| Background:Coronary heart disease (CHD) is the term for atherosclerosis or(and)Vasospasm affecting the coronary arteries, which leads to Vascular lumen stenosis or obstruction, furthermore, leads to myocardial ischemia and hypoxia or necrosis.It's a The most common type of Organ diseases induced by atherosclerosis.It's one of the major causes of death in the word, called the number one killer of human health.The specific pathogenesis of coronary heart disease has not yet fully understand.At present,It's considerd that multiple risk factors result in it, including: hypertension, diabetes mellitus (DM), smoking, hyperlipidemia, genetic factors, old age, obesity, reduction of physical activity and so on in recent years, many epidemiological research suggests that some new risk factors is closely related to the occurrence and development of coronary heart disease, such as hyperhomocysteinemia,hyperbilirubinemia,hyperfibrinogenemia,hyperuricemia and Some inflammation-related factors.Meanwhile.Diabetes is an independent risk factor for cardiovascular disease has become a consensus.Cardiovascular disease morbidity and mortality caused by Diabetes is 2-4 times higher among non-DM.70%of DM patients die of cardiovascular disease. American Heart Association (AHA) declared that "Diabetes is a cardiovascular disease" in 1999. it is officially classified as risk factors of coronary heart disease, on a par with hypertension, hyperlipidemia, smoking, family history of premature coronary heart disease. In 2001,the National Cholesterol Education Program (NCEP) Adult Treatment Panel Third Report (ATPⅢ) is explicitly proclaim that Diabetic patients without coronary heart disease is a equivalent diseases of coronary heart disease. Refers to the non-diabetic patients with coronary heart disease and non-diabetic Patients with history of coronary heart disease have the same risk of coronary heart disease, that is patients with diabetes and coronary heart disease Patients have the same risk of a new cardiovascular events (such as myocardial infarction or death resulted of coronary heart disease).In 1997,American Diabetes Association (ADA) introduce the concept of impaired glucose regulation (Impaired glucose regulation, IGR), also called pre-diabetes (pre-diabetes). Is a transition phase between normal glycemia and diabetes.It's a transition phase between normal glycemia and diabetes, including: Isolated impaired fasting glucose (I-IFG), Isolated impaired glucose tolerance (I-IGT), and IGT coexisted with IFG. Many studies have shown that the incidence of diabetes of IGR group was significantly higher than which of normal blood glucose group in 5-10 years.And diabetes is the equivalents risk disease of coronary heart disease, which means pre-diabetes is also an independent risk factors of coronary heart disease? Tominaga and Hanefeld believed that, IGT is a risk factor for death leaded by coronary heart disease. By stdudying 185 IGT patients suffering from cardiovascular disease, Some internal scholars believed that there is a strong correlation with IGT and cardiovascular disease. However,there are Differences in whether the IFG is a risk factor of CHD. The United States Cholesterol Control Guide points out IFG is a risk factor for cardiovascular disease. In the study of the predictive value of cardiovascular disease in Middle-aged population surfing from DM and IFG in China, Zhou Bei-fan[8] pointed out that the relative risk for coronary heart disease of IFG somewhat higher than which of normal blood glucose,but it's not statistically significant. In studying of the relationship between IFG and coronary artery disease,Zhai Ying-jiu[7] etc. considered that in the stage of IFG, occurrence of CHD is significantly higher than which of normal glycemia. So the relationship between pre-diabetes and the risk of coronary heart disease needs further study.As people's living standards improving, the population aging, lifestyle changing, the diabetes incidence is increasing year by year. According to latest information released by IDF[9], global prevalence of diabetes among 20-79 year-old rate was 6.0% (5.9%), diabetic patients arrive at up to 246 million, IGT prevalence rate of about 7.5%, IGT number reached 308 million. Estimated prevalence of diabetes in 2025 was about 7.3% to reach 800 million diabetic patients, IGT prevalence was 8.0%, the total number of 418 million. In China the prevalence of diabetes is increasing year by year. In 1980,the national survey showed that prevalence of diabetes is 0.67%.In 1996, nationwide survey in 11 provinces and cities among cmore than 40,000 adults showed that that prevalence of diabetes is 3.62%[10]. In 2002,a survey in some cities showed that the rate of diabetes patients around 5%. International Diabetes Forum in 2009 published the data even up to 9.7%. A survey in Guangdong among 11,742 population over 20 years old found that[11] the prevalence of diabetes was 3.5%, the prevalence of IGT was 5.9%; in Guangzhou, diabetes rate was 6.4%, the prevalence of IGT was 11.7%;In 2004, in the survey of local resident in Guangzhou,PAN Bing-ying etc. [12]pointed out that the prevalence of diabetes patients in Guangzhou residents aged over 20 was 7.4%(standardized rate 5.5%). Urban of DM prevalence was 8.