流行病学-精通糖尿病学

糖尿病的流⾏特点✓✓✓✓✓WeCare,WeShareWeCare,WeShareHUSL,LIUGN,XUZR,etal.ChineseHealthEconomics,2008,27(8):05-08YangW,LuJ,WengJ,etal.NEnglJMed.2010,362(12):1090-1011.:1090-101.0%10%198019941996200220083.21%0.67%()92402012IDFChinaWeCare,WeShareWeCare,WeShare2012IDF0%12%19801986199420022008201011.60%9.70%4.50%2.28%1.04%0.67%(%)()1.13YangWY,etal.NEnglJMed.2010;362:1090-101.YuXu,etal.JAMA.2013;310(9):948-958.9%-12%6%-9%4%-6%2%-4%11.6%30.1%39.7%50.1%5.1%26.5%40.8%30.5%9%-12%9%≥15%12%-15%9%-12%6%-9%4%-6%2%-4%9%-12%6%-9%4%-6%2%-4%CDC1621531JAMA2013DiabetesCare2013JACC2015LancetDiabetesEndo2015LillyDiabetesCompanyConfidential©2012EliLillyandCompanyLillyDiabetesCompanyConfidential©2012EliLillyandCompany2011
8.3%232011:52802030:642032011:32602030:597032011:71402030:1.232011:25102030:399032011:14.7million2030:28.0million32011:131902030:1879020309.9%132011:37702030:51201.IDF.://://©2012EliLillyandCompanyLillyDiabetesCompanyConfidential©2012EliLillyandCompany2011IGT
6.4%11.IDF.:IDF.://://://://://://:36902030:472042011:23902030:410072011:23802030:386062011:15102030:226022011:32802030:632082011:84902030:114102030IGT7.1%.132011:63002030:7150LillyDiabetesCompanyConfidential©2012EliLillyandCompanyLillyDiabetesCompanyConfidential©2012EliLillyandCompany0.002.505.007.5010.0019801994199620022008(%)WHO1985WHO1985WHO1999WHO199930214.3104.625-6420-74≥18≥200.67%2.28%3.12%4.5%1.8%9.7%10.6%8.8%DiabetesAtlas,Fourthedition©InternationalDiabetesFederation,2009;.2008;24:2a:1-22.YangWY,etal.NEnglJMed2010;362:1090-1101.;20102:p12,downloadedfrom糖尿病患病率随年龄增⻓⽽增加0.05.511.016.522.03.211.520.4糖尿病患病率%年龄岁YangW,etal.NEnglJMed2010;362:1090-1101.WeCare,WeShareBMI3025-29.918.5-24.918.50.05.010.015.020.04.57.612.818.5(%)BMIYangW,etal.NEnglJMed2010;362:1090-1101.国糖尿病患病率，城镇⾼于农村0.003.006.009.0012.008.2011.4糖尿病患病率(%)YangW,etal.NEnglJMed2010;362:1090-1101.IGT患病率，%1.YangWetal.NEnglJMed2010;362:1090–11012.IDF.Diabetesatlas,sixthedition.IDF,2013IGT国IGT的患病率⾼于IFG0.02.85.58.311.02.23.210.911.0IGTIFG患病率(%)YangW,etal.NEnglJMed2010;362:1090-1101.WeCare,WeShare成⼈新诊断糖尿病：IPH占46.6％男性：IPH患病率2.9%N=46,239IPH(IsolatedPostchallengeHyperglycemia)IPH44％PH/FH36％IFH20％⼥性：IPH患病率2.6%IPH50％PH/FH35％IFH15％YangWY.etal.NEnglJMed.2010Mar25;362(12):1090-1012hmmol/L0.05.010.015.020.014.413.515.914.8YangW,etal.NEnglJMed362:1090-1101March25,2010WeCare,WeShareWeCare,WeShare1.AmericanDiabetesAssociation.EconomicCostsofDiabetesintheU.S.in2007.DiabetesCare2008;31:1–20.2.✴,✴••/ICUWeCare,WeShareWeCare,WeShare1.UmpierrezG,etal.JClinEndocrinolMetab.2002;87:978-982;2LevetanCS,etal.DiabetesCare.1998;21:246;3KrinsleyJS.MayoClinProc.2003;78:1471-1478;4FalcigliaM,etal.AbstractPresentedat:AmericanDiabetesAssociation66thAnnualScientificSessions;June11,2006;Washington,DC.Abstract19-LB.✓38%✓ICU:29%-100%✴110mg/dL100%✴200mg/dL31%✴145mg/dL39%11/11/1511/11/15•••“”•7.8mmol/LUmpierrezGE1886UmpierrezGE,etal.JClinEndocrinolMetab2002;87:978–982...200612:815-818.1015202530NGTIFGIGTIFG+IGTDM27.915.522.911.522.2OGTTn=433（n=3,513）80%FPGDMDMOGTTDMI-IFG(5.6mmol/L)I-IGTIGT+IFGNGTFBG86.713.46.1mmol/L≥6.1mmol/L17.236.346.57.8mmol/L≥7.8mmol/L11.1mmol/L≥11.1mmol/LPBG⾼⾎压患者⼤多合并⾼⾎糖MatzK.DiabetesCare.2006Apr;29(4):792-7.20%20%1%23%16%20%DMDMIGTIFGNGT206YangWY,etal.NEnglJMed2010;362:1090-101.60.739.3男性女性InternationalJournalofObesity(2010)34,332–339;DECODA和DECODE研究，横断面调查，入选24515例男性和29952例女性，既往未诊断糖尿病，测量基线BMI，并进行OGTT检查诊断糖尿病DECODA/DECODEBMIAmJClinNutr2007;86:353–9.M-CHAT研究入选822例健康志愿者，来自加拿大土著、中国、欧洲和南亚，分析不同种族人群内脏脂肪差异男性女性BMI确诊糖尿病时已合并大血管并发症的患者比例确诊糖尿病时已合并微血管并发症的患者比例QJM.2002Apr;95(4):241-6.入选新诊断的早发2型糖尿病患者292例，年龄40岁，受试者接受大血管（包括CVD危险因素）、微血管疾病（视网膜、肾、神经病变）检查，比较南亚和欧洲人群合并糖尿病并发症的差异。p0.001p0.001QJM.2002Apr;95(4):241-6.入选新诊断的早发2型糖尿病患者292例，年龄40岁，受试者接受大血管（包括CVD危险因素）、微血管疾病（视网膜、肾、神经病变）检查，比较南亚和欧洲人群CVD风险。绝对心血管并风险*，%p0.001*Framingham风险评估，10年CVD事件发生风险❿2010391684❿47528.2%39.5%475/1204❿47565.9%66130❿50.1%74.8%28.4%25.9%