An Investigation Of Dysglycemia In Middle-aged And Elderly People In Chongming District Of Shanghai And Its Relationship With Other Metabolic Disorders

Objective To investigate dysglycemia in middle-aged and elderly people in Chongming district of Shanghai and the relationship between dysglycemia and other metabolic disorders.Methods This is a cross-sectional study of 10060 permanent residents of Chongming district.A random cluster sampling method was adopted.Of the 10060 studied subjects,9913 were between 40 and 70 years old.Results Of the 9913 cases,3218 were male(32.46%)with an average age of 57.67±7.54;6695 were female(67.54%)with an average age of 55.37±7.82.The prevalence rate of diabetes,iIFG,iIGT,IFG+IGT were 25.57%(2535/9913),9.27%(919/9913),15.90%(1576/9913)and 9.32%(924/9913).The prevalence of PreDM was 34.49%(3419/9913),and the prevalence of abnormal dysglycemia was 60.06%(5954/9913).IIGT was the main form of PreDM in this survey,accounting for 46.1%.The prevalence of iIFG,IFG+IGT and DM in male was higher than that of female,and the difference was statistically significant(P < 0.05),but the prevalence of iIGT was lower in male than female(P < 0.05).The prevalence of IFG+IGT and DM increased with age(P < 0.05),but the prevalence of iIFG and iIGT was not significantly associated with age(P>0.05).The prevalence of iIFG,IFG+IGT and DM decreased with elevated educational levels(P<0.05).The awareness rate of diabetes in this survey was only 38.9%(985/2535).There was no gender difference in diabetes awareness.Diabetes awareness increased with age.Different educational levels had different levels of awareness,and people with college or higher education had higher awareness rate than people with junior college(P<0.05).Among the diagnosed DM patients,the control rate of HbA1 c < 7.0% was 49.0%(483/985);the control rate of fasting glucose was 29.8%(294/985);the control rate of non-fasting glucose was 25.0%(246/985);the proportion of fasting and non-fasting glucose under control was 18.3%(180/985);The proportion of patients whose fasting,non-fasting glucose and HbA1 c < 7.0% were all controlled was only 17.1%(168/985).There was no statistical difference between the glucose control rates between men and women(P>0.05).The glucose control rate decreased with age(P<0.05).With the increase of cultural level,all glucose control rates showed a decrease trend(P < 0.05).In the new diagnosis of diabetes,322 patients with elevated isolated fasting glucose accounted for 20.8%;Only 609 cases of isolated impaired OGTT 2 hours glucose,accounting for 39.3%.Patients with both impaired fasting glucose and impaired OGTT 2 hours glucose were 619 cases,accounting for 39.9%.The total prevalence rate of hypertension in the survey was 46.51%(4574/9834).The prevalence rate of hypertension in NGT group,iIFG group,iIGT group,IFG+IGT group and DM group were 32.99%,44.91%,46.52%,57.05% and 64.37%.The prevalence rate of hypertension in each group with abnormal dysglycemia was significantly higher than that in the NGT group(P < 0.05),and that in the DM group was significantly higher than that in the iIFG group,iIGT group,and IFG+IGT group(P < 0.05).The prevalence rate of hypertension in IFG+IGT group was higher than that in iIFG group and iIGT group(P < 0.05).The prevalence rate of hypertension in NGT group,iIGT group and IFG+IGT group was higher in males than in females(P < 0.05),while there was no gender difference in the prevalence rate of hypertension in iIFG group and DM group(P > 0.05).The total prevalence rate of obesity was 14.97%(1461/9758),and the total prevalence rate of overweight was 40.33%(3935/9758).The overall prevalence rate of obesity and overweight was 55.30%(5396/9758).The prevalence rate of obesity in NGT group,iIFG group,iIGT group,IFG+IGT group and DM group was 10.23%,15.15%,15.60%,18.15% and 20.70%.The prevalence rate of obesity increased in the five groups(P =0.000).The prevalence rate of overweight was 34.38%,40.49%,42.81%,46.75% and 45.59%,respectively.The prevalencerate of overweight