Objective:To explore the relationship between blood pressure and prediabetes in Chinese adults.Methods:A total of 6 846 subjects (normal blood glucose) aged 18 years or older who participated in the baseline survey of China Chronic Disease Surveillance Project in 2010 and the cohort follow-up from 2016 to 2017 with complete survey data were enrolled. The general data and laboratory indicators of the subjects were collected, including age, gender, education, urban and rural, income, regions, smoking, drinking, physical activity, insufficient intake of fruits and vegetables, excessive intake of red meat, height, weight, waistline, systolic blood pressure, diastolic blood pressure, blood lipids, fasting plasma glucose (FPG), 2-hours plasma glucose (2hPG) after 75 g oral glucose test. Body mass index (BMI) was calculated. According to the standard established by the World Health Organization in 1999, FPG<7.0 mmol/L and 7.8 mmol/L≤2hPG<11.1 mmol/L, and/or 6.1 mmol/L≤FPG<7.0 mmol/L and 2hPG<7.8 mmol/L are defined as prediabetes. According to the level of systolic blood pressure and diastolic blood pressure, the subjects were divided into normal blood pressure group (4 304 cases), isolated systolic hypertension (ISH) group (960 cases), isolated diastolic hypertension (IDH) group (277 cases) and systolic diastolic hypertension (SDH) group (1 305 cases). Chi-square test and F-test were used to compare the basic characteristics of different blood pressure, and unconditional Logistic regression model was used to analyze the relationship between blood pressure and prediabetes. Results:Among the 6 846 subjects, there were 2 936 males (42.9%) and 3 910 females (57.1%), aged (46.67±13.33) years. The average follow-up was 6.4 years. During the follow-up period, a total of 809 cases developed prediabetes, including 452, 147, 31 and 179 cases in normal blood pressure group, ISH group, IDH group and SDH group, respectively. Logistic regression analysis showed that after adjusting for age, gender, education, income, urban and rural, regions, physical activities, central obesity, smoking, drinking, inadequate intake of fruits and vegetables, excessive red meat intake, BMI and dyslipidemia, the risk of prediabetes in the ISH group was 45% (OR=1.45, 95%CI 1.11—1.90, P<0.05) higher than that in the normal blood pressure group,and the risk of prediabetes increased by 53% (OR=1.53, 95%CI 1.21—1.94, P<0.05) in the SDH group. However, there was no correlation between IDH group and the risk of prediabetes ( P>0.05). Conclusions:The risk of prediabetes in hypertensive people in China is increasing. Therefore this population, especially those with ISH and SDH, should be taken as the key intervention target in the future.

Objective:To explore the incidence and influencing factors of prediabetes in adults in China.Methods:Ten provinces (cities) were selected from the surveillance survey of chronic diseases and their risk factors in China in 2010; two monitoring sites were selected from each province (city) as follow-up spots, and a follow-up survey was conducted from 2016 to 2017. An unconditional logistic regression model was used to analyze the influencing factors of prediabetes.Results:A total of 5 578 participants were included in this study. During the follow-up period, 612 patients (268 males and 344 females) developed impaired glucose tolerone (IGT), with a total follow-up of 37 364.82 person-years, and the incidence of IGT was 16.4/1 000 person-years. Impaired fasting glucose (IFG) occurred in 290 patients (128 males and 162 females) with a total follow-up of 39 731.31 person-years, and the incidence of IFG was 7.3/1 000 person-years. The multivariate unconditional logistic regression model included age, urban and rural areas, family history of diabetes, BMI, central obesity, dyslipidemia, hypertension, and physical activity, and the results showed that age (≥50 years old: OR=1.60, 95% CI: 1.32-1.95), urban residents ( OR=1.41, 95% CI: 1.16-1.71), obesity ( OR=1.56, 95% CI: 1.12-2.19), dyslipidemia ( OR=1.52, 95% CI: 1.25-1.83), hypertension ( OR=1.32, 95% CI: 1.07-1.61) and physical inactivity ( OR=1.25, 95% CI: 1.04-1.50) increase the risk of IGT. Age (≥50 years old: OR=1.31, 95% CI: 1.01-1.70), family history of diabetes ( OR=1.71, 95% CI: 1.13-2.60), overweight ( OR=1.41, 95% CI: 1.04-1.92), obesity ( OR=2.09, 95% CI: 1.38-3.17) and hypertension ( OR=1.53, 95% CI: 1.18-2.00) increase the risk of IFG. Conclusions:The incidence of IGT is higher than the IFG. People aged 50 and above, overweight and obese people, hypertension patients, dyslipidemia patients, people with insufficient physical activity, and family history of diabetes are prone to prediabetic events.

