Status and disparities of diabetes among urban and rural residents aged 40 years and older: insight from a population-based study in northeast China, 2017–2019
Status and disparities of diabetes among urban and rural residents aged 40 years and older: insight from a population-based study in northeast China, 2017–2019
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DOI：
10.1136/jech-2020-213755
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发表时间：
2021-02
影响因子：
6.3
通讯作者：
L. Xing;Yuanmeng Tian;L. Jing;Min Lin;Z. Du;Qun Sun;D. Dai;Lei Shi;Zuosen Yang;Shuang Liu
中科院分区：
文献类型：
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作者：
L. Xing;Yuanmeng Tian;L. Jing;Min Lin;Z. Du;Qun Sun;D. Dai;Lei Shi;Zuosen Yang;Shuang Liu
目的 评估中国东北地区糖尿病的最新流行病学状况。方法采用多阶段分层整群随机抽样方法，于2017年9月至2019年3月进行横断面研究。 18 796 名年龄≥40 岁的参与者（28.9% 城市和 71.1% 农村）入组。根据病史、空腹血糖（FPG）和糖化血红蛋白（HbA1c）水平诊断糖尿病和糖尿病前期。结果 城市居民糖尿病患病率为17.1%，高于农村居民（20.2% vs 15.8%，p<0.001）。与此同时，农村地区糖尿病前期患病率为44.3%，高于城市（49.4% vs 31.8%，p<0.001）。总体 FPG 和 HbA1c 分别为 6.10±1.94 mmol/L 和 5.59%±1.08%。农村地区FPG水平高于城市地区（6.15±1.83 mmol/L vs 5.97±2.18 mmol/L，p<0.001）。在患有糖尿病的参与者中，47.5%的人了解自己的糖尿病状况； 39.5% 的人正在服用抗糖尿病药物，36.8% 的人糖尿病得到控制。农村地区的知晓率和治疗率低于城市地区（47.3% vs 57.5%、34.4% vs 49.5%，p<0.001）。糖尿病患者，尤其是农村地区的糖尿病患者，往往存在多种危险因素，包括高血压（71.7%）、超重或肥胖（69.6%）和血脂异常（52.8%）。结论 东北地区糖尿病负担重，糖尿病未治疗比例高，糖尿病前期患病率高，总体FPG水平高，糖尿病患者存在多种未控制的危险因素。因此，应强调针对特定区域的糖尿病预防和管理策略。
Objectives To evaluate the up-to-date epidemiology of diabetes in northeast China. Methods The cross-sectional study was conducted between September 2017 and March 2019 using a multistage, stratified and cluster random sampling method. 18 796 participants (28.9% urban and 71.1% rural) aged ≥40 years were enrolled. Diabetes and pre-diabetes were diagnosed according to the history, fasting plasma glucose (FPG) and glycosylated haemoglobin A1c (HbA1c) levels. Results The prevalence of diabetes was 17.1%, higher in urban than in rural residents (20.2% vs 15.8%, p<0.001). Meanwhile, the prevalence of pre-diabetes was 44.3%, higher in rural than in urban areas (49.4% vs 31.8%, p<0.001). The overall FPG and HbA1c were 6.10±1.94 mmol/L and 5.59%±1.08%. The FPG level was higher in rural area than in urban areas (6.15±1.83 mmol/L vs 5.97±2.18 mmol/L, p<0.001). Among participants with diabetes, 47.5% were aware of their diabetes condition; 39.5% were taking antidiabetic medications and 36.8% of people had their diabetes controlled. The awareness and treatment rates in rural areas were lower than those in urban areas (47.3% vs 57.5%, 34.4% vs 49.5%, p<0.001). Patients with diabetic, especially those in rural areas, tended to have multiple risk factors including hypertension (71.7%), overweight or obesity (69.6%) and dyslipidaemia (52.8%). Conclusion A considerable burden of diabetes was observed in northeast China, with high percentage of untreated diabetes, high prevalence of pre-diabetes, high overall FPG level and multiple uncontrolled risk factors in patients with diabetics. Therefore, region-specific strategies on prevention and management of diabetes should be emphasised.