increased in the five groups(P =0.000).The total prevalence rate of obesity and overweight: 44.61%,55.64%,58.41%,64.90%,66.29%.The prevalence rate of obesity and overweight in the abnormal dysglycemia group was significantly higher than that in the NGT group(P < 0.05).There was no gender difference in the prevalence rate of obesity between males and females,and the prevalence rate of overweight in males was significantly higher than that in females(P < 0.05).In the survey,the prevalence rate of high triglycerides(TG)disease was 34.84%(3450/9902),high total cholesterol,the prevalence rate of total cholesterol(TC)disease was 14.41%(1427/9902),the prevalence rate of low high-density lipoprotein cholesterol(HDL-C)disease was 15.01%(1486/9902),the prevalence rate of high low-density lipoprotein cholesterol(LDL-C)was 9.31%(922/9902).The overall prevalence rate of dyslipidemia was 50.16%(4967/9902).The prevalence rate of dyslipidemia in males was higher than that in females(P < 0.05).The prevalence rate of dyslipidemia in NGT group,iIFG group,iIGT group,IFG+IGT group and DM group was 38.58%,48.91%,53.78%,62.01% and 62.12%,respectively.The prevalence rate of dyslipidemia in the five groups was on the rise(P =0.000).Comparison of the prevalence rate of TG: the abnormal glucose metabolism group was significantly higher than the NGT group(P < 0.05),and the prevalence of male was higher than female(P < 0.05).Comparison of the prevalence of TC: the abnormal glucose metabolism group was significantly higher than the NGT group(P < 0.05),while the prevalence of male was lower than that of female(P < 0.05).Comparison of the prevalence of low HDL-C: DM group was higher than NGT group(P < 0.05),iIFG group was lower than NGT group(P < 0.05).There was no difference between IFG+IGT group,iIGT group and NGT group.The prevalence was higher in males than in females(P < 0.05).The prevalence of high LDL-C was higher in DM group,IFG+IGT group and iIFG group than in NGT group(P < 0.05),and there was no difference between iIGT group and NGT group.DM group and IFG+IGT group were higher than iIGT group(P < 0.05).The prevalence was lower in males than in females(P < 0.05).The prevalence of microalbuminuria in the investigated population was 9.84%(971/9867),with 8.62%(276/3202)in males and 10.43%(695/6665)in females(P < 0.05).The prevalence of microalbuminuria in DM group was higher than that in other groups(P < 0.05).The prevalence of microalbuminuria in DM group,IFG+IGT group and iIFG group was higher than that in NGT group(P < 0.05),but there was no difference between iIGT group and NGT group.In this study,homa-ir of the abnormal glucose metabolism group was higher than that of the NGT group(P < 0.05).In the iIFG group,IFG+IGT group and DM group,homa-beta was lower than that in the NGT group(P < 0.05),and homa-beta was higher in the iIGT group than that in the NGT group(P < 0.05).The homa-beta of DM group was lower than that of iIFG group and IFG+IGT group(P < 0.05).IIFG group,HOMA-β was lower than IFG+IGT group(P < 0.05).Logistic regression analysis showed older age;male;low HDL-C;high TG;elevated systolic blood pressure;Urinary albumin/creatinine;Homa-ir are risk factors for diabetes.Older age;male;high TG;Homa-ir and elevated systolic blood pressure were risk factors for prediabetes.Conclusion The prevalence of dysglycemia in middle-aged and elderly people in Chongming district of Shanghai is quite high,but diabetes awareness is quite low.The glucose control of DM patients is not optimistic.The prevalence of hypertension,obesity,overweight,dyslipidemia and microalbuminuria in people with abnormal dysglycemia is significantly higher than that in the group with normal dysglycemia.It is urgent to take effective intervention measures,strengthen the diagnosis and treatment of diabetes,delay the development of pre-diabetes to diabetes,and adopt a variety of comprehensive treatment methods for patients with glucose metabolism disorder,and comprehensively manage glucose,blood pressure,blood lipid and urine protein.