The Epidemiologic Study Of Impaired Glucose Metabolism In The Elderly During 1996~2000

The Epidemiologic Study of Impaired Glucose Metabolism in the Elderly During 1996--2000 AbstractObjective The aim was to evaluate the sensitivity and specificity of WHO criteria and ADA criteria of DM when they are applied to elderly people, and to assess the use of fasting plasma glucose(FPG) alone for the screening of DM as defined by a 2-hour plasma glucose (PG-2h) 11. lmmol/L following a 75-g oral glucose tolerance test (OGTT). To determine the prevalence and incidence of type 2 diabetes mellitus (DM) and investigate the epidemiological characteristics as well as associated risk factors in the elderly people. To evaluate the influence of impaired glucose metabolism on the prevalence and incidence of coronary heart disease (CHD) and analyze its associated risk factors .To estimate the all-cause and cardiovascular disease mortality and analyze influence of impaired glucose metabolism on all-cause and cardiovascular mortality in the elderly.Method A survey was conducted among in old subjects aged 60 to 90 who had health examination in PLA general hospital once per year from 1996 to 2000. They were interviewed according to a structured questionnaire by physicians and trained assistants in department of endocrinology. Fasting plasma glucose(FPG) ,and postchallenge (steam-bread contained 80 g carbohydrate) plasma glucose(PPG) were measured. The subjects whose PPG were more than 7.2 nimol/L received a standard 75-g OGTT with 10-h overnight fasting. DM and IGT were diagnosed according to criteria of WHO in 1985. The prevalence of type 2 DM between the 1985 WHO criteria and the revised new ADA diagnostic criteria was compared. The risk factors of incidence in DM and IGT were analyzed with multiple logistic regression. The incidence of CHD and mortality at the end of four observed years were calculated by person-year method. The risk factors of it were analyzed with multiple logistic regression. The cumulative survival rates of different groups were calculated by Kaplan-Meier method and Cox's proportional hazard model.Results1.The prevalence of DM was 3.16% and 16.28% by FPG criteria (ADA) and PG-2h criteria(WHO) respectively. The sensitivity of diagnosed DM was 15.3% and specificity was 99.2% according to ADA criteria. The coincidence percentage under the two criteria was only 15.3% . The coincidence percentage under IFG and IGT was only 4.5% . The optimal FPG cut-point of diagnosed DM was 5.5 mmol/L in the elderly by using PG-2h 11.1 mmol/L criteria. The FPG corresponding to PG2h7.8mmolIL was 5.OrnmoJlL.2.There were 2239 subjects with the mean age of 70 year old into this study, there average follow-up duration was 3.7 years. The adjusted prevalence of DM increased from 15.8% in 1996 to 23.9% in 2000 and it increased significantly with age (P