不同诊断标准对上海市浦东新区40岁以上社区人群糖代谢类型分布的影响

目的比较不同诊断标准对社区自然人群糖代谢类型分布的影响。方法抽取2002年上海市浦东新区社区自然人群糖尿病调查数据库中40岁以上人群1716例,分别按照1999年世界卫生组织(WHO)和 2003年美国糖尿病学会(ADA)糖尿病诊断标准划分人群糖代谢类型。结果 40岁以上人群中,糖尿病患病率为 10．4％。与WHO标准相比,ADA标准所诊断的糖调节受损患病率升高8．9％(从21.3％至30．2％),而正常葡萄糖耐量下降8．9％(从68．3％至59．4％)。ADA标准新确定的空腹葡萄糖受损与正常葡萄糖耐量比较,其体重指数(40～49岁)和腰臀比(50～59岁)明显增加,而与WHO标准确定的空腹葡萄糖受损的差异无显著性。结论上海市浦东新区40岁以上社区自然人群糖代谢异常患病率较高,不同诊断标准对糖代谢类型比例有明显的影响,ADA新的诊断标准比WHO标准更有利于早期发现高危糖尿病人群。

Influence of different diagnostic criteria of diabetes on distribution and pattern of carbohydrate metabolism among in-habitants above 40 in Shanghai Pudong New District

Objective To appraise the influence of two different diagnostic criteria for diabetes, on the distribution and pattern of carbohydrate metabolism among the inhabitants in Pudong New District. Methods 1716 diabetic inhabitants over 40 years-of-age from the database established in 2002 Shanghai Pudong Diabetes Survey were analyzed. Glucose tolerance was categorized according to the 1999 WHO criteria and the 2003 ADA diagnotic criteria of diabetes respectively. Results The prevalence of diabetes was 10. 4% among the people over 40 year old. Comparing with the WHO criteria, ADA new criteria showed an increase in IGR and a decrease in NGT group significantly. Body mass index and waist-hip ratio were increased in newly diagnosed IFG group in comparison with NGT according to ADA criteria. Conclusions The prevalence of impaired carbohydrate metabolism in Shanghai Pudong New District is higher in inhabitants over 40 years of age. There is significant influence on the distribution and pattern of cabohydrate metabolism by using different diabetic diagnostic criteria. (Shanghai Med J, 2006, 29: 283-285)