Yang Chen, Li Shaohua, Wu Liangyan, Ding Zan, Zhou Hua, Pan Ying, Yang Chufu, Lin Jinjun, Li Qiang, You Yingbin, Zhong Xu, Chen Yuyuan, Zhao Yu
Department of Endocrinology, Baoan Central Hospital of Shenzhen, The 5th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, China.
Department of Endocrinology and Metabolism, Zhuhai People's Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai, Guangdong, China.
Front Endocrinol (Lausanne). 2024 Jan 19;15:1301921. doi: 10.3389/fendo.2024.1301921. eCollection 2024.
Prediabetes is associated with an increased risk of cardiovascular diseases and all-cause mortality. Rare research in China has evaluated the prevalence of prediabetes among children and adolescents using the HbA1c criterion or the combined FPG-or-HbA1c diagnostic criterion, and researchers paid no attention to the distributions of blood glucose in Shenzhen, especially for juveniles.
We conducted a school-based cross-sectional study based on the first-year students from 17 primary, middle, and high schools. Prediabetes was defined as FPG of 5.6-6.9 mmol/L or HbA1c of 5.7%-6.4%. The crude and standardized prevalence of prediabetes with 95% confidence interval (95% CI) was estimated.
A total of 7519 participants, aged 6 to 17 years, were included. For all subjects, the crude prevalence (95% CI) of prediabetes was 1.49% (1.21-1.77), 8.72% (8.08-9.36), and 9.80% (9.13-10.47) by the FPG-only, HbA1c-only, and FPG-or-HbA1c criteria, respectively. Based on the 2010 Shenzhen census population, the standardized prevalence was 1.56% (males 1.85%, females 1.19%), 11.05% (males 11.47%, females 10.53%), and 12.19% (males 13.01%, females 11.15%) by the corresponding criteria. The proportion of prediabetes was higher for males than females, and the prevalence decreased with grade for males but increased for females. The association of BMI and prediabetes was U-shaped curve, indicating higher rates of prediabetes for underweight and obesity people.
The blood glucose status of children and adolescents in Shenzhen is worrisome, and the early detection and management of prediabetes are imperative.
糖尿病前期与心血管疾病风险增加及全因死亡率相关。在中国，罕有研究使用糖化血红蛋白（HbA1c）标准或空腹血糖（FPG）与HbA1c联合诊断标准评估儿童及青少年糖尿病前期的患病率，且研究者未关注深圳人群的血糖分布情况，尤其是青少年。
我们以17所小学、初中和高中的一年级学生为基础开展了一项基于学校的横断面研究。糖尿病前期定义为空腹血糖5.6 - 6.9 mmol/L或糖化血红蛋白5.7% - 6.4%。估计了糖尿病前期的粗患病率和标准化患病率及其95%置信区间（95%CI）。
共纳入7519名年龄在6至17岁的参与者。对于所有受试者，仅依据空腹血糖标准、仅依据糖化血红蛋白标准以及空腹血糖或糖化血红蛋白标准诊断的糖尿病前期粗患病率（95%CI）分别为1.49%（1.21 - 1.77）、8.72%（8.08 - 9.36）和9.80%（9.13 - 10.47）。基于2010年深圳人口普查数据，相应标准下的标准化患病率分别为1.56%（男性1.85%，女性1.19%）、11.05%（男性11.47%，女性10.53%）和12.19%（男性13.01%，女性11.15%）。糖尿病前期男性比例高于女性，男性患病率随年级升高而降低，女性则升高。体重指数（BMI）与糖尿病前期呈U型曲线关系，表明体重过轻和肥胖人群患糖尿病前期的比例更高。
深圳儿童及青少年的血糖状况令人担忧，糖尿病前期的早期检测与管理势在必行。
