摘要
目的:分析2005—2024年复旦大学附属中山医院就诊及体检人群的空腹血糖(FBG)变化趋势。方法:回顾性纳入2005年11月9日至2024年12月31日复旦大学附属中山医院实验室信息系统数据库中进行过FBG检测的人群,并从中筛选出每年连续监测FBG的固定人群。采用Mann-Kendall趋势检验和Theil-Sen斜率估计法分析总体人群、固定人群及不同年龄人群、性别人群FBG及其异常率(FBG≥7 mmol/L)的变化趋势。结果:总体人群4523490例,男2561242例,女1962248例,年龄[M(Q1,Q3)]为53(39,64)岁;固定人群4280例,男2426例,女1854例,入组时(2008年)年龄47(35,57)岁。2005—2024年,总体人群FBG从4.8(4.3,5.4)mmol/L上升至5.4(4.9,6.3)mmol/L(P=0.015),FBG异常率从6.9%(95%CI:6.8%~7.1%)上升至16.1%(95%CI:16.0%~16.2%,P<0.001);固定人群FBG从4.8(4.3,5.4)mmol/L上升至5.5(5.0,6.4)mmol/L(P<0.001),FBG异常率从6.0%(95%CI:5.3%~6.8%)上升至18.0%(95%CI:16.8%~19.1%,P<0.001)。2008—2024年,总体人群20~39岁男性和女性FBG水平均稳定(Theil-Sen斜率分别为0.018、0.011,均P>0.05);40~59岁男性FBG水平缓慢上升(Theil-Sen斜率为0.023,P=0.018);60~79岁男性和女性FBG水平均明显升高(Theil-Sen斜率分别为0.039、0.022,均P<0.05);≥80岁男性和女性FBG水平升高最为显著(Theil-Sen斜率分别为0.042、0.026,均P<0.05)。固定人群40~59岁男性和女性FBG水平均明显升高(Theil-Sen斜率分别为0.062、0.052,均P<0.001)。结论:2005—2024年复旦大学附属中山医院就诊及体检人群中,总体人群及固定人群FBG及其异常率均呈上升趋势。总体人群中20~39岁FBG水平和异常率相对稳定,40~59岁男性FBG水平缓慢上升,从60岁开始FBG增高明显,≥80岁FBG水平升高最为显著。
Objective:To analyze the trends in fasting blood glucose(FBG)levels among patients and health examinees at Zhongshan Hospital,Fudan University from 2005 to 2024.Methods:A retrospective analysis was conducted using the laboratory information system database of Zhongshan Hospital,Fudan University from November 9,2005,to December 31,2024.Individuals with FBG test records were included,and a fixed cohort with consecutive annual FBG measurements was selected.The Mann-Kendall trend test and Theil-Sen slope estimator were employed to analyze the changing trends of FBG levels and their abnormal rates(FBG≥7 mmol/L)in the overall population,fixed cohort,as well as different age subgroups and gender-specific subgroups.Results:The general population comprised 4523490 individuals(2561242 males and 1962248 females),with the age[M(Q1,Q3)]of 53(39,64)years.The fixed cohort consisted of 4280 individuals(2426 males and 1854 females),with a median age of 47(35,57)years(at enrollment in 2008).From 2005 to 2024,in the overall population,FBG levels increased from 4.8(4.3,5.4)mmol/L to 5.4(4.9,6.3)mmol/L(P=0.015),and the prevalence of abnormal FBG rose from 6.9%(95%CI:6.8%-7.1%)to 16.1%(95%CI:16.0%-16.2%,P<0.001).Among the fixed cohort,FBG levels increased from 4.8(4.3,5.4)mmol/L to 5.5(5.0,6.4)mmol/L(P<0.001),and the prevalence of abnormal FBG rose from 6.0%(95%CI:5.3%-6.8%)to 18.0%(95%CI:16.8%-19.1%,P<0.001).From 2008 to 2024,in the overall population,FBG levels remained stable in both males and females aged 20-39 years(Theil-Sen slopes of 0.018 and 0.011,respectively,both P>0.05);FBG levels in males aged 40-59 years increased slowly(Theil-Sen slope of 0.023,P=0.018);FBG levels in both males and females aged 60-79 years increased significantly(Theil-Sen slopes of 0.039 and 0.022,respectively,both P<0.05);and the most pronounced increases were observed in males and females aged≥80 years(Theil-Sen slopes of 0.042 and 0.026,respectively,both P<0.05).Among the fixed cohort,FBG levels in both males and females aged 40-59 years increased significantly(Theil-Sen slopes of 0.062 and 0.052,respectively,both P<0.001).Conclusions:From 2005 to 2024,among the patients and individuals undergoing physical examinations at Zhongshan Hospital,Fudan University,both the overall population and the fixed cohort exhibited an upward trend in FBG levels and their abnormality rates.In the overall population,the FBG levels and abnormality rates remained relatively stable among individuals aged 20-39 years.For males aged 40-59 years,FBG levels showed a gradual increase,with a more pronounced rise starting from the age of 60,and the most significant elevation in FBG levels was observed in those aged 80 years and above.
作者
熊赢
朱晶
段昕岑
潘柏申
王蓓丽
郭玮
Xiong Ying;Zhu Jing;Duan Xincen;Pan Baishen;Wang Beili;Guo Wei(Department of Laboratory Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
出处
《中华医学杂志》
北大核心
2025年第39期3541-3546,共6页
National Medical Journal of China
基金
国家重点研发计划(2022YFC3602302、2022YFC3602301)
国家自然科学基金(82172348,82473063)。
关键词
血糖
大样本数据
二十年变化趋势
性别差异
年龄分层
Blood glucose
Big data analysis
Twenty-year trend
Gender differences
Age stratification
