Department of Endocrinology, Ningde Municipal Hospital, Fujian Medical University, Ningde, China.
Diabetes Technol Ther. 2012 May;14(5):430-9. doi: 10.1089/dia.2011.0244. Epub 2012 Feb 3.
According to recent reports, the development of type 2 diabetes in China has soared at an alarming rate. However, most of the investigations were based on Han people, who account for the majority of people in China. Little is known about the prevalence of diabetes its chronic complications in the She people, who have their own traditional lifestyle and hereditable background, different from other Asian population. The present study investigated the prevalence of type 2 diabetes and associated risk factors in the adult population of She nationals.
A total of 5,385 participants entered into the analysis eventually, including 2,308 men and 3,077 women. An oral glucose tolerance test was performed in subjects without diagnosed diabetes. Liver function, cardiovascular risk (brachial-ankle pulse wave velocity, estimated glomerular filtration rate, and abnormal Minnesota codes findings), uric acid, and neuropathy were tested to assess the profiles of associated risks.
In general, the self-reported diabetes rate was 9.5%. After age and sex standardization, the prevalence of diabetes was 6.1% (6.7% for men and 5.7% for women) in She Chinese people. In logistic regression models, age, family history of diabetes, alcohol use, total cholesterol, and triglycerides were all significantly associated with the risk of diabetes in this cross-sectional study (all P<0.05). In all, 47.4% had cardiovascular risks, 19.4% had liver dysfunction, and 6.2% had hyperuricemia. For women, compared with the first quartile, log-transformed homeostasis model assessment for insulin resistance of the fourth quartile was significantly higher (P<0.05), and log-transformed homeostasis model assessment for β cells was also higher in the second, third, and fourth quartiles (all P<0.05). The prevalences of polyneuropathy in impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG/IGT, and diabetes mellitus (DM) were 16.1%, 13.1%, 18.6%, and 28.4% separately, which was higher than that in normal glucose tolerance. The prevalences of polyneuropathy in IFG/IGT and DM were higher than that in IGT.
The present study revealed that a total of 6.1% She people suffered from type 2 diabetes, which was lower than the average level of China, but the standardized prevalence of prediabetes was higher, 20.6%. Early peripheral neuropathy screening should be performed in the prediabetes population. The Toronto Clinical Neuropathy Scoring System is convenient to assess diabetic polyneuropathy in clinical practice and should be tested regularly for people in prediabetes. Liver dysfunction, headache, and insomnia, appearing before type 2 diabetes, should be assessed regularly to avoid deterioration.
根据最近的报告,中国 2 型糖尿病的发病率呈惊人的上升趋势。然而,大多数研究都是基于汉族人,汉族人在中国占大多数。对于具有独特传统生活方式和遗传背景的畲族人的糖尿病患病率及其慢性并发症知之甚少,畲族人不同于其他亚洲人群。本研究旨在调查畲族成年人 2 型糖尿病的患病率及相关危险因素。
共有 5385 名参与者进入分析,包括 2308 名男性和 3077 名女性。所有无糖尿病诊断的受试者均进行口服葡萄糖耐量试验。检测肝功能、心血管风险(肱踝脉搏波速度、估算肾小球滤过率和异常明尼苏达州编码发现)、尿酸和神经病变,以评估相关风险的特征。
总的来说,自我报告的糖尿病患病率为 9.5%。在年龄和性别标准化后,畲族中国人的糖尿病患病率为 6.1%(男性为 6.7%,女性为 5.7%)。在逻辑回归模型中,年龄、糖尿病家族史、饮酒、总胆固醇和甘油三酯均与该横断面研究中的糖尿病风险显著相关(均 P<0.05)。共有 47.4%的人存在心血管风险,19.4%的人肝功能异常,6.2%的人尿酸升高。对于女性,与第一四分位相比,第四四分位的稳态模型评估胰岛素抵抗的自然对数值显著升高(P<0.05),第二、三、四分位的稳态模型评估β细胞的自然对数值也升高(均 P<0.05)。在空腹血糖受损(IFG)、葡萄糖耐量受损(IGT)、IFG/IGT 和糖尿病(DM)中,多发性神经病的患病率分别为 16.1%、13.1%、18.6%和 28.4%,均高于糖耐量正常者。IFG/IGT 和 DM 中的多发性神经病患病率高于 IGT。
本研究表明,畲族人群中共有 6.1%的人患有 2 型糖尿病,低于中国的平均水平,但糖尿病前期的标准化患病率较高,为 20.6%。在糖尿病前期人群中应进行早期周围神经病变筛查。多伦多临床神经病变评分系统方便在临床实践中评估糖尿病性多发性神经病,应定期对糖尿病前期人群进行检测。2 型糖尿病发生前出现的肝功能异常、头痛和失眠应定期评估,以避免病情恶化。