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山东大学学报(医学版) ›› 2012, Vol. 50 ›› Issue (4): 19-23.

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山东省18~69岁常住居民糖尿病筛查的人体测量指标适宜切点分析

陈希1,郭晓雷2,马吉祥3,唐俊利2,鹿子龙2,张吉玉2,张高辉1,徐爱强1,2   

  1. 1.山东大学公共卫生学院流行病与卫生统计研究所, 济南 250012;
    2.山东省疾病预防控制中心, 济南 250014; 3.中国疾病预防控制中心慢病中心, 北京 102206
  • 收稿日期:2012-01-08 出版日期:2012-04-10 发布日期:2012-04-10
  • 通讯作者: 徐爱强(1963- ),男,主任医师,硕士生导师,主要从事慢性非传染性疾病流行病学研究。 E-mail: aqxuepi@163.com
  • 作者简介:陈希(1986- ),女,硕士研究生,主要从事慢性非传染性疾病预防与控制的研究。

Analysis of anthropometric cut points for screening diabetes mellitus
among residents aged 1869 in Shandong Province

CHEN Xi1, GUO Xiao-lei2, MA Ji-xiang3, TANG Jun-li2, LU Zi-long2,
ZHANG Ji-yu2, ZHANG Gao-hui1, XU Ai-qiang1,2   

  1. 1. Institute of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan 250012, China;
    2. Shandong Center for Disease Control and Prevention, Jinan 250014, China;
    3. Chronic Disease Center, Chinese Center for Disease Control and Prevention, Beijing 102206, China
  • Received:2012-01-08 Online:2012-04-10 Published:2012-04-10

摘要:

目的   评价人体测量指标筛检糖尿病(DM)的价值及各测量指标最佳切点,为山东省DM疾病筛查和健康教育宣传提供科学依据。方法   采用多阶段分层整群随机抽样,对15350名18~69岁山东省常住居民进行DM筛查,其诊断采用WHO标准。同时测量身高、体质量、腰围、臀围及空腹血糖,并利用受试者工作特征曲线(ROC)计算曲线下面积(AUC)和不同切点下筛检DM的灵敏度、特异度及约登指数,以约登指数最大的点为最佳切点值,并对最佳切割点及其邻近点值进行筛检的一致性分析。结果   本次共筛查出DM病例794例,患病率为 4.59%。山东省居民人体测量指标和糖尿病患病率均有随年龄增加而增大的趋势,此趋势在女性中尤为明显。男、女性各人体测量指标AUC差异均有统计学意义(P均<0.001)。腰臀比(WHR)筛检DM的AUC最大,与体质量指数(BMI)比较有统计学意义(P<0.05)。男女之间AUC大小差异无统计学意义(P均>0.05)。男性BMI、腰围和WHR筛检DM的最佳切割点分别为25kg/m2、91cm和0.92,女性分别为25kg/m2、83cm和0.87,其筛检DM的约登指数最大,且筛检的一致性最好。结论   BMI、腰围和WHR对DM均具有较好的筛检价值,且一致性好,上述切割点可作为山东省居民筛检DM和确定DM高危人群的重要参数。

关键词: 人体测量指标;切点值;糖尿病;山东省居民

Abstract:

Objective   To explore the value and the optimal cut points of the anthropometric indexes to screen diabetes mellitus(DM), and to provide scientific evidence for DM screening and health education of the risk population in Shandong Province. Methods   Using the multistage stratified cluster random sampling method, 15,350 residents aged 16 to 69 in Shandong Province were screened for DM defined by WHO criteria of 1999, and physically examined on height, weight, WC and hip circumference. The curves of receiver operating characteristic (ROC) were used to calculate the area under the curve (AUC), the sensitivity, the specificity and Youden indexes. Optimal cut points were determined by the maximum of Youden indexes. Optimal cut points and adjacent points were computed by consistency analysis. Results   794 cases were found with DM, and the prevalence was 4.59%. The anthropometric indexes and DM prevalence rates increased with age, and this trend was particularly obvious in females. The AUCs for both males and females had significant meaning (P<0.001). The AUC of WHR was the maximum, and had significant difference compared with BMI (P<0.05). But there were no significant differences in AUCs between the males and females(P>0.05). The cut points of BMI, WC and WHR for men were 25kg/m2, 91cm and 0.92 respectively. The cut points of BMI, WC and WHR for women were 25kg/m2, 83cm and 0.87 respectively, and they had the best consistency for screening DM. Conclusion   BMI, WC and WHR are effective indicators for DM screening, and have good consistency. The optimal cut points can be used for screening DM and defining the risk population of DM in Shandong Province.

Key words: Anthropometric indexes; Cut points; Diabetes mellitus; Residents of Shandong province

中图分类号: 

  • R181.2
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