目的 构建基本公共卫生服务项目2型糖尿病患者健康管理数据质量评价指标体系,为促进2型糖尿病患者健康管理服务提供科学适宜工具.方法 通过文献回顾国内外电子健康档案的数据质量评价维度及指标,结合2型糖尿病患者健康管理的工作需要和数据特点,构建具有针对性的数据质量评价指标体系;并利用2012年1月-2017年12月湖南湘潭某区和四川成都某区2型糖尿病患者健康管理项目数据对该指标体系进行应用可行性评价.结果 构建的基本公共卫生服务项目2型糖尿病患者健康管理数据质量评价指标体系包含数据的合理性、完整性和一致性3个维度共7个指标,通过实际应用发现该指标体系具有良好的应用可行性;2012年1月-2017年12月湖南湘潭某区和四川成都某区的2型糖尿病患者健康管理数据质量总体上较好,且近年来改善明显,但两地区数据仍存在数据格式不一致、重复录人和数据匹配率低等现实问题.结论 本研究构建的基本公共卫生服务项目2型糖尿病患者健康管理数据质量评价指标体系在实际应用中具有良好的适宜性和可操作性,建议将数据质量评价纳入常规工作中以发现患者管理过程中存在的问题.

目的 了解中国成人BMI和腹型肥胖与急性心肌梗死(acute myocardial infarction,AMI)的发病关系.方法 从2010年中国慢性病及危险因素监测中抽取11个省(市),再从中选择60个监测点作为随访点,并于2016-2017年进行随访调查,共随访到27 604人,数据清理后共26 794名调查对象纳入分析.采用Cox比例风险回归模型分析BMI和腹型肥胖与AMI发病的关系.结果 26 794名调查对象,平均随访6.0年,随访期间共观察到256例AMI事件.在调整相关混杂因素后,与腰围(waist circumference,WC)正常、BMI＜24 kg/m2组相比,腹型肥胖、BMI＜24 kg/m2组AMI的发病风险增加85％(HR=1.85,95％CI:1.14～3.01),腹型肥胖、BMI≥24 kg/m2组AMI 的发病风险增加 56％(HR=1.56,95％CI:1.11～2.18),而 WC 正常、BMI≥24 kg/m2组与AMI的发病风险无相关(HR=0.85,95％CI:0.49～1.47).结论 无论BMI值为多少,腹型肥胖都是AMI发病的重要危险因素.

Objective: To explore the relationship between body mass index (BMI), waist circumference (WC) and the risk for ischemic stroke in adults in China. Methods: A total of 36 632 adults were selected from 60 surveillance areas (25 urban surveillance areas and 35 rural surveillance areas) in China Chronic Disease Surveillance Project in 2010 for a follow up study from 2016 to 2017 based on the baseline data in 2010. The follow up was completed for 27 762 adults. Cox proportional hazard regression model was used to analyze the association of body mass index and waist circumference with the risk for ischemic stroke in different populations. The death and hypercholesterolemia cases were excluded by sensitivity analysis. Results: A total of 26 907 adults were included in the analysis. During the follow up period, 1 128 ischemic stroke events were observed (491 in men and 637 in women). After adjusting the related confounding factors and taking normal BMI/normal WC group as the reference, the risk for ischemic stroke increased by 50% in normal BMI/abdominal obesity group (HR=1.50, 95%CI:1.07-2.08), 51% in overweight/abdominal obesity group (HR=1.51, 95%CI:1.20-1.91), 46% in obesity/abdominal obesity group (HR=1.46, 95%CI:1.09-1.96), and 63% in normal BMI/abdominal obesity group (HR=1.63, 95%CI:1.12-2.38), 56% in overweight/abdominal obesity group (HR=1.56, 95%CI: 1.20-2.03) and 45% in obesity/abdominal obesity group (HR=1.45, 95%CI: 1.05-2.01) respectively in men and in men with CVD risk factors. There was no increased risks in the overweight/normal WC group. The risk increased by 40% in overweight/abdominal obesity group (HR=1.40, 95%CI:1.15-1.72) and 46% in obesity/abdominal obesity group (HR=1.46, 95%CI:1.16-1.83), and 35% in overweight/abdominal obesity group (HR=1.35, 95%CI:1.08-1.69) and 30% in obesity/abdominal obesity group (HR=1.30, 95%CI:1.01-1.67) respectively in women and women with CVD risk factors. There were no risk increases in overweight/normal WC group and normal BMI/abdominal obesity group. Sensitivity analysis results showed no change. Conclusion: Overweight/obesity with abdominal obesity or abdominal obesity alone could increase the risk for stroke in men, and overweight/obesity with abdominal obesity could increase the risk for ischemic stroke in women; suggesting that BMI and WC should be used jointly to evaluate obesity in population for weight control to prevent ischemic stroke.

