基于人群的2017-2019年中国儿童自我报告的小儿糖尿病患病率及未确诊2型糖尿病筛查的横断面研究

IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES The Lancet Regional Health: Western Pacific Pub Date : 2024-09-18 DOI:10.1016/j.lanwpc.2024.101206
Wei Wu , Jian-Wei Zhang , Yangxi Li , Ke Huang , Rui-Min Chen , Mireguli Maimaiti , Jing-Si Luo , Shao-Ke Chen , Di Wu , Min Zhu , Chun-Lin Wang , Zhe Su , Yan Liang , Hui Yao , Hai-Yan Wei , Rong-Xiu Zheng , Hong-Wei Du , Fei-Hong Luo , Pin Li , Ergang Wang , Jun-Fen Fu
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引用次数: 0

摘要

背景全世界糖尿病发病率的地域和时间差异是一个挑战,但也是获得病因学见解的一个机会。中国是东亚人的聚居地,东亚人在世界人口中占很大的比例,因此,中国可以为糖尿病流行病学研究提供有价值的信息,尤其是在病理生理学开始的生命早期。我们于 2017 年至 2019 年在中国开展了一项全国性的流行病学调查--"青少年肥胖和糖尿病患病率及风险"(Prevalence and Risk of Obesity and Diabetes in Youth,PRODY),以估算已确诊小儿糖尿病的人群患病率,并筛查未确诊的小儿 2 型糖尿病(T2D)。方法PRODY是一项基于学校人群的全国性横断面多中心调查,通过问卷调查、空腹尿糖检测和简易口服葡萄糖耐量试验(s-OGTT)等方法,对来自全国12个省份的193,801名3-18岁普通人群儿童和青少年(覆盖儿科人口超过9,680万)进行了调查。研究分析了自我报告的儿童糖尿病患病率、亚型比例、普通青少年人群中未确诊的 T2D 和糖尿病前期的粗患病率以及 1 型糖尿病(T1D)和 2 型糖尿病(T2D)的主要危险因素。研究结果所有自我报告的儿童糖尿病患病率估计为 0.62/1000 (95% CI: 0.51-0.74),其中 T1D 为 0.44/1000 (95% CI: 0.35-0.54),T2D 为 0.18/1000 (95% CI: 0.13-0.25)。就未确诊的 T2D 而言,粗略患病率几乎高出 10 倍,为 1.59/1000,通过 s-OGTT 筛查,估计未确诊的糖耐量受损 (IGT) 和未确诊的空腹血糖受损 (IFG) 分别增加了 28.45/1000 和 53.74/1000。母体糖尿病史是中国所有亚型儿童糖尿病的主要危险因素。 解读:PRODY 研究首次基于人群估计了中国儿童糖尿病的患病率,并揭示了未确诊儿童 T2D 问题的严重性。基金资助国家重点研发计划、浙江省重点研发计划、国家自然科学基金、浙江省医学重点学科、浙江省重点研发计划项目。
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Population-based prevalence of self-reported pediatric diabetes and screening for undiagnosed type 2 diabetes in Chinese children in years 2017–2019, a cross-sectional study

Background

The worldwide geographical and temporal variation in the prevalence of diabetes represents a challenge, but also an opportunity for gaining etiological insights. Encompassing the bulk of East Asians, a large and distinct proportion of the world population, China can be a source of valuable epidemiological insights for diabetes, especially in early life, when pathophysiology begins. We carried out a nationwide, epidemiological survey of Prevalence and Risk of Obesity and Diabetes in Youth (PRODY) in China, from 2017 to 2019, to estimate the population-based prevalence of diagnosed pediatric diabetes and screen for undiagnosed pediatric type 2 diabetes (T2D).

Methods

PRODY was a nation-wide, school population-based, cross-sectional, multicenter survey by questionnaire, fasting urine glucose test and simple oral glucose tolerance test (s-OGTT), among a total number of 193,801 general-population children and adolescents (covered a pediatric population of more than 96.8 million), aged 3–18, from twelve provinces across China. The prevalence of the self-reported pediatric diabetes, the proportion of subtypes, the crude prevalence of undiagnosed T2D and prediabetes in general juvenile population and the main risk factors of type 1 (T1D) and type 2 (T2D) diabetes had been analyzed in the study.

Findings

The prevalence of all self-reported pediatric diabetes was estimated at 0.62/1000 (95% CI: 0.51–0.74), with T1D at 0.44/1000 (95% CI: 0.35–0.54) and T2D at 0.18/1000 (95% CI: 0.13–0.25). For undiagnosed T2D, the crude prevalence was almost ten-fold higher, at 1.59/1000, with an estimated extra 28.45/1000 of undiagnosed impaired glucose tolerance (IGT) and 53.74/1000 of undiagnosed impaired fasting glucose (IFG) by s-OGTT screening. Maternal diabetes history is the major risk factors for all subtypes of pediatric diabetes in China.

Interpretation

The PRODY study provides the first population-based estimate of the prevalence of pediatric diabetes China and reveals a magnitude of the problem of undiagnosed pediatric T2D. We propose a practical screening strategy by s-OGTT to address this serious gap.

Funding

The National Key Research and Development Programme of China, Key R&D Program of Zhejiang, the National Natural Science Foundation of China and the Zhejiang Provincial Key Disciplines of Medicine, Key R&D Program Projects in Zhejiang Province.

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来源期刊
The Lancet Regional Health: Western Pacific
The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health
CiteScore
8.80
自引率
2.80%
发文量
305
审稿时长
11 weeks
期刊介绍: The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.
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