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人口老龄化对糖尿病患病率趋势的影响:对16万日本成年人的荟萃回归分析

Impact of population aging on trends in diabetes prevalence: A meta-regression analysis of 160,000 Japanese adults.

作者信息

Charvat Hadrien, Goto Atsushi, Goto Maki, Inoue Machiko, Heianza Yoriko, Arase Yasuji, Sone Hirohito, Nakagami Tomoko, Song Xin, Qiao Qing, Tuomilehto Jaakko, Tsugane Shoichiro, Noda Mitsuhiko, Inoue Manami

机构信息

Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center Tokyo, Japan.

Department of Diabetes Research, National Center for Global Health and Medicine Tokyo, Japan.

出版信息

J Diabetes Investig. 2015 Sep;6(5):533-42. doi: 10.1111/jdi.12333. Epub 2015 Mar 2.

Abstract

AIMS/INTRODUCTION: To provide age- and sex-specific trends, age-standardized trends, and projections of diabetes prevalence through the year 2030 in the Japanese adult population.

MATERIALS AND METHODS

In the present meta-regression analysis, we included 161,087 adults from six studies and nine national health surveys carried out between 1988 and 2011 in Japan. We assessed the prevalence of diabetes using a recorded history of diabetes or, for the population of individuals without known diabetes, either a glycated hemoglobin level of ≥6.5% (48 mmol/mol) or the 1999 World Health Organization criteria (i.e., a fasting plasma glucose level of ≥126 mg/dL and/or 2-h glucose level of ≥200 mg/dL in the 75-g oral glucose tolerance test).

RESULTS

For both sexes, prevalence appeared to remain unchanged over the years in all age categories except for men aged 70 years or older, in whom a significant increase in prevalence with time was observed. Age-standardized diabetes prevalence estimates based on the Japanese population of the corresponding year showed marked increasing trends: diabetes prevalence was 6.1% among women (95% confidence interval [CI] 5.5-6.7), 9.9% (95% CI 9.2-10.6) among men, and 7.9% (95% CI 7.5-8.4) among the total population in 2010, and was expected to rise by 2030 to 6.7% (95% CI 5.2-9.2), 13.1% (95% CI 10.9-16.7) and 9.8% (95% CI 8.5-12.0), respectively. In contrast, the age-standardized diabetes prevalence using a fixed population appeared to remain unchanged.

CONCLUSIONS

This large-scale meta-regression analysis shows that a substantial increase in diabetes prevalence is expected in Japan during the next few decades, mainly as a result of the aging of the adult population.

摘要

目的/引言:提供日本成年人群中按年龄和性别划分的糖尿病患病率趋势、年龄标准化趋势以及到2030年的患病率预测。

材料与方法

在本次荟萃回归分析中,我们纳入了来自1988年至2011年在日本开展的六项研究和九次全国健康调查的161,087名成年人。我们使用糖尿病记录病史评估糖尿病患病率,对于无已知糖尿病的个体人群,则使用糖化血红蛋白水平≥6.5%(48 mmol/mol)或1999年世界卫生组织标准(即75克口服葡萄糖耐量试验中空腹血糖水平≥126 mg/dL和/或2小时血糖水平≥200 mg/dL)进行评估。

结果

对于男女两性,除70岁及以上男性外,所有年龄组的患病率多年来似乎保持不变,70岁及以上男性的患病率随时间显著增加。基于相应年份日本人群的年龄标准化糖尿病患病率估计显示出明显的上升趋势:2010年女性糖尿病患病率为6.1%(95%置信区间[CI] 5.5 - 6.7),男性为9.9%(95% CI 9.2 - 10.6),总人口为7.9%(95% CI 7.5 - 8.4),预计到2030年将分别升至6.7%(95% CI 5.2 - 9.2)、13.1%(95% CI 10.9 - 16.7)和9.8%(95% CI 8.5 - 12.0)。相比之下,使用固定人群的年龄标准化糖尿病患病率似乎保持不变。

结论

这项大规模荟萃回归分析表明,在未来几十年中,日本糖尿病患病率预计将大幅上升,主要是由于成年人口老龄化。

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