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研究估算中国糖尿病人超1亿

  我国研究人员2013年9月3日在《美国医学会杂志》上报告说,中国已成为糖尿病人口大国,成人糖尿病患者数量估计超过1亿,可能已达“警戒级别”。专家认为,糖尿病人群不断增多,对中国社会与公共卫生构成挑战。

  上海交通大学医学院附属瑞金医院、上海市内分泌代谢病研究所与中国疾病预防控制中心组成的研究团队,基于中国慢性非传染性疾病监测系统,在2010年选取具代表性的近1万名18岁及以上成人进行调查,并对参与者进行了血糖等测试。

  在依据调查结果进行推算后,中国成人糖尿病患病率已上升至11.6%,其中男性糖尿病患病率为12.1%,女性患病率为11%。城市居民与农村居民患病率均在上升,分别为14.3%与10.3%。此外,中国约70%的糖尿病患者不知道自己已患此病。

以糖化血红蛋白(HbA1c)小于7.0%作为血糖获得控制的标准,中国接受治疗的成人糖尿病患者中,血糖控制率不到40%。

  中国人对糖尿病的认识亟待进一步提高,特别是在糖尿病患病率不断增长的情况下,糖尿病的知晓率与控制率更需大幅提高。研究人员认为,从中国总人口角度看,其糖尿病总体规模可能已达“警戒级别”。

  论文指出:“如果没有一个覆盖全国的有效干预措施,中国可能在不久的将来会大量出现与糖尿病相关的并发症,这些并发症包括心血管疾病、中风及慢性肾病。”

Prevalence and Control of Diabetes in Chinese Adults

Yu Xu,Limin Wang,Jiang He,et al. JAMA. 2013;310(9):948-959.

ABSTRACT

Importance Noncommunicable chronic diseases have become the leading causes of mortality and disease burden worldwide.

Objective To investigate the prevalence of diabetes and glycemic control in the Chinese adult population.

Design, Setting, and Participants Using a complex, multistage, probability sampling design, we conducted a cross-sectional survey in a nationally representative sample of 98?658 Chinese adults in 2010.

Main Outcomes and Measures Plasma glucose and hemoglobin A1c levels were measured after at least a 10-hour overnight fast among all study participants, and a 2-hour oral glucose tolerance test was conducted among participants without a self-reported history of diagnosed diabetes. Diabetes and prediabetes were defined according to the 2010 American Diabetes Association criteria; whereas, a hemoglobin A1c level of <7.0% was considered adequate glycemic control.

Results The overall prevalence of diabetes was estimated to be 11.6% (95% CI, 11.3%-11.8%) in the Chinese adult population. The prevalence among men was 12.1% (95% CI, 11.7%-12.5%) and among women was 11.0% (95% CI, 10.7%-11.4%). The prevalence of previously diagnosed diabetes was estimated to be 3.5% (95% CI, 3.4%-3.6%) in the Chinese population: 3.6% (95% CI, 3.4%-3.8%) in men and 3.4% (95% CI, 3.2%-3.5%) in women. The prevalence of undiagnosed diabetes was 8.1% (95% CI, 7.9%-8.3%) in the Chinese population: 8.5% (95% CI, 8.2%-8.8%) in men and 7.7% (95% CI, 7.4%-8.0%) in women. In addition, the prevalence of prediabetes was estimated to be 50.1% (95% CI, 49.7%-50.6%) in Chinese adults: 52.1% (95% CI, 51.5%-52.7%) in men and 48.1% (95% CI, 47.6%-48.7%) in women. The prevalence of diabetes was higher in older age groups, in urban residents, and in persons living in economically developed regions. Among patients with diabetes, only 25.8% (95% CI, 24.9%-26.8%) received treatment for diabetes, and only 39.7% (95% CI, 37.6%-41.8%) of those treated had adequate glycemic control.

Conclusions and Relevance The estimated prevalence of diabetes among a representative sample of Chinese adults was 11.6% and the prevalence of prediabetes was 50.1%. Projections based on sample weighting suggest this may represent up to 113.9 million Chinese adults with diabetes and 493.4 million with prediabetes. These findings indicate the importance of diabetes as a public health problem in China.
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