上海市闵行区江川社区老年糖尿病患病率调查

摘要

目的:了解上海老城区老年糖尿病的患病率.方法:采用分层整群随机抽样方法对闵行江川社区4 566例60岁以上的老年人进行调查,检测所有受试者血糖(空腹和餐后2 h)、体质量指数(BMI)、血压、血脂、尿微量白蛋白/尿肌酐,采用稳态模式(HOMA)评价胰岛素抵抗(HOMA-IR)和胰岛β细胞功能(HOMA-β).结果:按2008年上海市老年人口标准化,60岁以上老年人空腹葡萄糖受损(IFG)、糖耐量异常(IGT)、1型糖尿病(T1DM)和2型糖尿病(T2DM)标准化患病率分别为0.34%、10.31%、0.12%和25.50%.男性60岁以上老年人IFG、IGT、T1DM和T2DM标准化患病率分别为0.53%、10.74%、0.17%和25.49%.女性60岁以上老年人IFG、IGT、T1DM和T2DM标准化患病率分别为0.20%、10.05%、0.11%和25.42%.70岁以上老年人IFG、IGT、T1DM和T2DM标准化患病率分别为0.20%、11.36%、0.13%和28.63%.Logistic回归分析显示,年龄、HOMA-β、HOMA-IR和高血压病是老年糖尿病发生的独立危险因素(P<0.05).结论:上海市闵行江川社区老年人糖尿病患病率高于一般人群的患病率.老年糖尿病的发生与增龄、高血压、胰岛素抵抗和胰岛功能下降密切相关.%Objective:To investigate the prevalence of diabetes in the elderly in Shanghai Jiangchuan community. Methods:Multi-stage random cluster sampling was employed to recruit subjects who over 60 years age, living in the jiangchuan community of Minghang district in Shanghai. A total of 4 566 subjects were measured blood glucose(fasting and postprandial), body mass index(BMI), blood pressure, blood lipids, urine microalbumin/creatinine ratio. Homeostasis model assessment (HOMA) was applied to assess the status of insulin resistance and beta-cell function. Results: Based on the 2008 census data of Shanghai, the standardized prevalences of impaired fasting glycemia (IFG), impaired glucose tolerance(IGT), type 1 diabetes(T1DM) and type 2 diabetes(T2DM) over 60 years were 0.34％, 10. 31％, 0. 12％ and 25.50％, respectively. The standardized prevalence of IFG, IGT, T1DM and T2DM in male were 0. 53％, 10.74％, 0. 17％ and 25.49％, respectively. The standardized prevalence of IFG, IGT, T1DM and T2DM in female were 0. 20％, 10. 05％, 0. 11％ and 25.42％, respectively. The standardized prevalence of IFG, IGT, T1DM and T2DM who over 70 years age were 0.20％, 11.36％, 0. 13％ and 28.63％, respectively. Logistic regression analysis showed that age, HOMA-β, HOMA-IR and hypertension were the independent risk factor for diabetes in elderly (P＜0. 05). Conclusions: The prevalence of diabetes aged over 60 years in Minhang Jiangchuan community in Shanghai is higher than the general population prevalence. The occurrence of senile diabetes with age, hypertension, insulin resistance and decreased insulin secretion are closely related.