Objective: To explore the relationship between self-rated health status and risk of stroke in Chinese adults. Methods: Data was collected from the Chronic Disease Risk Factor Surveillance in China (2010) as baseline. A total of 60 follow-up monitors (25 urban and 35 rural) in 11 provinces were selected. A total of 36 195 participants without prior cardiovascular diseases were followed and investigated 27 441 people in 2016 and 2017. Cox proportional hazard regression model was used to analyze the self-assessed health status and stroke onset hazard ratio (HR), further conducted several subgroup analyses by demographic characteristics such as age and gender, and sensitivity analysis was performed by excluding death and baseline diabetes. Results: A total of 26 699 study subjects were included according to the inclusion criteria. We identified 1 332 stroke cases (32 subarachnoid hemorrhage, 197 cerebral hemorrhage, and 1 149 cerebral infarction) during an average of 6.4 years (171 431.1 person-years) of follow-up, and the incidence density was 7.77/1 000 person-years. After adjusting the related factors, the risk of stroke in participants with poor self-related health increased by 68% (HR=1.68, 95%CI:1.22-2.32) and the risk of ischemic stroke increased by 47% (HR=1.47, 95%CI:1.05-2.05), with a reference of excellent ones. In subgroup analysis, only age and BMI had an effect-modifying effect on the association between self-rated health and risk of stroke. Only age and dyslipidemia had an effect-modifying effect on the association between self-rated health and ischemic stroke risk (interaction P<0.05). The results of the sensitivity analysis were consistent with the results of the total population. Conclusion: People with poor self-assessed health, especially for those who were overweight/obesity with poor self-assessed health or age less than 60 or dyslipidemia are at increased risk of stroke and ischemic stroke and should be targeted for intervention.

Objective: To analyze the association between waist-to-height ratio and the overall and type specific incidence of stroke in adults in China. Methods: A total of 36 632 people were selected from 60 surveillance sites (25 in urban area and 35 in rural area) in China Chronic Disease Surveillance Project in 2010. The China Chronic Disease Surveillance Project data in 2010 were used as baseline data. A total of 27 762 people were followed up from 2016 to 2017. Cox proportional risk regression model was used to analyze the risk ratio of waist-to-height ratio for the overall and type specific incidence of stroke. Subgroup analyses were performed based on baseline characteristics such as age and sex, and sensitivity analysis was performed by excluding those who died and those with diabetes at baseline survey. Results: A total of 27 112 subjects were included in the stroke analysis, and 1 333 stroke events were observed. A total of 26 907 subjects were included in the ischemic stroke analysis, and 1 128 ischemic stroke events were observed. A total of 25 984 subjects were included in the hemorrhagic stroke analysis, and 205 cases of hemorrhagic stroke were observed. After adjusting for relevant confounders and taking group with waist-to-height ratio of 0-0.45 as a reference, the stroke analysis indicated that in groups with waist-to-height ratio of 0.46-0.49, 0.50-0.54 and ≥0.55 the risk for stroke increased by 21% (HR=1.21, 95%CI:1.00-1.46), 26% (HR=1.26, 95%CI:1.04-1.53) and 60% (HR=1.60, 95%CI:1.29-1.99) respectively. Subgroup analysis revealed that age specific waist-to-height ratio had modification effect on the risk for stroke (interaction P=0.001). Ischemic stroke analysis indicated that in groups with waist-to-height ratio of 0.46-0.49, 0.50-0.54 and ≥0.55 the risk for ischemic stroke increased by 30% (HR=1.30, 95%CI: 1.05-1.60), 33% (HR=1.33, 95%CI: 1.07-1.64) and 61% (HR=1.61, 95%CI: 1.26-2.05) respectively. Subgroup analysis revealed that age specific waist-to-height ratio had modification effect on the risk for ischemic stroke (interaction P=0.024). Hemorrhagic stroke analysis indicated that in group with waist-to-height ratio of ≥0.55 the risk for hemorrhagic stroke increased by 73% (HR=1.73, 95%CI: 1.02-2.94), but the differences in the risk increase in groups with waist-to-height ratio of 0.46-0.49 and 0.50-0.54 were not significant. The sensitivity analysis showed no changes. Conclusions: In the prevention and control of stroke by body weight control, it is necessary to take waist to height ratio as one of the indicators of body weight control. Particular attention needed to be paid to the people aged <50 years with waist-to-height ratio of ≥0.55 as well as those with waist-to-height ratio of <0.5 (i.e., 0.46-0.49).

