1996~2016年中国≥20岁成年人2型糖尿病患病率meta分析

Meta-analysis of prevalence of type 2 diabetes mellitus in adult Chinese from 1996 to 2016

摘要:

目的 采用meta分析方法系统评价1996年1月至2016年10月中国≥20岁成年人2型糖尿病(T2DM)患病率的变化趋势。方法 系统检索中国知网(CNKI)、维普中文期刊全文数据库、EMbase、Cochrane及Pubmed中与1996~2016年中国≥20岁成年人T2DM患病率相关的文献,采用CMA 2.2软件,利用I²衡量文献研究内容的异质性,运用固定效应模型或随机效应模型合并分析T2DM总体患病率及不同特征间T2DM患病率差异。结果 本研究最终纳入相关文献30篇,文献总体质量较好。Meta分析显示,1996~2016年中国≥20岁成年人T2DM总体患病率为6.6%(95%CI 5.5~7.9)。不同年龄段比较:20~39岁、40~59岁及≥60岁中国成年人T2DM患病率分别为1.7%(95%CI 1.2~2.2)、6.7%(95%CI 5.2~8.6)和14.7%(95%CI 12.2~17.7),差异有统计学意义(P＜0.05)。不同地区比较:城市与农村T2DM患病率分别为6.8%(95%CI 5.0~9.3)和3.7%(95%CI 2.4~5.6),差异无统计学意义(P＞0.05)。不同性别比较:男性与女性T2DM患病率分别为6.3%(95%CI 5.0~7.8)和6.3%(95%CI 5.3~7.4),差异无统计学意义(P＞0.05)。不同经济带比较:中部、西部和东部经济带T2DM患病率分别为3.2%(95%CI 2.5~4.2)、5.9%(95%CI 4.3~7.9)和6.5%(95%CI 5.1~8.1),中部经济带显著低于西部和东部地区,差异有统计学意义(P＜0.05),但东西部经济带之间T2DM患病率差异不明显。不同教育程度比较:小学及以前、中学、大专及以后T2DM患病率分别为6.9%(95%CI 4.4~10.7)、4.6%(95%CI 3.3~6.4)和4.3%(95%CI 2.9~6.4),随教育程度增加,T2DM患病率有下降趋势,但差异无统计学意义(P＞0.05)。结论 1996~2016年中国≥20岁成年人T2DM患病率随年龄增加而升高,中部地带低于东西部地带。可根据人口及地区特征进一步加强对T2DM的预防和控制措施。

Abstract:

Objective To systematically evaluate the prevalence of type 2 diabetes mellitus (T2DM) by meta-analysis in adult Chinese aged 20 years or over from January 1996 to October 2016. Methods A systematic literature search was conducted in China National Knowledge Internet(CNKI), VIP Chinese Journal Database (VIP), EMbase, Cochrane and Pubmed for the prevalence of T2DM among adult Chinese aged over 20 years from January 1996 to October 2016. I² test for heterogeneity among studies was performed using Comprehensive Meta-analysis (CMA, version 2.2). Fixed effect model or random effect model was employed to analyze the overall prevalence of T2DM and the differences between different population groups. Results A total of 30 pertinent articles were selected for the final analysis, with overall quality of the literature being good. The prevalence of T2DM in adult Chinese was 6.6%(95%CI 5.5-7.9). In terms of age, the prevalence was 1.7%(95%CI 1.2-2.2) among those aged 20-39, 6.7%(95%CI 5.2-8.6) among those aged 40-59, and 14.7%(95%CI 12.2-17.7) among those aged over 60 years, the difference being statistically significant (P＜0.05). In terms of locality, the prevalence was 6.8%(95%CI 5.0-9.3) in the urban areas as against 3.7%(95%CI 2.4-5.6) in the rural areas with no significant difference (P＞0.05). In terms of gender, the prevalence was 6.3%(95%CI 5.0-7.8) in men and 6.3%(95%CI 5.3-7.4) in women, with no significant difference (P＞0.05). In terms of economic zone, the prevalence was 3.2%(95%CI 2.5-4.2) in central economic zone, 5.9%(95%CI 4.3-7.9) in the western economic zone, and 6.5% (95%CI 5.1-8.1) in the eastern economic zone, that in central economic zone being significantly lower than that in western and eastern economic zones (P<0.05). However, there was no significant difference between the eastern and western zones (P＞0.05). In terms of educational level, the prevalence was 6.9%(95%CI 4.4-10.7) in those with an education of primary school and before, 4.6%(95%CI 3.3-6.4) in those with an education of secondary school, and 4.3%(95%CI 2.9-6.4) in those with an education of tertiary institution and beyond. The prevalence of T2DM decreased with the level of education, but there was no significant difference (P>0.05). Conclusion From 1996 to 2016, the prevalence of T2DM in adult Chinese aged 20 years and over increased with age and was lower in the central part of China than in the eastern and western parts. Measures for prevention and control of T2DM should be further strengthened according to the demographic and regional characteristics.