National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, China.
JAMA. 2021 Dec 28;326(24):2498-2506. doi: 10.1001/jama.2021.22208.
IMPORTANCE: Recent data on prevalence, awareness, treatment, and risk factors of diabetes in China is necessary for interventional efforts. OBJECTIVE: To estimate trends in prevalence, awareness, treatment, and risk factors of diabetes in China based on national data. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional nationally representative survey data collected in adults aged 18 years or older in mainland China from 170 287 participants in the 2013-2014 years and 173 642 participants in the 2018-2019 years. EXPOSURES: Fasting plasma glucose and hemoglobin A1c levels were measured for all participants. A 2-hour oral glucose tolerance test was conducted for all participants without diagnosed diabetes. MAIN OUTCOMES AND MEASURES: Primary outcomes were diabetes and prediabetes defined according to American Diabetes Association criteria. Secondary outcomes were awareness, treatment, and control of diabetes and prevalence of risk factors. A hemoglobin A1c level of less than 7.0% (53 mmol/mol) among treated patients with diabetes was considered adequate glycemic control. RESULTS: In 2013, the median age was 55.8 years (IQR, 46.4-65.2 years) and the weighted proportion of women was 50.0%; in 2018, the median age was 51.3 years (IQR, 42.1-61.6 years), and the weighted proportion of women was 49.5%. The estimated prevalence of diabetes increased from 10.9% (95% CI, 10.4%-11.5%) in 2013 to 12.4% (95% CI, 11.8%-13.0%) in 2018 (P < .001). The estimated prevalence of prediabetes was 35.7% (95% CI, 34.2%-37.3%) in 2013 and 38.1% (95% CI, 36.4%-39.7%) in 2018 (P = .07). In 2018, among adults with diabetes, 36.7% (95% CI, 34.7%-38.6%) reported being aware of their condition, and 32.9% (95% CI, 30.9%-34.8%) reported being treated; 50.1% (95% CI, 47.5%-52.6%) of patients receiving treatment were controlled adequately. These rates did not change significantly from 2013. From 2013 to 2018, low physical activity, high intake of red meat, overweight, and obesity significantly increased in prevalence. CONCLUSIONS AND RELEVANCE: In this survey study, the estimated diabetes prevalence was high and increased from 2013 to 2018. There was no significant improvement in the estimated prevalence of adequate treatment.
重要性：中国近期有关糖尿病患病率、知晓率、治疗率和危险因素的数据对于干预措施非常重要。
目的：基于全国数据估计中国糖尿病的患病率、知晓率、治疗率和危险因素的趋势。
设计、设置和参与者：横断面全国代表性调查数据来自中国大陆 2013-2014 年的 170287 名年龄在 18 岁及以上的成年人和 2018-2019 年的 173642 名成年人。
暴露因素：所有参与者均检测空腹血糖和糖化血红蛋白水平。所有无诊断糖尿病的参与者均进行 2 小时口服葡萄糖耐量试验。
主要结果和措施：主要结局为根据美国糖尿病协会标准定义的糖尿病和前期糖尿病。次要结局为糖尿病的知晓率、治疗率和控制率以及危险因素的患病率。治疗糖尿病患者的糖化血红蛋白水平＜7.0%（53mmol/mol）被认为血糖控制良好。
结果：2013 年，中位数年龄为 55.8 岁（IQR，46.4-65.2 岁），女性的加权比例为 50.0%；2018 年，中位数年龄为 51.3 岁（IQR，42.1-61.6 岁），女性的加权比例为 49.5%。糖尿病的估计患病率从 2013 年的 10.9%（95%CI，10.4%-11.5%）上升至 2018 年的 12.4%（95%CI，11.8%-13.0%）（P＜0.001）。2013 年前期糖尿病的估计患病率为 35.7%（95%CI，34.2%-37.3%），2018 年为 38.1%（95%CI，36.4%-39.7%）（P=0.07）。2018 年，糖尿病患者中，36.7%（95%CI，34.7%-38.6%）报告知晓自己的病情，32.9%（95%CI，30.9%-34.8%）报告接受治疗；接受治疗的患者中，50.1%（95%CI，47.5%-52.6%）血糖控制良好。这些比率从 2013 年开始没有明显变化。从 2013 年到 2018 年，低体力活动、高红肉摄入、超重和肥胖的患病率显著增加。
结论和相关性：在这项调查研究中，估计的糖尿病患病率较高，且从 2013 年到 2018 年呈上升趋势。估计的适当治疗率没有显著改善。
JAMA. 2021-12-28
JAMA. 2013-9-4
Ann Intern Med. 2014-4-15
J Clin Endocrinol Metab. 2020-4-1
Int J Environ Res Public Health. 2016-5-19
J Multidiscip Healthc. 2025-8-27
J Clin Transl Hepatol. 2025-8-28
Front Endocrinol (Lausanne). 2025-8-8
N Engl J Med. 2021-6-10
Lancet Diabetes Endocrinol. 2021-7
Diabetes Metab J. 2021-1
Diabetes Care. 2021-1
Nat Rev Endocrinol. 2020-11
Zotero 插件