目的 探讨我国成人血脂水平与糖尿病前期及糖尿病的发病关系.方法 将2010年中国慢性病及其危险因素监测数据作为基线数据,从2010年监测点中选取8个省,每个省选择2个点作为随访点,排除糖尿病前期及糖尿病者,共7046人进入随访队列,并于2016-2017年进行随访调查,共随访到4886人.采用Cox比例风险回归模型分析总人群及不同性别下血脂水平与糖代谢异常发病关系.结果 共纳入4759名研究对象,随访期间糖尿病前期发病密度为26.1/1000人年,糖尿病发病密度为10.4/1000人年.多因素Cox分析结果显示,在总人群中,与TG＜0.77 mmol/L相比,0.77≤TG＜ 1.08 mmol/L糖尿病前期发病风险增加32％(HR=1.32,95％CI: 1.11～1.94,P＜0.05).与HDL-C ＜0.91 mmol/L相比,HDL-C≥1.31 mmol/L糖尿病前期发病风险降低30％(HR =0.70,95％CI:0.54～0.90,P＜0.05),P趋势检验＜0.05.与TG＜0.77 mmol/L相比,TG≥1.57 mmol/L糖尿病发病风险增加75％(HR=1.75, 95％CI: 1.07～2.52,P＜0.05),糖尿病发病风险随TC和TG的升高而显著上升.在男性中,糖尿病前期发病风险与TG、HDL-C呈剂量反应关系,糖尿病发病风险随TC升高而上升,均P趋势检验＜0.05.结论 TG升高、HDL-C降低可增加糖尿病前期发病风险,TC、TG升高可增加糖尿病发病风险,应采取针对性措施加强血脂异常和糖尿病的综合防治.

Objective: To explore the relationship between sedentary time and the incidence of type 2 diabetes in adults in China. Methods: Data collected from the Chinese Chronic Disease and Risk Factor Surveillance (CCDRFS) in 2010 were used as baseline data. Eight provinces where CCDRFS were conducted in 2010 were selected, and two surveillance spots (one in urban area and another one in rural area) of each provinces were further selected for the follow-up studies. After excluding diagnosed diabetes patients according to baseline data, a total of 8 625 of subjects were recruited as participants. In the follow up carried out from 2016 to 2017, a total of 5 991 people received complete follow up. Cox proportional hazards models were used to analyze the relationship between sedentary time and the incidence of type 2 diabetes, and subgroup analysis was conducted based on variables such as gender, geographic area, and urban area or rural areas. Results: A total of 5 782 subjects were included in final analysis. During an average 6.4 years of follow up (36 927.0 person-years), 592 participants developed type 2 diabetes, the incidence rate was 16.0 per 1 000 person years. Multivariate Cox regression analysis showed that after adjustment for possible confounders, compared with the 0.0-h/d group, the risk of diabetes incidence increased by 33% (HR=1.33, 95%CI: 1.05-1.68) for those who had sedentary time for more than 6.0 h every day. The subgroup analysis showed that the significant association was only observed in those who were men, current smokers, central obese, had family history of diabetes, had rural residency, and lived in eastern and central areas of China. Conclusions: Longer sedentary time can increase the risk of type 2 diabetes. Lifestyle intervention should be strengthened to reduce sedentary time, especially for people who had sedentary time for more than 6.0 h every day.

