Quoc P S, Charles M A, Cuong N H, Lieu L H, Tuan N A, Thomas M, Balkau B, Simon D
Endocrinology Department, Bach Mai Hospital, Hanoi, Vietnam.
Am J Epidemiol. 1994 Apr 1;139(7):713-22. doi: 10.1093/oxfordjournals.aje.a117061.
Few epidemiologic surveys have been performed to assess the prevalence of diabetes in representative samples, and few data are available on the epidemiologic features of diabetes in Southeast Asia. We report the results of a 1990 study performed in the Hanoi area (Vietnam) on 4,912 subjects (95.0% of the eligible population), aged 15 years or over, selected by a stratified random cluster procedure using the 1989 census list. A two-step design was used: 1) screening for diabetes by measuring capillary blood glucose (CBG) before dinner with a Glucometer II device; and 2) for subjects with a CBG measurement of > or = 105 mg/dl, a diagnostic test on the following morning, using a 75-g oral glucose tolerance test and World Health Organization criteria (93.9% of the positive screenees took this test). CBG values before dinner were unimodally distributed and skewed to the right, increasing with age in both sexes. Women had a significantly higher level of age-adjusted CBG than did men before dinner (p < 0.0001) as well as when fasting (p < 0.0001) and 2 hours after the oral glucose tolerance test (p = 0.013). The prevalence of diabetes was 1.2% (95% confidence interval (CI) 0.9-1.5) and of impaired glucose tolerance, 1.6% (95% CI 1.3-2.0). Women had a significantly higher age-adjusted prevalence of diabetes than did men (relative risk = 2.3; 95% CI 1.3-4.1). Of the 63 diabetic subjects, nine (14.3%) had been diagnosed before the study, only one was obviously insulin dependent, and only one was obese with a body mass index of > or = 27 kg/m2. The subjects living in the urban areas had higher levels of fasting and 2-hour CBG and a higher diabetes prevalence than did the rural inhabitants (relative risk = 1.3; 95% CI 1.04-3.23). Diabetes appears to be a rare disease in the Hanoi area (1.4% for subjects aged 30-64 years, after age standardization using the Segi distribution), affecting women two times as often as men. Typical insulin-dependent (type I) or obese non-insulin-dependent (type II) diabetes mellitus patients are uncommon.
很少有流行病学调查针对具有代表性的样本评估糖尿病患病率，关于东南亚地区糖尿病流行病学特征的数据也很少。我们报告了1990年在河内地区（越南）针对4912名15岁及以上受试者开展的一项研究结果，这些受试者（占符合条件人群的95.0%）是通过使用1989年人口普查名单的分层随机整群抽样程序选取的。采用了两步设计：1）使用血糖仪II设备测量晚餐前毛细血管血糖（CBG）以筛查糖尿病；2）对于CBG测量值≥105mg/dl的受试者，在次日早晨采用75g口服葡萄糖耐量试验及世界卫生组织标准进行诊断性检测（93.9%的筛查阳性者接受了此项检测）。晚餐前CBG值呈单峰分布且向右偏态，在两性中均随年龄增加。晚餐前女性经年龄调整后的CBG水平显著高于男性（p<0.0001），空腹时（p<0.0001）以及口服葡萄糖耐量试验后2小时（p=0.013）也是如此。糖尿病患病率为1.2%（95%置信区间（CI）0.9 - 1.5），糖耐量受损患病率为1.6%（95%CI 1.3 - 2.0）。女性经年龄调整后的糖尿病患病率显著高于男性（相对风险 = 2.3；95%CI 1.3 - 4.1）。在63名糖尿病受试者中，9名（14.3%）在研究前已被诊断，只有1名明显为胰岛素依赖型，且只有1名肥胖，体重指数≥27kg/m²。与农村居民相比，城市地区的受试者空腹及2小时CBG水平更高，糖尿病患病率也更高（相对风险 = 1.3；95%CI 1.04 - 3.23）。在河内地区，糖尿病似乎是一种罕见疾病（采用世标分布进行年龄标准化后，30 - 64岁受试者中患病率为1.4%），女性受影响的频率是男性的两倍。典型的胰岛素依赖型（I型）或肥胖非胰岛素依赖型（II型）糖尿病患者并不常见。
