| Background& Aims:Estimated by 2010 China non-communicable disease national survey, the overall prevalence of diabetes and pre-diabetes had increased to be 11.6% and 50.1% in the Chinese adult population, which indicated it as severely public health issue. Meanwhile, the rising prevalence of multimorbidity is challenging global governments and health-care systems and arouses great attention. As well known to us, concomitant conditions can result in a multiplicative interaction with the progression, outcome and treatment of diseases. Therefore, exploring the features of comorbidities among diabetics will be bound to provide clinical basis for better glucose control and delay the relevant complications. The aims of the study were to gain more-precise understanding of the epidemiology of comorbidities with diabetes and to clarify the correlation with coronary heart disease (CHD) in Chinese population.Methods:Based on REACTION study, created to investigate the epidemiology of metabolic diseases in China between 2011 and 2012, totally 18,696 participants aged over 40 years were included in the cross-sectional analysis. Information on demographic characteristics, education level, medical history, and lifestyle factors were acquired by interviews. Weight, height and blood pressure were measured according to standard methods. Blood samples were collected from all participants after an overnight fast of at least 10 hours. Each participant without a self-reported history of diabetes was given an oral glucose tolerance test (OGTT). Plasma glucose, thyroid function, serum lipid profiles and renal functions were further measured.Results:Diabetes was more prevalent in patients with older age and lower education level, with relatively low awareness (36.3%), treatment (27.9%) and control (34.7%) rate. The proportion of diabetics with additional condition was 86.1%, nearly half (49.6%) had more than two comorbidities. Compared with patients with comorbidities, diabetics only had the highest controlled HbAlc rate (35.6%). Dyslipidemia (61.40%) was the most common comorbidity, followed by hypertension (58.19%), hypothyroidism (21.24%). The HbAlc of diabetes only with the indicated conditions were 7.38,7.33,6.97,6.61, and 6.75, respectively for dyslipidemia, hypothyroidism, hypertension, hyperthyroidism, and renal insufficiency. A strong gradient existed between the number of comorbidities and CHD versus "diabetes only" group, the odds ratio was 1.732.81 and 3.94 for diabetics with one, two and three additional diseases, respectively.Conclusions:Low glycemic control and high prevalence of diabetes comorbidities are common in China, which increases the risk of CHD.Backgrounds & Aims: The prevalence of noncommunicable diseases, such as cardiovascular disease, diabetes mellitus, nonalcoholic fatty liver disease, have been increasing worldwide. As a common pathogenic risk factor, dyslipidemia played a great role in the incidence and progress of these diseases. Over the past decades, with the development of economics and changes in lifestyle,dyslipidemia has been projected th increase in absolute number in China. However, based on China’s national conditions, more than half of the Chinese population is spread in rural areas.Compared with the population in urban areas,people in rural areas relatively have low income,limited medical costs wimbursement and inequitable allocation of healthcare resources: which pushed lack of large epidemiology and less health education. So, we sought to achieve accurate and up-to-date information on the prevalence, awareness,treatment, and control of dyslipidemia and analyze its associations with other lipid-related diseases in rural North China.Methods: We conducted a large-scale cross-sectional study, between July 2014 and January 2015, in a representative sample of 8,528 participants aged over 18 years.Information on demographic characteristics,education level,medical history,and lifestyle factors were acquired by questionnaires,Physical examinations were carried out by medical workers. Blood samples were acquired from all participants after an overnight fast of at least 10 hours and detected collectively. Each participant was performed abdominal and carotid intitna-media thickness(CIMT) examination.Prevalence and characteristics of dyslipidemia were demonstrated. The odds ratios between dyslipidemia types and lipid-related diseases were further analyzed by logistic regression.Results: Among the overall population, 45.8% suffered from dyslipidemia. The prevalence of lipid abnormality (including high and very high levels) was 18.6%,12.7%, 9.8% and 12,7% for total cholesterol(TC), high-density lipoprotein cholesterol(HDLC),and low-density lipoprotein cholesterol(LDLC) and triglycerides(TG), respectively. Among all participants with dyslipidemia, 23,9%were aware,only 11.5% were treated, 10.0% were controlled. For subjects with dyslipidemia,the risk fbr non-alcoholic fatty liver disease(NAFLD) was highest with a 3.3-fold over that of non-dyslipidmia(OR=3.30,P<0.001); followed by hyperuricemia and dkbetes mellitus(DM), while wkh 2-fold increase(OR=l.99,P<0.001; OR=L92,P<0.001); with only 1.5-fold risk for atherosclerosis(AS)(OR=1.47,P<0.001). The presence of high cholesterol was mainly associated with AS,while abnormal TG was correlated with NAFLD and DM.Conclusions:The prevalence of dyslipidemia in rural areas was 45.8%, with a2.5 fbld increase of that in 2002. The increase of abnormal TC was most rapid.However, the awareness,treatment and control were low in rural population. For patients with dyslipidemia, the risk of NAFLD was highest, and TG played a role in the development of NAFLD and DM. |
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