目的 了解2018年北京市朝阳区网络直报死亡报告的数据质量,为提高朝阳区死因监测资料质量提供依据.方法 对2018年朝阳区使用死因网络直报系统的医疗机构报告的23 691例死亡报告进行及时性和根本死因编码准确性评价,抽取4 303例死亡病例个案信息进行漏报率分析,分层随机抽取4 839例死亡报告的证明书和对应的报告卡进行完整性、规范性和准确性评价.采用Excel 2016和SPSS 23.0软件进行x2检验和Bonferroni检验.结果 2018年朝阳区网络直报死亡报告漏报率为0.5％,不及时率为0.3％,根本死因编码不准确率为4.7％;证明书填写不完整率为5.3％、基本项不准确率为2.1％,死因链填写不合理率为0.4％;报告卡不完整率为0.3％,基本项目不一致率为3.6％,死因链部分不一致率为0.7％.其中社区卫生服务中心的不及时率(0.6％)、根本死因编码不准确率(10.5％)、证明书基本项不准确率(7.4％)、报告卡基本项目不一致率(9.7％)和死因链部分不一致率(2.6％)最高;2018年报卡数较少(＜100例)的医疗机构的不及时率、根本死因编码不准确率、证明书填写不完整率、基本项不准确率、死因链不合理率、报告卡不完整率、基本项目不一致率和死因链部分不一致率均高于2018年报卡数较多(≥100例)的医疗机构,差异均有统计学意义(P＜0.05).结论 朝阳区医疗机构死亡病例报告及时性、完整性和准确性等需进一步提高,应针对不同特征医疗机构的薄弱环节,开展针对性培训和现场指导.

Objective: To understand the control attempts of body weight and its related factors among overweight and obese adults in China. Methods: Data was from the 2013 Chinese Chronic Diseases and Risk Factors Surveillance Program, which covered 302 surveillance sites. 179 570 adults, selected through multistage stratified cluster sampling method, were interviewed. Demographic characteristics and weight-control attempts were collected via face-to-face interview. BMI, waist circumstance and blood pressure were individually measured under physical examination. Venous blood samples were obtained and tested for FPG, OGTT-2h, TC, TG, LDL-C and HDL-C. A total of 87 545 overweight and obese patients were included in this study, with the exclusion of 152 patients having the missed critical information. Rates on weight control and attempts were analyzed, using the complex weighting on samples to represent the overall overweight and obese adults in China. Results: The rate of weight-control attempts was 16.3% (95%CI: 14.9%-17.7%). Among all the 12 133 patients who had undergone weight-control measures, the proportions of different attempts were as follows: diet (40.9%, 95%CI: 38.4%-43.3%), combination of diet and physical activity (31.5%, 95%CI: 28.9%-34.0%), physical activity (22.8%, 95%CI: 21.0%-24.6%) and drug control (1.3%, 95%CI: 1.0%-1.7%). Factors as: being female (OR=1.26, 95%CI: 1.15-1.38), at younger age (18-44 years old, OR=1.51, 95%CI: 1.31-1.74), with high education levels (college degree or above, OR=4.52, 95%CI: 3.76-5.43), having high annual income (≥24 000 Yuan, OR=1.94, 95%CI: 1.63-2.30) etc., appeared as favorable factors for taking the measures vs. rural residency (OR=0.63, 95%CI: 0.55- 0.72) as the unfavorable one. Conclusion: The rate of weight-control attempts appeared low among the overweight and obese adults who were affected by factors as age, education and income level. Personalized intervention measures should be carried out for people with different characteristics.

