该研究旨在调查中国广州市石牌村社区55岁以上人群的糖尿病发病率以及危险因素。调查分为3次，以2002年对547例非糖尿病人群的调查数据作为基线，分别于2007年和2008年分别再次检测这些人群的血糖情况。患糖尿病的标准为空腹血糖（FPG）≥7.0mmol/L或口服葡萄糖耐量试验（OGTT）2h后血糖≥11.1mmol/L，或由医生诊断为糖尿病。空腹血糖受损（IFG）则采用1999年WHO诊断标准。

 

    研究人员共获得406例（74.2%）非糖尿病受试者的随访数据。基线时有40例被诊断为IFG，366例空腹血糖正常（<6.1mmol/L）。在随访期间有54例受试者被诊断为糖尿病。糖尿病的累计发病率为13.3% （男性15.1%，女性12.8%，P>0.05），发病率为17.96/1000人年（男性20.69/1000人年，女性17.24/1000人年，P>0.05）。在366例空腹血糖正常的受试者中，糖尿病累计发病率和发病率分别为7.9%和10.58/1000人年。

 

    采用多因素logistic回归分析对年龄、性别、收缩压和甘油三酯进行校正后发现，BMI、腰围和空腹血糖是糖尿病的独立危险因素。预测所有受试者（n=406）发生糖尿病的空腹血糖ROC曲线下面积为0.817（95%CI：0.776~0.854）。且当空腹血糖截点为≥5.58mmol/L时，预测糖尿病的灵敏度(75.9%) 和特异性 (83.8%) 均最高。

 

    该研究提示，我国55岁以上人群的糖尿病发病率较高，空腹血糖、腰围和BMI是该类人群发生糖尿病的独立危险因素。空腹血糖≥5.6mmol/L可能是一个很好的糖尿病预测指标。

【研究摘要】

Abstract Number:	1376-P
Title:	Incidence and Risk Factors of Diabetes among Chinese Subjects Aged Over 55 Years: A Community-based Study（中国55岁以上人群糖尿病的发病率和危险因素：一项基于社区的研究）
Authors:	SHUO LIN, LI HU, XIAOFENG LI, YANMING CHEN, BILIAN ZHU, SHENGQING HE, XIXIANG TANG, PANWEI MU, LONG-YI ZENG, Guangzhou, China
Abstract:	This study aims to explore the incidence and risk factors of diabetes among subjects over 55 years old in Shipai community (a typical village in Guangzhou, China). Three surveys conducted in this community were used to explore the incidence and risk factors of diabetes in this population. Non-diabetic subjects (n=547) in survey 2002 were used as baseline population. The glucose status of these population were determined in 2007 and 2010. Incidence of diabetes were defined as fasting plasma glucose (FPG)≥7.0mmol/l or 2h-PG during OGTT or diagnosed with diabetes by doctors. Diagnosis of impaired fasting glucose (IFG) were made by 1999 WHO criteria. A total of 406 non-diabetic subjects (74.2%) had follow-up data. Of them, 40 subjects (78.4%) were identified as IFG at baseline, and 366 subjects(73.8%)were with normal FPG (<6.1mmol/l). Fifty four subjects were diagnosed as diabetes during follow-up. The cumulative incidence of diabetes were 13.3% (15.1% in male and 12.8% in female, P>0.05), while the incidence rate of diabetes were 17.96/1000 person years(20.69/1000 person years in male and 17.24/1000 person years in female, P>0.05). Among 366 subjects with normal FPG, the cumulative incidence and incidence rate of diabetes were 7.9% and 10.58/1000 person years. By multivariate logistic regression, after adjusted by age, sex, systolic pressure and triglycerides, body mass index(BMI), waist circumference and FPG were independent risk factors of diabetes. The area under ROC curve is 0.817(95%CI 0.776-0.854)for FPG in predicting incidence of diabetes among all subjects (n=406). An FPG cut point of ≥5.58mmol/l yielded the highest combination of sensitivity (75.9%) and specificity (83.8%) for predicting diabetes. These results suggested the incidence of diabetes in subjects over 55 years old was high; FPG, waist circumference and BMI were independent risk factors of diabetes in this population. FPG ≥5.6mmol/l may be a good predicting index of incidence of diabetes in this population.