Abstract: Background　The increasing prevalence of diabetes has imposed a huge economic burden on the whole society.Screening for diabetes in high-risk population in community can find diabetes mellitus and pre-diabetic patients in time.Early intervention can help to delay or reverse the course of disease and reduce the possibility of developing diabetes-related complications.Objective　To perform a screening for diabetes in high-risk individuals in Shanghai's Putuo District and to analyze the risk factors associated with diabetes and prediabetes.Methods　From March to September 2017，residents in Putuo District of Shanghai who met the criteria of high-risk population for diabetes in the Chinese Guideline for Diabetes Prevention and Management （2013 edition） were enrolled.Basic personal characteristics，prevalence of risk factors for diabetes and related symptoms，physical parameters and glycemic parameters were collected via questionnaire survey，physical measurement and laboratory testing.The results of screening were statistically analyzed.Results　A total of 13 057 cases participated in the survey.Among them，the prevalence of diabetes and prediabetes was 10.61% （1 386/13 057） and 11.93% （1 558/13 057）.Compared with women，men showed a higher prevalence of diabetes 〔12.19% （747/6 127） vs 9.22% （639/6 930）〕 （χ2=30.256，P<0.001），but similar prevalence of prediabetes 〔12.15% （744/6 127） vs 11.75% （814/6 930）〕 （χ2=0.488，P>0.05）．The prevalence of diabetes and prediabetes increased with age （χ2trend=244.746，P<0.001；χ2trend=144.104，P<0.001）．Logistic regression analysis showed that age，impaired glucose regulation，overweight/obesity/central obesity，family history of diabetes mellitus in first-degree relatives，history of macrosomia or gestational diabetes mellitus，hypertension or under antihypertensive treatment，dyslipidemia or under lipid-lowering treatment，history of atherosclerotic cardio-cerebrovascular disease，and history of transient steroid diabetes were the factors associated with the diabetes identified in the residents （P<0.05）．Age，impaired glucose regulation，overweight/obesity/central obesity，family history of diabetes mellitus in first-degree relatives，hypertension or antihypertensive treatment，dyslipidemia or lipid-lowering treatment，and history of atherosclerotic cardiovascular and cerebrovascular diseases were the influencing factors for prediabetes identified in the residents （P<0.05）．The prevalence of diabetes differed significantly in the residents by the number of diabetes-related risk factors （χ2=469.623，P<0.001）．Moreover，the prevalence of pre-diabetes varied obviously in the residents by prediabetes-related risk factors （χ2=129.073，P<0.001）．The prevalence of diabetes differed significantly in the residents by risk factors associated with diabetes （χ2=469.623，P<0.001）．Moreover，the prevalence of pre-diabetes varied obviously in the residents by risk factors associated with prediabetes （χ2=129.073，P<0.05）．Those with 4 or more risk factors had a higher prevalence of diabetes or pre-diabetes compared with those with only one （P<0.05）．Conclusion　The detection rate of diabetes or prediabetes increased with the increase in the number of diabetes-related risk factors.Individuals with 40 years of age or older，hypertension，overweight or obesity or central obesity，or dyslipidemia are priority populations of diabetes screening.The diabetes screening in community-dwelling high-risk population，especially the key high-risk groups，should be continued.

Key words: Diabetes, High-risk individuals, Screening, Risk factors, Shanghai

摘要： 背景　糖尿病患病率的持续上升，给社会带来了巨大的经济负担。开展社区糖尿病高危人群筛查，能及时发现糖尿病和糖尿病前期患者，通过早期干预，有助于延缓或逆转疾病进程，减少糖尿病患者并发症的发生。目的　利用上海市普陀区糖尿病高危人群筛查结果，分析相关因素对筛查结果的影响。方法　2017年3—9月对上海市普陀区符合《中国2型糖尿病防治指南（2013年版）》中的糖尿病高危人群标准的常住居民通过问卷评估、身体测量、实验室检测的形式，收集调查对象的基本信息、糖尿病危险因素及相关症状、体格检查数据及血糖数据，对筛查结果进行统计分析。结果　共调查13 057例高危人群，糖尿病检出率为10.61%（1 386/13 057），糖尿病前期检出率为11.93%（1 558/13 057）。男性糖尿病检出率为12.19%（747/6 127），女性为9.22%（639/6 930），差异有统计学意义（χ2=30.256，P<0.001）。男性糖尿病前期检出率为12.15%（744/6 127），女性为11.75%（814/6 930），差异无统计学意义（χ2=0.488，P>0.05）。随年龄升高，糖尿病及糖尿病前期的检出率逐渐升高（χ2趋势=244.746，P<0.001；χ2趋势=144.104，P<0.001）。Logistic回归分析结果显示，年龄、糖调节受损史、超重/肥胖/中心性肥胖、一级亲属中糖尿病家族史、巨大儿生产史或妊娠糖尿病史、高血压或正在接受降压治疗、血脂异常或正在接受调脂治疗、动脉粥样硬化性心脑血管病史、一过性类固醇糖尿病史是居民糖尿病检出阳性的影响因素（P<0.05）；年龄、糖调节受损史、超重/肥胖/中心性肥胖、一级亲属中糖尿病家族史、高血压或正在接受降压治疗、血脂异常或正在接受调脂治疗、动脉粥样硬化性心脑血管病史是居民糖尿病前期检出阳性的影响因素（P<0.05）。具有不同危险因素数量的居民糖尿病及糖尿病前期检出率比较，差异有统计学意义（χ2=469.623，P<0.001；χ2=129.073，P<0.001）。具有4个及以上危险因素居民糖尿病和糖尿病前期检出率均高于危险因素数量为1个的居民（P<0.05）。结论　糖尿病及糖尿病前期检出率随危险因素数量的增长而增长，≥40岁、高血压、超重/肥胖/中心性肥胖、血脂异常的人群属于糖尿病筛查的重点对象，应持续开展社区高危人群特别是重点高危人群的筛查工作。

关键词: 糖尿病, 高危人群, 筛查, 危险因素, 上海市