目的 了解2013年我国18岁及以上超重肥胖患者体重知晓情况,分析其影响因素,为制定慢性病重点人群防控策略提供依据.方法 2013年在中国慢性病及其危险因素监测的302个监测点,采用多阶段分层整群随机抽样方法调查≥18岁居民共计179 570人,选取超重肥胖患者有效样本87 466人作为研究对象.问卷调查基本信息、体重知晓情况,测量身高、体重、腰围等指标.经复杂加权后计算样本体重知晓和准确知晓情况及影响因素.结果 我国18岁及以上超重肥胖患者体重知晓率、准确知晓率、低估率和高估率分别为60.8％、38.2％、15.6％和7.0％.体重知晓率和准确知晓率均为男性高于女性,＜60岁组高于≥60岁组,城市高于农村(P＜0.05),超重组体重准确知晓率高于肥胖组(P＜0.05).高年龄(60岁以上OR =0.78,95％CI:0.69～0.87)、农村(OR=0.78,95％CI:0.66～0.91)、肥胖(OR=0.85,95％CI:0.78～0.92)是准确知晓的危险因素;高文化程度(大专及以上OR=1.82,95％CI:1.55～2.13)、高年收入(2.4万元以上OR=1.47,95％ CI:1.26～ 1.70)是准确知晓的保护因素.结论 应提高超重肥胖患者体重准确知晓率,尤其是女性、老年人及低教育水平和低社会经济地位人群.

目的 了解北京市朝阳区城镇和农村社区2型糖尿病患者血糖监测现状及其影响因素,为提高糖尿病患者自我管理水平提供依据.方法 采用单纯随机抽样方法在北京市朝阳区4个社区共抽取610例2型糖尿病患者.通过面对面问卷调查方法收集资料,采用二元Logistic回归分析自我血糖监测(SMBG)影响因素.结果 共有78.5％的社区糖尿病患者进行SMBG,城镇(83.8％)高于农村(73.1％)(P＜0.001),SMBG频率达标率仅为4.8％,城乡差异无统计学意义(P＞0.05).有46.9％的患者进行HbA1c监测,城镇(64.0％)高于农村(29.8％)(P<0.001).年龄、家庭人均月收入、病程、自备血糖仪及自我效能得分与城镇社区患者SMBG行为有关,病程为1年以下(OR=0.61,95％CI:0.38～0.98)、有自备血糖仪(OR=3.09,95％CI:1.51～6.30)及自我效能得分在88分以上(OR=7.30,95％CI:2.46～21.61)是糖尿病患者进行SMBG独立的影响因素.病程、医疗保险类型、使用降糖药/胰岛素治疗、自备血糖仪、定期随访及自我效能得分与农村社区患者SMBG行为有关,病程1年以下(OR=0.59,95％CI:0.35～0.99)、有自备血糖仪(OR =7.80,95％CI:3.80～16.10)及使用降糖药/胰岛素治疗(OR =4.71,95％CI:1.08 ～20.50)是糖尿病患者进行SMBG独立的影响因素.结论 北京市朝阳区社区糖尿病患者血糖监测及控制情况不理想,SMBG频率达标率低.应重点对新发糖尿病患者进行健康教育,建议糖尿病患者自备血糖仪,对患者提供糖尿病管理知识和技能指导,提高自我效能,促进血糖监测行为.

目的 了解2013年中国18岁及以上高血压患者体重测量行为及自我评价情况.方法 2013年中国慢性病及其危险因素监测采用多阶段分层整群随机抽样方法,在302个监测点共计调查18岁及以上居民179 570人,选取63 492例高血压患者作为研究对象,通过问卷调查获取人口学特征、体重测量行为和体重自评等信息,实际测量个体的体重、身高和腰围等指标.复杂加权后分析成人高血压患者体重测量行为和体重自我评价情况.结果 我国成人高血压患者中1周内、1月内和1年内测量过体重的比例分别为14.8％、20.1％和30.0％.17.7％的成人高血压患者从未测量过体重.成人高血压患者自评体重状况为偏瘦、正常、超重和肥胖的比例分别为9.4％、62.9％、23.6％和4.1％;以实测体质指数分组为标准,体重自评准确率为39.4％(38.2％ ～40.6％),其中实测低体重组、正常体重组、超重组和肥胖组分别为49.8％(40.4％～59.3％)、76.2％(74.7％～77.8％)、24.9％(23.1％～26.6％)和10.9％(9.5％～12.3％).结论 我国成人高血压患者对自身体重关注不够,体重测量行为的频率和体重自评准确性均有待提高.

