A Study On The Prevalence And Associated Factors Of Diabetes Mellitus Among Han And Bouyei Residents In Guizhou Province

Background and significanceDiabetes mellitus(DM) is caused by a variety of causes of metabolic disorder, characterized by chronic hyperglycemia, with insufficient insulin secretion and/or function disorder, cause of carbohydrate, fat and protein metabolism disorder, cause chronic injuries, multiple organ dysfunction failure, especially for the eyes, kidneys, nerves, heart and blood vessels. Epidemiological studies have showed that the prevalence of Diabetes is rising in the global scope, diabetes caused deaths are also growing, it has become the global public health problem. According to the WHO reports, in 2012, WHO estimated 1.5 million deaths were directly caused by diabetes, in which more than 80% of diabetes deaths occur in low and middle income countries. In 2014,9% of the global adults over 18 years old people have diabetes. Diabetes will become the 7th leading cause of death in 2030, and the number of diabetes patients is expected to rise to 592 million by 2035.In China, diabetes is also a very important public health problem. Bouyei is one of the major minorities in China. The population of Bouyei ranked tenth among other minority ethnic groups. There was no literature has been published regarding the prevalence of Diabetes in Bouyei people in China.Objectives1. To determine the epidemiology of diabetes among Han and Bouyei people that living in Guizhou Province.2. To determine the rate of awareness, treatment and control of Diabetes.3. Analysis associated risk factors of diabetes and differences between Han and Bouyei residents.MethodsA cross-sectional survey was conducted among 20 to 80 years old people among Han and Bouyei residents living in Guizhou province. Using stratified mutistage cluster sampling method, a sample of 2967 Han residents and 2968 Bouyei residents aged over 20 years were selected from October,2012 to December,2012. Questionnaire survey, anthropometric measurement and blood test were carried out. The DM was defined by the definition proposed by World Health Organization in 1999. All data analyses were performed using SAS software with P<0.05 considered to be statistically significant.2010 census data was used to represent the data for reference population. Multiple logistic regression analysis was performed to estimate the associated risk factors of DM.Results1. The gender-age standardized prevalence of diabetes was 6.01% in urban Han residents (male:7.88%, female:4.73%), and 3.47%in rural Han residents (male:4.3%, female:2.87%), and 3.04%in urban Bouyei residents (male:5.93%, female.-1.32%), and 2.83%in rural Bouyei residents (male:4.55%, female:1.58%). Gender-age standardized prevalence was higher in Han residents than in Bouyei residents. Prevalence of DM in urban was higher than in rural area and higher in male than in female both among Han and Bouyei residents. The prevalence of DM increased significantly with increasing age in both gender in Han and Bouyei residents.2. The total rate of awareness was 46.74%,56.59% for Han patients and 24.05% for Bouyei patients (P<0.01), higher in urban than in rural place (64.05% vs.22.22%, P<0.01), and higher in female than in male (54.55% vs.41.06%, P<0.05); The rate of treatment was 81.15% for total awareness patients, Han patients were more likely to take medicine treatment than Bouyei patients(84.47% vs.63.16%, P<0.05), there were no significant difference between region and gender; The control rate was 40.40%. There were no difference observed between race、region and gender.3. Multiple logistic regression analysis showed that gender, age, family history, Hypertension and high TG were positively associated with DM in Han residents and Bouyei residents. Income and activities were associated with DM in Bouyei residents. Exercise was associated with DM in Han residents. Furthermore, after other factors were controled race was still the influence factor of diabetes.ConclusionsFindings from this cross-sectional study indicated that the prevalence of DM was significantly higher in Han residents than in Bouyei residents. The prevalence of DM was significant differences between Han and Bouyei people, suggested that genetic differences may exist. Further studies of gene polymorphism should be conducted.