.04 mmol/L).
These data indicate that multiple metabolic risk factors--individually or jointly--were more prevalent in diabetes patients than in controls. Further research will examine hypotheses concerning the high prevalence of IFG, family history, and central obesity, aiding development of multifaceted preventive strategies specific to this population.
2 型糖尿病在中国正呈流行趋势。为评估代谢危险因素的流行情况、聚集性及其对 2 型糖尿病的影响，我们在中国最大的都市区上海进行了一项基于人群的研究。
2006 年至 2007 年间，我们招募了年龄在 40 至 79 岁的 2113 例 2 型糖尿病患者和 2458 例可比对照者。通过标准化问卷评估人口统计学、生活方式和饮食因素。采集并储存血浆、红细胞和白细胞，用于未来的研究。测量人体测量指数和生化中间产物（包括血压、空腹血糖、糖化血红蛋白和血脂）。还根据中国糖尿病学会（CDS，2004 年）和美国国家胆固醇教育计划成人治疗专家组 III（ATP III，2002 年）推荐的两项标准比较代谢综合征的患病率。
与对照组相比，糖尿病患者的代谢综合征（分别使用 CDS 和 ATP III 标准时为 62%和 15%）及其个体成分，包括肥胖（51%和 42%）、高血压（54%和 41%）、高三酰甘油血症（42%和 32%）和低高密度脂蛋白胆固醇（HDL）水平（36%和 25%）更为常见。无论采用何种标准，空腹血糖受损（IFG）患者的代谢综合征患病率与糖尿病患者相似。在调整人口统计学和生活方式危险因素的多因素逻辑回归模型中，超重（28 >= BMI >= 24）、肥胖（BMI > 28）、中心性肥胖（腰围> 80 cm 女性或腰围> 85 cm 男性）、高血压（sbp/dbp >= 140/90 mmHg）、高三酰甘油血症（三酰甘油> 1.70 mmol/L）和低 HDL-C（HDL-C < 1.04 mmol/L）的糖尿病的比值比（95%可信区间）分别为 1.23（1.04-1.45）、1.81（1.45-2.25）、1.53（1.30-1.80）、1.36（1.17-1.59）、1.55（1.32-1.82）和 1.52（1.23-1.79）。
这些数据表明，与对照组相比，糖尿病患者存在多种代谢危险因素，这些危险因素单独或联合存在的情况更为常见。进一步的研究将检验 IFG 高患病率、家族史和中心性肥胖的假设，这有助于针对该人群制定多方面的预防策略。
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