Objective: To investigate the status of self-measurement of body weight in overweight and obese adults in China and identify the related factors. Methods: A total of 87 670 adults were enrolled in this study, who were selected through multi stage cluster random sampling from 177 099 residents aged ≥18 years in 302 surveillance areas in China where the fourth chronic non-communicable disease and related factor surveillance project was conducted in 2013. The information about their demographic characteristics and body weight measurement were collected by using questionnaire. Their body height, body weight, waist circumstance and blood pressure were measured respectively through physical examination. Fasting venous blood samples were obtained and assayed for FPG, TC, TG, LDL-C and HDL-C levels. Venous blood samples after 75 g glucose intake were obtained and assayed for OGTT-2h level. The proportion of self-body weight measurement were analyzed after complex sample weighting. Results: The proportion of overweight and obese adults who had self-body weight measurement within 1 week, 1 month and 1 year were 18.9%, 23.0% and 30.2%, respectively. The proportion of those having self-body weight measurement within 1 week was higher in men than in women, and lowest in ≥60 years old group (P<0.05). The proportion of overweight and obese adults who had never measured their body weight was 20.5%, the proportion was higher in women than in men, and highest in ≥60 years old group (P<0.05). Older age (OR=0.73, 95%CI: 0.64-0.82) was risk factor for self-body weight measurement; female (OR=1.11, 95%CI: 1.03-1.19), higher education level (junior college and above OR=3.79, 95%CI: 2.89-4.97), high- income (OR=1.61, 95%CI: 1.31-1.98), dyslipidemia (OR=1.13, 95%CI: 1.04-1.23), diabetes (OR=1.15, 95%CI: 1.03-1.30) were the protective factors for self-body weight measurement. Conclusion: It is necessary to promote self-body weight measurement in overweight and obese adults in China. Targeted health education should be carried out for different groups to encourage regular self-body weight measurement to maintain healthy body weight.

目的 了解北京市朝阳区糖尿病患者糖尿病管理APP知晓情况及使用现状,分析其影响因素,为糖尿病管理APP技术开发及推广使用提供依据.方法 于2017年11月至2018年1月,在北京市朝阳区2个城市社区和2个农村社区中采用单纯随机抽样方法抽取610名2型糖尿病患者,通过面对面问卷调查收集调查对象的一般情况、糖尿病管理APP知晓情况、知晓途径、使用情况,分析糖尿病管理APP不同使用情况的原因.采用SPSS19.0软件进行x2检验,糖尿病管理APP知晓及使用的影响因素采用多因素logistic回归进行分析.结果 共608名2型糖尿病患者纳入研究,糖尿病管理APP知晓率为8.2％,知晓率随糖尿病患者的年龄增加而降低,城镇高于农村,商业服务人员高于其他职业人群,高中及以上人群高于初中及以下人群,未婚或离婚或丧偶者高于已婚者,差异均有统计学意义(P＜0.05,P＜0.01).多因素logistic回归分析显示,18～44岁年龄组糖尿病管理APP知晓情况是60岁及以上年龄组3.106倍(OR =3.106,95％CI:1.059～9.109).糖尿病管理APP的使用率为2.1％,城镇高于农村,商业服务人员高于其他职业人群,高中及以上人群高于初中及以下人群,差异均有统计学意义(P＜0.05).多因素logistic回归分析显示,从事商业服务的患者糖尿病管理APP使用情况是从事其他劳动者的15.645倍(OR=1 5.645,95％CI:1.737～137.664).糖尿病管理APP知晓途径占比从高到低依次为网络或电视、朋友或亲人、医护人员、报纸或杂志及其他,分别占47.8％、43.5％、39.1％、26.1％和4.3％.在知晓糖尿病管理APP的患者中,不使用者、使用者分别占74.0％(37/50)、26.0％(13/50).13例使用者中8例中途放弃使用(61.5％).糖尿病管理APP不使用的原因主要为“感觉没有用处”,占54.1％(20/37);使用的原因主要为“能提供糖尿病疾病相关知识”、“能记录血糖值”和“能提供饮食指导”,分别占53.8％(7/13)、53.8％(7/13)和46.2％(6/13);中途放弃使用的主要原因为“咨询需要付费”,占50.0％(4/8).结论 北京市朝阳区2型糖尿病患者糖尿病管理APP的知晓率及使用率均较低,将糖尿病管理APP用于患者自我管理需加强宣传教育,尤其是对中老年患者的宣传教育.

