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来自《柳叶刀》的惊人数据:全世界有约三万万五千万人患糖尿病

(2011-08-11 20:15:16) 下一个

个国际研究小组与世界卫生组织(WHO)合作进行了一个研究,结果显示全球成年人患糖尿病的人数比三十年前翻了一番,为3亿4千7百万人。这个发表在《柳叶刀》(The Lancet)上的文章揭示在过去三十年里,世界各地的患糖尿病的人数都有所增加或保持不变。

研究发现中国有1亿3千8百万人患糖尿病,而美国有3千6百万人。在高收入国家中,美国,格陵兰,马耳它,新西兰,和西班牙的糖尿病发生率最高。荷兰,澳大利亚,和法国的糖尿病发生率最低。


Background

Data for trends in glycaemia and diabetes prevalence are needed to understand the effects of diet and lifestyle within populations, assess the performance of interventions, and plan health services. No consistent and comparable global analysis of trends has been done. We estimated trends and their uncertainties in mean fasting plasma glucose (FPG) and diabetes prevalence for adults aged 25 years and older in 199 countries and territories.

Methods

We obtained data from health examination surveys and epidemiological studies (370 country-years and 2·7 million participants). We converted systematically between different glycaemic metrics. For each sex, we used a Bayesian hierarchical model to estimate mean FPG and its uncertainty by age, country, and year, accounting for whether a study was nationally, subnationally, or community representative.

Findings

In 2008, global age-standardised mean FPG was 5·50 mmol/L (95% uncertainty interval 5·37—5·63) for men and 5·42 mmol/L (5·29—5·54) for women, having risen by 0·07 mmol/L and 0·09 mmol/L per decade, respectively. Age-standardised adult diabetes prevalence was 9·8% (8·6—11·2) in men and 9·2% (8·0—10·5) in women in 2008, up from 8·3% (6·5—10·4) and 7·5% (5·8—9·6) in 1980. The number of people with diabetes increased from 153 (127—182) million in 1980, to 347 (314—382) million in 2008. We recorded almost no change in mean FPG in east and southeast Asia and central and eastern Europe. Oceania had the largest rise, and the highest mean FPG (6·09 mmol/L, 5·73—6·49 for men; 6·08 mmol/L, 5·72—6·46 for women) and diabetes prevalence (15·5%, 11·6—20·1 for men; and 15·9%, 12·1—20·5 for women) in 2008. Mean FPG and diabetes prevalence in 2008 were also high in south Asia, Latin America and the Caribbean, and central Asia, north Africa, and the Middle East. Mean FPG in 2008 was lowest in sub-Saharan Africa, east and southeast Asia, and high-income Asia-Pacific. In high-income subregions, western Europe had the smallest rise, 0·07 mmol/L per decade for men and 0·03 mmol/L per decade for women; North America had the largest rise, 0·18 mmol/L per decade for men and 0·14 mmol/L per decade for women.

Interpretation

Glycaemia and diabetes are rising globally, driven both by population growth and ageing and by increasing age-specific prevalences. Effective preventive interventions are needed, and health systems should prepare to detect and manage diabetes and its sequelae.


REF:Goodarz Danaei MD, Mariel M Finucane PhD, Yuan Lu MSc, Gitanjali M Singh PhD, Melanie J Cowan MPH, Christopher J Paciorek PhD, John K Lin AB, Farshad Farzadfar MD, Prof Young-Ho Khang MD, Gretchen A Stevens DSc, Mayuree Rao BA, Mohammed K Ali MBChB, Leanne M Riley MSc, Carolyn A Robinson MSc, Prof Majid Ezzati PhD, on behalf of the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Glucose). National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participants. The Lancet, Volume 378, Issue 9785, Pages 31 - 40, 2 July 2011

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