Prevalence of impaired glucose metabolism and potential predictors: a rapid appraisal among ≥45 years old residents of southern Tajikistan 葡萄糖代谢受损的患病率以及潜在的预测因子：一项针对塔吉克斯坦南部年龄 ≥45岁居民的快速评估

Background An estimated 2% of all deaths in Tajikistan can be attributed to diabetes but reliable data are scarce for the country and across Central Asia. We assessed the prevalence of impaired glucose tolerance and diabetes and associated predictors among residents aged ≥45 years in two districts in southern Tajikistan. Methods A population-representative survey following the WHO STEPwise approach to surveillance and including a two-stage cluster sampling was conducted. Enrolled participants were asked about risk factors for diabetes, and blood pressure, height and weight were measured. The blood glucose level was determined after overnight fasting, and the 2 h oral glucose tolerance test was performed if indicated. Results Complete datasets were available for 584 out of 672 study participants. One third of the cohort was male and half were 45–54 years old. Overall, 21.2% of the participants were found to be diabetic, 5.1% had impaired glucose tolerance and 4.3% impaired fasting glucose. An elevated body mass index ≥25 was observed in 61.5% of the cohort and an elevated blood pressure in 45.6% (systolic, cut-off 140 mm Hg) and 52.3% (diastolic, cut-off 90 mm Hg) respectively. Half of the participants classified as diabetic were aware of their status. Conclusions Impaired glucose tolerance and overweight are common among elderly residents of southern Tajikistan. Primary health care services should be strengthened to improve early detection and ensure adequate treatment of diabetes and quality of care. Community-based awareness rising about available peripheral services is crucial. 摘要 背景： 据估计在塔吉克斯坦所有的死亡中有2%要归咎于糖尿病，但是对于国家以及整个中亚地区来说还缺乏可靠的数据。我们在塔吉克斯坦南部的2个地区中评估了年龄 ≥45岁居民的葡萄糖耐量受损与糖尿病的患病率以及相关的预测因子。 方法： 在一个有代表性的人群中使用WHO逐步监测法进行调查，包括两个阶段的整群抽样。向入组的参与者询问糖尿病相关的危险因素，并且测定了血压、身高与体重。测定隔夜后的空腹血糖水平，如果有指征就进行2小时口服葡萄糖耐量试验。 结果： 在672名参与者中获得了584人的完整数据集。三分之一为男性并且有一半人的年龄为45–54岁。总的来说，发现21.2%的参与者有糖尿病，5.1%为葡萄糖耐量受损，而4.3%为空腹葡萄糖受损。发现有61.5%的人群体重指数升高 ≥25，并且分别有45.6%（收缩压，阈值为140 mmHg）与52.3%（舒张压，阈值为90 mmHg）的人群血压升高。有一半被诊断为糖尿病的参与者知道他们自己的情况。 结论： 在塔吉克斯坦南部老年居民中葡萄糖耐量受损与超重都很常见。应该加强初级卫生保健服务以提高糖尿病的早期检测率，确保患者能够得到适当的治疗并且提高护理质量。提高社区意识提供外围服务是关键。