A Study Of Prevalences And Risk Factors Of Type 2 Diabetes And Its Complications In Tianjin

Objects: To investigate the prevalence of type 2 diabetes and its complications inTianjin. At the same time to analyze the risk factors for the development of type 2diabetes.Methods: A cross-sectional study was conducted in Tianjin from June toSeptember in 2005. The multi-phasic stratified cluster sampling method wasadapted. All the populations were divided into 3 strata, higy, middle and low byGDP of various districts. Then one district of each stratum was randomly selectedas sampling frame. Next step was almost the same to select the community byGDP. Finally 21454 people (9986 males, 10755 females) were selected as surveysample.Information on risk factors was collected through face-to-facequestionnaire interview, and information of fasting glucose level and physicalexamination was collected at the same time. The 2h post prandial blood glucoseand complications diagnostic examination was conducted among the populationwhich FBG≥6.1 mmol/L. In this study, DN is diagnosed by urine UMA test(≥30mg/24h), DR by ophthalmofundoscopy, diabetes complicated with CHD byelectrocardiogram test, diabetes complicated with hypertension by hypertensionhistory interview and blood pressure measurement while diabetes complicatedwith cere-brovascular disease by history interview. Then the prevalence ofdiabetes, IFG, IGT and complications is calculated. Unconditional Logisticregression model was used to analyze the risk factors for the development of type2 diabetes. And multivariate Logistic regression was used to analyze the 28 variables directly in comparison with the model which modified by the principalcomponent analysis, factor analysis and K-Mean Cluster analysis.Results: In this study, the prevalence of type 2 diabetes based on the criterion ofFBG≥6. lmmol/L is 11.68% (standardized prevalence: 11.17%), in which theprevalence in male is 10.43%(standardized prevalence: 9.84%) and in female is12.84%(standardized prevalence: 12.17%). And the prevalence of type 2 diabeteswhich based on the criterion of FBG≥7.0mmol/L is 6.07% (standardizedprevalence: 5.87%), in which the prevalence in male is 5.12%(standardizedprevalence:4.83%) and in female is 6.95%(standardized prevalence: 6.59%). Andboth of the prevalence in female is higher than the male.The prevalence of IFG in the population is 5.61% (5.32% in male, 5.89% infemale). The prevalence of IGT is 2.91% (2.59% in male, 3.20% in female),andthe prevalence of female is statistic significantly higher than male.The prevalence of five complications in a descending sort is: type 2 diabetescomplicated with CHD (prevalence: 46.65%, and 35.96% in male, 54.12% infemale), and the prevalence in female is significantly higher than the male; type 2diabetes complicated with hypertension (prevalence 27.25%, and 25.84% in male,28.24% in female); DN(prevalence:18.24%, and 20.22% in male,16.86% infemale); DR( prevalence: 8.89%, and 8.71 in male, 9.02% in female); type 2diabetes complicated with cerebrovascular disease( prevalence: 0.58%, and 0.56inmale, 0.59 in female).The Logistic regression analysis shows that the risk factors for type 2 diabetes are: higher educational level, higher total income level of the family, Engelcoefficient, alcohol assumption, tea drinking, higher level of BMI and WHR,intake more carbohydrate, fruits, milk and bean food, character trait of type A,history of injury and family history of diabetes. And intake more meat is also arisk factor after controlled by age, education level, occupation, total income of thefamily, Engel coefficient and income of single person. And the protective factorsare: physical labour occupation, more physical exercise, regular dinner and intakemore vegetables. Breakfast is also a protective factor when controlled by age,educational level, occupation and three variant for income.The result of multivariate logistic regression which modified by the principalcomponent analysis, factor analysis and K-Mean Cluster analysis shows that therisk factors for type 2 diabetes are: the factor of obesity, the factor of educationallevel and habits, the factor of income level, and the factor of family history ofdiabetes; while the protective factors are: the factor of good dietetic habits, thefactor of intake more vegetables and fruits and intake more carbohydrate togetherwith the factor of character and occupation. At the same time, the result ofmultivariate Logistic regression of 28 variant directly suggests that the risk factorsfor type 2 diabetes are: intake more bean food and meat, older, alcohol asstimption,higher level of education and family history of diabetes; while the protectivefactors including: regular dinner, physical labour occupation, intake morevegetables and more physical, exercise. The two results of multivariate Logisticanalyze are similar. Conclusions: This study suggests that the prevalence of type 2 diabetes and IGT,IFG and also the complications in Tianjin are similar to the level of the other bigcities in China. And the study also suggests that the intake more bean food andmeat, older, alcohol assumption, higher level of education, obesity and familyhistory of diabetes may increase the risk for type 2 diabetes while regular dinner,physical labour occupation, intake more vegetables and more physical exercisemay decrease the risk.