[Geographical variation and related factors in prediabetes prevalence in Chinese adults in 2013].
2018; National Institutes of Health; Volume: 52; Issue: 2 Linguagem: Inglês
10.3760/cma.j.issn.0253-9624.2018.02.008
AutoresZhenping Zhao, Y C Li, L M Wang, M Zhang, Zhuojie Huang, Xuan Zhang, C Li, Q Deng, M G Zhou,
Tópico(s)Diabetes, Cardiovascular Risks, and Lipoproteins
ResumoObjective: To investigate the geographical variation of prediabetes in adults in different regions of China, and to analyze the related factors of prediabetes. Methods: Data was obtained from China Chronic Disease and Related Risk Factor Surveillance in 2013. The surveillance adopted multiple-stage stratified cluster random sampling method, which sampled 177 099 residents aged above 18 years old among 298 surveillance points in 31 provinces of Chinese Mainland. Questionnaire interview was used to obtain demographic variables, personal living style, and socio-economical information. Physical examination was conducted and fasting venous blood sample and (oral glucose tolerance test-2 hours, OGTT-2 h) venous blood sample were obtained from the participants. A total of 171 567 residents aged 18 and above were included in the analysis. The prevalence of prediabetes was analyzed by provinces and by China's geographical regions, after complex weighting. Multilevel logistic models were established to explore the related factors of prediabetes on the area level and individual level. Results: The prevalence of prediabetes among residents aged 18 and above was 16.6% (95%CI: 15.6%-17.6%) in China. The prevalence of prediabetes was the highest (18.3%) in the south China and lowest (13.1%) in the northwest area. The difference of the prevalence in different areas were not statistically significant (P=0.510). If categorized the prevalence of prediabetes into 5 groups by quintile, Hainan, Jilin, Shandong, Anhui, Hunan and Chongqing were in the highest group of prevalence of prediabetes (18.6%-22.7%), and Tibet, Qinghai, Gansu, Ningxia, Guizhou, and Jiangxi were in the lowest group (7.6%-12.6%). The variance of prevalence of prediabetes on the county level (MOR: 1.60 (95%CI:1.53-1.67)) was more diverse than the province level (MOR: 1.21(95%CI:1.08-1.29)) and higher than the street level (1.23 (95%CI:1.14-1.30)). Several factors increased risk of pre-diabetes, including smoking, hazardous drinking and harmful drinking, drinking in the past 30 days, overweight, obesity, central obesity, sugary drink intake, hypertension, high total cholesterol, high triglycerides, high blood low-density lipoprotein cholesterol, low blood high-density lipoprotein cholesterol (all P<0.05). After adjusted the above variables, 92.5% of variance of prediabetes prevalence conld be explained on the provincial level. Conclusion: The geographical distribution of prediabetes in adults in China differed by geographic areas, and it significantly varied on the county level. The related variables included demographic variables, personal behavior, and geographic related variables.目的： 了解中国不同区域成人糖尿病前期的地理分布，分析糖尿病前期流行的相关因素。 方法： 2013年中国慢性病及其危险因素监测采用多阶段分层整群随机抽样方法，抽取内地31个省（自治区、直辖市）298个监测点的18岁及以上常住居民177 099名。问卷调查获取人口统计学特征、个人生活方式和社会经济区域因素等信息。采集调查对象身体测量数据，抽取空腹和服糖后2 h静脉血。本研究纳入了糖尿病前期相关信息完整的171 567名调查对象。经复杂抽样加权后，计算中国不同省份及地理分区的糖尿病前期流行率，选取糖尿病前期相关因素建立多水平logistic模型，分析糖尿病前期流行率的区域和个体因素。 结果： 中国18岁以上常住居民的糖尿病前期流行率为16.6%（95%CI: 15.6%~17.6%）。华南地区最高（18.3%），西北地区最低（13.1%），不同区域的糖尿病前期流行率差异无统计学意义（P=0.510）。将中国各省糖尿病前期流行率按五分位数分成5组，海南、吉林、山东、安徽、湖南和重庆为糖尿病前期高流行区（18.6%~22.7%），西藏、青海、甘肃、宁夏、贵州与江西为糖尿病前期低流行区（7.6%~12.6%）。糖尿病前期流行率在县/区级水平中位数比值比为1.60（95%CI:1.53~1.67），变异程度高于省级及乡镇/街道水平[中位数比值比分别为1.21（95%CI:1.08~1.29）、1.23（95%CI:1.14~1.30）]。糖尿病前期风险的相关因素包括现在吸烟、危险饮酒、有害饮酒、过去30 d饮酒、超重或肥胖、中心型肥胖、含糖饮料摄入、高血压、高胆固醇血症、高甘油三酯血症、高低密度脂蛋白胆固醇血症、低高密度脂蛋白胆固醇血症等因素（P值均<0.05）。在模型中调整以上变量后，可解释92.5%的糖尿病前期省级水平变异。 结论： 中国成人居民糖尿病前期在不同地理区域存在分布差异，县/区级水平差异明显，相关因素包括人口学特征、个体行为方式及地理区域因素等。.
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