【摘要】： 目的:研究大連獐子島地區(qū)2型糖尿病及糖調(diào)節(jié)受損的患病情況及危險(xiǎn)因素,為制定適宜的干預(yù)措施提供依據(jù)。 方法:采用整群隨機(jī)抽樣的方法抽取大連獐子島18歲以上的常住居民907人,采取自制的問(wèn)卷進(jìn)行一般狀況,生活方式及行為、疾病史的調(diào)查,同時(shí)進(jìn)行體格檢查和相關(guān)的生化指標(biāo)檢測(cè)。所有人進(jìn)行口服75g葡萄糖耐量(OGTT)試驗(yàn),測(cè)空腹血糖(FPG)、OGTT2小時(shí)血糖(2hPG)、空腹胰島素(FINS)、血清總膽固醇(TC)、甘油三脂(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、血尿酸(UA)。計(jì)算胰島素抵抗指數(shù)(IRI),HOMA穩(wěn)態(tài)模型β細(xì)胞功能指數(shù)(HOMA-β)及胰島素敏感性指數(shù)(ISI)。分析研究對(duì)象的流行病學(xué)特征,研究對(duì)象主要分為正常糖耐量(NGT)、糖調(diào)節(jié)受損(IGR)、糖尿病(DM),比較各組間的臨床特征,并分析影響糖調(diào)節(jié)受損和糖尿病的危險(xiǎn)因素。應(yīng)用SPSS11.5軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果:1.大連獐子島地區(qū)2型糖尿病及糖調(diào)節(jié)受損的患病率分別為11.4%、37.4%,其中男性分別為10.4%及36.4%,女性分別為12.2%及38.3%,(χ2=0.87,P 0.05 vsχ2=0.24,P 0.05)。而糖尿病患病的知曉率僅為29.13%。2型糖尿病和糖調(diào)節(jié)受損的患病率均隨年齡的增長(zhǎng)而增加(P 0.01)。2.DM、IGR與NGT比較,從NGT到IGR再到DM的發(fā)展過(guò)程中,TC、LDL、BMI、腰圍、收縮壓、舒張壓、IRI、HOMA-β、ISI、FPG及FINS幾種相關(guān)臨床指標(biāo)的數(shù)值顯著性升高,三組間差距有統(tǒng)計(jì)學(xué)意義。TG在最終發(fā)展為糖尿病時(shí)也產(chǎn)生了顯著性差異,但HDL和UA無(wú)差異性。同時(shí)胰島素敏感性不斷下降,IR不斷加重,胰島素β細(xì)胞功能衰退,發(fā)展到糖尿病階段更為嚴(yán)重。而血糖濃度在一定范圍內(nèi)時(shí),血漿胰島素水平是隨血糖濃度升高而增高的。3.多因素非條件Logistic回歸分析結(jié)果顯示:年齡、文化程度、飲酒和高TC血癥與糖調(diào)節(jié)受損的發(fā)生有關(guān);而年齡、文化程度、高TG血癥、高TC血癥、BMI和高血壓可增加2型糖尿病的危險(xiǎn)性。 結(jié)論:大連獐子島地區(qū)2型糖尿病和糖調(diào)節(jié)受損的患病率較高,而糖尿病的知曉率低,疾病的發(fā)生與多種因素有關(guān),應(yīng)采取綜合性措施進(jìn)行防治,以降低患病率。
[Abstract]:Objective: to study the prevalence and risk factors of type 2 diabetes mellitus and impaired glucose regulation in Swertia Island, Dalian. Methods: 907 residents over 18 years old in Swertia Island, Dalian were selected by cluster random sampling, and self-made questionnaire was used to investigate the general condition, life style, behavior and disease history. At the same time, physical examination and related biochemical indicators were performed. 75 g glucose tolerance (OGTT) test was performed on all subjects. Fasting blood glucose (FPG), OGT T 2 hour glucose (2hPG), fasting insulin (FINS), total cholesterol, (TC), low density lipoprotein (TG), high density lipoprotein (LDL), high density lipoprotein (HDL),) were measured. Calculation of insulin resistance index (IRI) and homeostasis model 尾 cell function index (HOMA- 尾) and insulin sensitivity index (ISI).) The epidemiological characteristics of the subjects were analyzed. The subjects were divided into normal glucose tolerance (NGT), impaired glucose regulation (IGR),) and diabetes mellitus (IGR),). The clinical characteristics of each group were compared, and the risk factors affecting impaired glucose regulation and diabetes mellitus were analyzed. SPSS11.5 software was used for statistical analysis. The result is 1: 1. The prevalence rates of type 2 diabetes mellitus and impaired glucose regulation in Swertia davidii area were 11.4m 37.4%, 10.4% and 36.4% in males and 12.2% and 38.3% in females, respectively (蠂 ~ 2 0.87 P 0.05 vs 蠂 ~ (0.24) P 0.05). However, the awareness rate of diabetes mellitus was 29.13.2% and the prevalence of impaired glucose regulation increased with age (P0.01) .2.DMIGR was compared with NGT. During the development from NGT to IGR to DM, TCC LDLBMI, waist circumference, systolic blood pressure (SBP). The clinical values of FINS and FPG were significantly increased, and the difference between the three groups was statistically significant. TG also had significant difference in the development of diabetes mellitus, but there was no difference between HDL and UA. At the same time, the insulin sensitivity decreased and IR increased, the function of insulin 尾-cells declined, and it became more serious in the stage of diabetes. When blood glucose concentration is in a certain range, plasma insulin level is increased with the increase of blood glucose concentration. Multivariate conditional Logistic regression analysis showed that age, education, alcohol consumption and hyperglycemia were associated with impaired glucose regulation, while age, education, and hyperglycemia were associated with hyperglycemia. High TC and hypertension may increase the risk of type 2 diabetes. Conclusion: the prevalence of type 2 diabetes mellitus and impaired glucose regulation in Swertia davidiana area is higher, but the awareness rate of diabetes mellitus is low, the occurrence of disease is related to many factors, comprehensive measures should be taken to prevent and cure the disease in order to reduce the prevalence rate.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2009
【分類號(hào)】：R587.1;R181.3

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