Stolk R P, Pols H A, Lamberts S W, de Jong P T, Hofman A, Grobbee D E
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
Am J Epidemiol. 1997 Jan 1;145(1):24-32. doi: 10.1093/oxfordjournals.aje.a009028.
To estimate the prevalence of glucose intolerance in the elderly, oral glucose tolerance tests were performed as part of the Rotterdam Study, a population-based study in subjects aged 55 years and over. The study population consisted of 2,668 men and 3,950 women. Diabetes mellitus was defined as the use of antidiabetes medication, or a random or post-load serum glucose level of > or = 11.1 mmol/liter. Impaired glucose tolerance was defined as a post-load serum glucose between 7.8 and 11.1 mmol/liter. In men, the frequency of diabetes mellitus ranged from 5.9% in ages < 60 years to 19.8% in ages > 85 years, and in women from 3.8% in ages < 60 years to 18.9% in ages > 85 years; more than half of the subjects with diabetes were newly diagnosed. The prevalence of impaired glucose tolerance ranged from 8.8% and 11.0% in men and women aged < 60 years to 24.3% and 34.7% in men and women aged > 85 years. The prevalence of diabetes mellitus in the total Rotterdam Study population of 7,439 elderly men and women was estimated to be 11.3% (95% confidence interval (CI) 10.5-12.0). Waist/hip ratio, systolic blood pressure, hypertension, and number of cigarettes smoked increased with a worsening of the glucose tolerance from normal, hyperinsulinemia, impaired glucose tolerance to diabetes in both men and women (p < 0.01, adjusted for age). Body mass index was higher in subjects with glucose intolerance, but the frequency of obesity showed a relative decrease with worsening of glucose tolerance. These results show that glucose intolerance, especially impaired glucose tolerance and undetected diabetes mellitus, is common in the elderly. Moreover, not only subjects with diabetes mellitus but also subjects with hyperinsulinemia and impaired glucose tolerance have an increase of cardiovascular risk factors.
为评估老年人糖耐量异常的患病率，作为鹿特丹研究的一部分，对年龄在55岁及以上的人群进行了口服葡萄糖耐量试验，该研究是一项基于人群的研究。研究人群包括2668名男性和3950名女性。糖尿病定义为使用抗糖尿病药物，或随机或负荷后血清葡萄糖水平≥11.1毫摩尔/升。糖耐量受损定义为负荷后血清葡萄糖在7.8至11.1毫摩尔/升之间。在男性中，糖尿病的发生率从年龄<60岁者的5.9%到年龄>85岁者的19.8%不等；在女性中，从年龄<60岁者的3.8%到年龄>85岁者的18.9%不等；超过一半的糖尿病患者是新诊断出来的。糖耐量受损的患病率在年龄<60岁的男性和女性中分别为8.8%和11.0%，在年龄>85岁的男性和女性中分别为24.3%和34.7%。在鹿特丹研究的总共7439名老年男性和女性人群中，糖尿病的患病率估计为11.3%（95%置信区间(CI) 10.5 - 12.0）。男性和女性的腰臀比、收缩压、高血压及吸烟量均随着糖耐量从正常、高胰岛素血症、糖耐量受损到糖尿病的恶化而增加（p<0.01，经年龄校正）。糖耐量异常的受试者体重指数较高，但肥胖发生率随糖耐量恶化呈相对下降。这些结果表明，糖耐量异常，尤其是糖耐量受损和未被发现的糖尿病在老年人中很常见。此外，不仅糖尿病患者，而且高胰岛素血症和糖耐量受损的患者心血管危险因素也增加。
