National Patterns in Diabetes Screening: Data from the National Health and Nutrition Examination Survey (NHANES) 2005-2012
National Patterns in Diabetes Screening: Data from the National Health and Nutrition Examination Survey (NHANES) 2005-2012
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DOI：
10.1007/s11606-014-3147-8
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发表时间：
2015-05-01
影响因子：
5.7
通讯作者：
Nelson, Karin M.
中科院分区：
文献类型：
--
作者：
Kiefer, Meghan M.;Silverman, Julie B.;Nelson, Karin M.
在美国，目前很少有基于人群的糖尿病筛查模式的估计。美国糖尿病协会（ADA）建议对45岁以上的成年人和45岁以下的高危人群进行普遍筛查，但目前还没有对ADA指南在检测糖尿病和前驱糖尿病方面的性能进行评估。此外，关于筛查的种族/民族模式的数据是有限的，我们的目的是估计美国成年人群的糖尿病筛查患病率，特别是那些符合ADA标准的人群;报告这些人群中糖尿病前期和糖尿病的患病率;并确定高危人种/种族是否与报告的筛查相关。这是一项横断面调查。在2005-2012年参加国家健康和营养检查调查（NHANES）的无糖尿病或糖尿病前期的患者（n = 17，572）被纳入研究。根据ADA标准分类的“筛查推荐”参与者包括（1）45岁的成年人和（2）< 45岁的“高风险”成年人。“不推荐筛查”的受试者是年龄小于45岁且不符合标准的成年人。糖尿病筛查状态通过自我报告获得。我们使用校准的HbA 1c和/或空腹血糖水平来定义未诊断的糖尿病和前驱糖尿病。76%的研究人群（约1.36亿美国成年人）符合ADA标准。其中，不到一半（46.2%）报告筛查;未诊断的糖尿病影响3.7%（500万人），未诊断的前驱糖尿病影响36.3%（4900万人）。非裔美国人更有可能报告筛查，无论是45岁的成年人还是“高风险”的年轻人（OR分别为1.27和1.36）。西班牙裔参与者也更有可能报告筛查（老年人OR 1.31，年轻人OR 1.42）。在“不推荐筛查”的成人中，筛查率为29.6%;糖尿病和前驱糖尿病的患病率分别为0.4%和10.2%。在全国代表性样本中，76%的成人符合ADA筛查标准，其中不到一半的人报告了筛查。局限性包括横断面设计和筛选自我报告。
There are few current population-based estimates of the patterns of diabetes screening in the United States. The American Diabetes Association (ADA) recommends universal screening of adults a parts per thousand yen 45 years, and high-risk adults < 45 years, but there is no current assessment of ADA guideline performance in detecting diabetes and prediabetes. Furthermore, data on racial/ethnic patterns of screening are limited.Our aim was to estimate diabetes screening prevalence for the US adult population and specifically for those who meet ADA criteria; to report the prevalence of prediabetes and diabetes among these groups; and to determine if high-risk race/ethnicity was associated with reported screening.This was a Cross-sectional survey.Non-pregnant adults (a parts per thousand yen 21 years) without diabetes or prediabetes who participated in the National Health and Nutrition Examination Survey (NHANES) in 2005-2012 (n = 17,572) were included in the study. "Screening-recommended" participants, classified by ADA criteria, included (1) adults a parts per thousand yen 45 years and (2) "high-risk" adults < 45 years. "Screening-not-recommended" participants were adults < 45 years who did not meet criteria.Diabetes screening status was obtained by self-report. We used calibrated HbA(1c) and/or fasting glucose levels to define undiagnosed diabetes and prediabetes.Seventy-six percent of the study population (approximately 136 million US adults) met ADA criteria. Among them, less than half (46.2 %) reported screening; undiagnosed diabetes affected 3.7 % (5 million individuals), and undiagnosed prediabetes affected 36.3 % (49 million people.) African Americans were more likely to report screening, both among adults a parts per thousand yen 45 years and among "high risk" younger adults (OR 1.27 and 1.36, respectively.) Hispanic participants were also more likely to report screening (OR 1.31 for older adults, 1.42 for younger adults.) The screening rate among "screening-not-recommended" adults was 29.6 %; the prevalence of diabetes and prediabetes were 0.4 and 10.2 %, respectively.In a nationally representative sample, 76 % of adults met ADA screening criteria, of whom fewer than half reported screening. Limitations include cross-sectional design and screening self-report.