%, And and which of rural was 5.4%.The difference was statistical significance(P<0.05).2005, a survey invested by ZHU Kai-sing, LUAN Yu-ming, etc.[13]among 8403 population over the age of 18 in Haizhu District, showed that, the diabetes prevalence in Haizhu District was 9.0%, standardized prevalence rate was 5.5%.2007, a survey invested by LIN-Shuo, etc. [14]among population over the age of 55 in in Shipai community of Panyu District of Guangzhou City, showed that, the diabetes prevalence in Shipai community of Guangzhou City was 12.8%, standardized prevalence rate was 11.6%. prevalence of male was 10%(standardized prevalence rate 9%), which of female was 13.9%(standardized prevalence rate 14.1%)。Shipai community is a typical "urban village" in Guangzhou。There is quite difference between Shipai community and Haizhu District in economic level, population structure, way of life etc. It's necessary to have a survey among the quinquagenarian in this district, which can provide the basis of primary and secondary prevention for cardiovascular disease in this distric or evenPearl River Delta.Health risk appraisal (HRA) is a method to study relationship between the risk factors and development of disease. Assessment of individual risk factors of cardiovascular disease is evaluated by quantitative analysis to comprehensive assesse future cardiovascular events in individuals especially of which caused by the absolute risk of coronary heart disease. It's facilitate to intervene patients at different risk levels with corresponding measure,which is meaningful to the primary prevention of disease[15]. Currently, The Framingham coronary heart disease prediction model and PROCAM scores are both used widely.Framingham coronary heart disease prediction model which as a practical assessment tool widely used not only in the United States and other countries were introduced in different national context of the prediction of cardiovascular diseases, and achieved a series of results. In this study, we use the Framingham coronary heart disease prediction model to predict the risk of coronary heart disease in the quinquagenarian in Haizhu district.Purpose To understand prevalence of diabetes and prediabetes in Haizhu District of Guangzhou city.To understand rate of hyperlipidemia, obesity and central obesity rates, smoking rates in different blood glucose levels of quinquagenarian in Haizhu District of Guangzhou City to explore combined situation of coronary heart disease risk in quinquagenarian.To explore the relationship between the risk of coronary heart disease and levels of quinquagenarian in Haizhu District of Guangzhou City.MethodExtract 1,800 community residents aged over 45 in Haizhu District of Guangzhou city.by Stratified Random Sampling. Select further investigation by questionnaire, blood tests and medical examinations and other means if sample meet the requirement that a fasting blood glucose fingertips greater than 5.6mmol/L. Subjects were divided into 3 groups:normal blood glucose (NBG) group, IGR group, DM group.Compare prevalence of risk factors for CHD (hypertension, hyperlipidemia, obesity, central obesity) in each group. Apply Framingham coronary heart disease prediction model to predict the possibility of CHD in 10 years.ConclusionThe situation of prevalence of DM and IGR in Haizhu District of Guangzhou in quinquagenarian from July 2009 to December 2009 is serious.The prevalence of hypertension, high blood lipid rate, obesity rate, central obesity rate in Haizhu District of Guangzhou in quinquagenarian is in the increase with the increase of blood glucose. However, this difference between DM and IGR is not statistical significant.It is important to prevent major vascular complications, especially cardiovascular events by intervening blood sugar in early stage, intervening hypertension, hyperlipidemia, obesity, central obesity comprehensively. The possibility of CHD in 10 years in Haizhu District of Guangzhou in quinquagenarian is tended to increase with the increase of blood glucose.Early blood glucose intervention, particularly in the pre-diabetes through lifestyle changes, exercise, diet, if necessary, with the use of drugs is extremely significant to delay progression to diabetes or CHD.
|
PDF Full Text Request