| [Background]Diabetes mellitus(DM) is a syndrome of glucose, protein and lipid metabolism disorder due to absolute/relative shortage of insulin or the cell metabolism defects, characterized by the abnormal increase of the concentration of glucose in the blood circulation and urine. According to the causes, it can be divided into Type1, Type2, other specific types and gestational diabetes. Type2diabetes mellitus accounts for about90%-95%. With the socio-economic development and changing lifestyles, the prevalence of diabetes in China is showing a rising trend, and it has become a serious public health problem. Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are considered as pre-diabetic state, but there are a few epidemiological studies of pre-diabetes. So it is particularly important to take a large-scale epidemiological survey in Shandong province to know well about the epidemiological features of DM. Therefore, we research the epidemiological characteristics of DM, IFG and IGT among18to69-year-old residents of urban and rural area of our province as well as the related risk factors of DM, detect DM patients and high-risk groups, to provide guiding significance for the prevention and control of DM in our province. [Objectives]1. With the way of cross-sectional study, to know the epidemic situation of DM and IFG, IGT among18to69year-old residents of urban and rural area of Shandong province through multi-stage stratified sample survey.2. To explore the risk factors of DM in Shandong province, and provide scientific data for the development of DM prevention plan and evaluation of the effects of interventions of Shandong province.[Methods]The data in this study were collected from Shandong province chronic diseases and their risk factors monitoring database in2010, which was part of the country chronic disease monitoring in2010.This study was a cross-section epidemiological study. Multi-stage stratified randomized sampling was used in this study. The survey included the questionnaire, physical examination and laboratory testing. Fasting venous blood was collected from all of the subjects, and in addition to DM patients, all of the subjects had acceptted the oral glucose tolerance test (OGTT). The indicators of detection included blood glucose, lipids and so on. Blood glucose was measured at the local laboratory, which had identified by the national standard qualification. Blood lipid results were determinated by the central laboratory of Shandong center for disease control and prevention.As this survey was a multi-stage stratified cluster sample one, the sample data showing the multi-layer hierarchical structure and the characteristics of non-independent, so the sampling weights were used for the complex sampling point value of prevalence and the Taylor series linearization method was adopted to estimate the variance of rate and construct95%confidence interval (CI).The overall weighted prevalence rates and their95%CIs of DM、IFG and IGT among permanent residents aged18to69in Shandong province, as well as that among population subgroups divided by urban and rural areas, age groups, gender and other demongraphic factors were described. The relationship between DM/IFG/IGT and BMI, waist circumference and other related factors was analyzed. The risk factors of DM were analyzed using univariate and multiple surveylogistic regression analysis.[Results]1. The survey planned to investigate7800people, and finally got samples for7675people, of which7670were measured fasting plasma glucose, and7589accepted the oral glucose tolerance test (OGTT). There were3438males (44.79%), women4237females (55.21%) in this sample, and it included city residents of2246(29.26%), the rural residents of5429(70.74%). The means of age was45.59±13.55years old.2. The weighted prevalence rates of DM, IFG and IGT were6.28%(95%CI:5.35%-10.08%),11.36%(95%C7:7.07%-15.66%),5.85%(95%CI:3.85%-7.86%) respectively. All of the580cases of DM,21.21%patients were confirmed before the survey, new patients accounted for69.87%of the total.3. The weighted prevalence rates of DM, IFG and IGT did not differ significantly between male and female, as well as urban and rural. The prevalence rates of DM and IGT increased significantly with increasing age, and the prevalence rates in60to69age group population were the highest. The prevalence rate of IFG was the highest in50to59age group population and lowest in18to29age group population.4. The weighted prevalence rates of DM, IFG and IGT significantly differed in BMI groups and waist circumference groups. There was a linear trend between the prevalence of DM, IGT and BMI, and the prevalence rates of DM, IFG and waist circumference,"√" trend between the prevalence of IFG and BMI, and the prevalence of IGT and waist circumference. Stratification analysis showed that the effects of BMI, waist circumference on the prevalence rates of DM, IFG, IGT between male and female were different. Blood pressure, lipids, smoking, drinking, physical activity and other factors influenced the prevalence rates of DM, IFG and IGT.5. The surveylogistic regression of complex sample model showed that, the main risk factors of DM included age, obesity, central obesity, family history of the DM, hypertension, hypercholesterolemia, hypertriglyceridemia, IGT, and higher income was protective factor.[Conclusions]1. The prevalence rates of DM, IFG and IGT were serious among18to69-year-old residents of urban and rural area of Shandong province. The weighted prevalence rates of DM, IFG and IGT did not differ significantly between urban and rural.2. The prevalence rates of DM in obesity, central obesity, hypertension, dyslipidemia population were significantly higher than those in normal population. The prevalence rates of IFG, IGT in obesity and hypertension population were higher than those in normal population. The effect of BMI and waist circumference on the prevalence of DM, IFG, IGT between male and female were different.3. Age, obesity, central obesity, DM family history, hypertension, hypercholesterolemia and hypertriglyceridemia were major risk factors for DM.[Suggestions]1. To strengthen the study of IFG, IGT patients, through the cohort study, master the conversion rate of DM and prognosis; and to study the comprehensive interventions for IFG/IGT patients.2. To strengthen the health education of DM prevention and improve the self-detection rate and prevention awareness.3. According to epidemiological characteristics and risk factors of DM, take prevention and control strategies and measures for the actual situation of DM in Shandong province, including establishing surveillance system of DM, and strengthening administration of DM patients. |
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