上海市中老年人群中糖尿病发病与糖化血红蛋白基线值相关性的回顾性研究

摘要

Objective To evaluate the correlation of diabetes pathogenesis and HbA1c baseline value in middle-aged and aged adults and to analyze the influencing factors of HbA1c. Methods Multistage stratified cluster sampling was used to randomly select 3219 registered residents aged 50 years old and over in Shanghai to participate the baseline survey in 2009. Phone call interview was used to follow up subjects with impaired fasting glucose (IFG, 6. 1 mmol/L≤FPG < 7.0 mmol/L) ,as well as with no previous diabetes diagnosis in 2011 to survey diabetes incidence. All respondent were traced back for HbA1c assay. Results Self-reported prevalence of diabetes in baseline population was 8.6% (278/ 3219). IFG cases accounted for 11% (313/2938). Telephone follow-up was carried out to 240 subjects in 2011, and the respondent rate was 45% (108/240). 15% (16/108) cases were newly diagnosed as diabetes. 50% of the subjects with HbA1cSs6. 5% (6/12) were newly diagnosed as diabetes,compared to 14% of those with HbA1c <6. 5% (10/72) (unadjusted OR = 6. 4; 95 % CI: 1. 45～29. 06). Multiple liner regression analysis showed that triglyceride level was positively related with HbAle level (r = 0. 176, P = 0. 026). Conclusions Prevalence of diabetes in the population with IFG is higher than that in normal population. HbA1c≥6. 5% is significantly associated with newly diagnosed diabetes. Long-term follow-up study with larger samples should be taken to set up screening criteria of diabetes based on HbA1c.%目的 研究中老年人群中糖尿病发病与糖化血红蛋白(HbA1c)基线值的相关性,并分析影响其检测结果的个体因素. 方法 在2009年通过多阶段分层随机抽样在上海地区调查了3219名≥50岁的上海常住居民.对空腹血糖受损(6.1 mmol/L≤空腹血糖＜7.0 mmol/L)但调查前未被各级医疗机构诊断为糖尿病的调查对象,于2011年通过电话开展糖尿病发病率调查,并检测随访应答对象2009年所留血液样本HbA1c. 结果 基线人群自报糖尿病发病率为8.6％ (278/3219).2938名非糖尿病人中,空腹血糖受损病例为11％(313/2938).对其中240名留有电话信息的调查对象于2011年开展电话随访,随访应答率为45％ (108/240).15％ (16/108)在2年中新诊断为糖尿病.HbA1c≥6.5％的对象中有50％(6/12)发展为糖尿病,而HbA1c＜6.5％的对象中仅有14％ (10/72)(OR=6.4,95％ CI:1.45～ 29.06).多元线性逐步回归分析表明,HbA1c水平和三酰甘油水平呈显著正相关(r=0.176,P=0.026). 结论 空腹血糖受损人群糖尿病发病率高于正常人群.基线HbA1c≥6.5％和新发糖尿病显著相关.空腹血糖受损人群应要求检测HbA1c以利于糖尿病的早期诊断和早期治疗.