目的 了解2013年我国超重肥胖成人体重水平低估情况,分析其影响因素.方法 2013年中国慢性病及其危险因素监测采用多阶段分层整群抽样的方法调查≥18岁成人共计179 570人.问卷调查获取人口学特征、体重水平自我评价、慢性病患病知晓情况等信息;体格测量获取个体的身高、体重和血压;采集调查对象静脉血,检测空腹血糖、服糖后2h血糖和血脂四项.选取收集到的87 552名超重肥胖成人作为研究对象,复杂加权后分析不同特征人群体重水平低估情况及其影响因素.结果 我国有74.7％(95％ CI:73.3％～76.1％)的超重肥胖成人低估自我体重水平,其中轻度低估率为60.7％ (59.6％ ～61.7％),严重低估率为14.0％(13.1％～14.9％).较高年龄、低文化程度、低收入水平、农村地区和肥胖是低估和严重低估体重水平的危险因素(均有P ＜0.05);高血压患者知晓和血脂异常患者知晓是低估和严重低估体重水平的保护因素(均有P＜0.05).结论 中国大部分超重肥胖成人低估自身的体重水平,低估受年龄、文化程度、收入水平和慢性病知晓等因素影响,应对不同特征人群开展针对性干预.

目的 了解生活方式干预对2型糖尿病患者的影响,为创建安全、有效、易于推广的2型糖尿病管理模式提供依据.方法 于2016年3-6月,选择北京市朝阳区3个社区中心60名自愿参加“2型糖尿病营养与运动优化干预项目”的社区2型糖尿病患者为研究对象,以自我管理小组形式进行饮食运动干预,干预期为90 d.干预前后采用面对面问卷调查了解调查对象吸烟、饮酒、饮食、身体活动等生活方式情况,测量身高、体重、腰围、血压、体脂率,并检测空腹血糖、糖化血红蛋白、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇等生化指标,比较干预前后上述指标的变化情况.用SPSS19.0软件进行t检验、x2检验和非参数检验.结果 干预后糖尿病患者主食摄入量、蔬菜水果摄入量、锻炼率及睡眠时间均高于干预前,差异均有统计学意义(P＜0.05);干预后糖尿病患者空腹血糖、糖化血红蛋白、体脂率及收缩压水平均低于干预前,差异均有统计学意义(P＜0.05);其余指标在于预前后差异均无统计学意义(P＞0.05).结论 依托自我管理小组活动的个性化饮食与运动干预模式可有效控制2型糖尿病患者血糖水平,具有推广应用价值.

Objective: To investigate the prevalence of physical activity and its influencing factors in rural residents in Shanxi and Chongqing. Methods: In four counties (districts) of Shanxi and Chongqing, local residents aged ≥18 who lived there for more than one year and had no plan to migrate to other areas in 2 years were surveyed through face to face questionnaire interviews to collect the information about their daily physical activity time, sedentary time, related knowledge and attitude, and others. Results: The physical inactivity rate of the residents was 14.9%, and 88.7% of residents never took daily physical activity. The average sedentary time was (3.91±2.06) hours. The results of multivariate analysis showed that education level, per capita monthly income and activity degree were the factors influencing physical inactivity. Conclusion: The proportion of people who never took daily physical activity in the survey area was higher than the average level in rural areas in China, so measures should be taken to improve the overall rate of physical activity. For people who have exercise willingness, but have no practice, and those who have already increased their physical activities, targeted guidance is needed on the basis of strengthened health education.

目的 探讨建立在移动通信技术基础上的知己健康管理方式,应用于糖尿病高危人群所产生的干预效应.方法选择糖尿病高危患者160例,经随机数法分为干预组(n=78)和对照组(n=82),在对照组每季度健康教育一般干预的基础上,干预组另通过安装"知己健康星"手机APP软件提供个体化的防治管理,为期12个月,比较两组干预前后各指标的变化,了解干预效果.结果干预组对糖尿病相关知识的掌握率明显高于对照组(P<0.05);干预组有效运动量较管理前有所改善(P<0.05);干预组在体质量指数、三酰甘油、总胆固醇、低密度脂蛋白等的变化差值与对照组比较,差异有统计学意义(P<0.05);干预组空腹血糖增加较对照组少0.21 mmol/L,口服葡萄糖耐药试验(OGTT)减少较对照组多0.14 mmol/L.结论采用智能化的知己健康管理方式对糖尿病高危人群实施干预,可以有效降低糖尿病危险因素,依从性好,适宜功能社区人群健康管理实践.