Chinese General Practice ›› 2022, Vol. 25 ›› Issue (06): 729-734.DOI: 10.12114/j.issn.1007-9572.2021.02.076

Special Issue: 内分泌代谢性疾病最新文章合集

• Big Data·Population Health Research • Previous Articles     Next Articles

Analysis of the Spatial Epidemiological Characteristics of the Probability of Diabetes Death and Premature Death among Residents in Pudong New Area of Shanghai from 2010 to 2020

  

  1. 1.School of Public HealthFudan UniversityShanghai 200032China

    2.Shanghai Pudong New Area Center for Disease Control and PreventionFudan University Pudong Institute of Preventive MedicinePudong New AreaShanghai 200136China

    *Corresponding authorsZHOU YiAssociated chief physicianE-mailyizhou517@163.com

    XU WanghongProfessorE-mailwanghong.xu@fudan.edu.cn

  • Received:2021-06-15 Revised:2021-09-28 Published:2022-02-20 Online:2022-01-25

2010—2020年上海市浦东新区居民糖尿病死亡及早死概率空间流行病学特征分析

  

  1. 1.200032 上海市,复旦大学公共卫生学院
    2.200136 上海市浦东新区疾病预防控制中心 复旦大学浦东预防医学研究院
  • 通讯作者: 周弋,徐望红
  • 基金资助:
    上海市公共卫生体系建设三年行动计划(2020—2022年)优秀青年人才培养计划(GWV-10.2-YQ43);上海市公共卫生体系建设三年行动计划(2020—2022年)优秀学科带头人项目(GWV-10.2-XD24);上海市浦东新区卫生系统学科带头人培养计划(PWRd2019-11);浦东新区疾病预防控制中心卫生科技项目(PDCDC-2021-06)

Abstract: Background

With the development of society and economy, the rapid growth of diabetes incidence has become an important public health problem, but there are still few studies on the urban and rural distribution of diabetes.

Objective

To explore the spatial epidemiological characteristics of mortality and probability of premature death caused by diabetes among residents in Pudong New Area of Shanghai from 2010 to 2020, so as to provide the reference for the development of the regional strategy for diabetes control and prevention.

Methods

The diabetes death data reported from 2010 to 2020 were screened for analysis based on the death surveillance system in Pudong New Area in May 2021. The Crude mortality, age-standardized mortality, probability of premature death caused by diabetes and the annual percentage change (APC) of the residents from diabetes in each subdistricts and towns of Pudong New Area, so as to analyze the status and trend of diabetes death in Pudong New Area. The geographical information system (GIS) was used to plot the spatial distribution map of diabetes deaths and carry out trend surface analysis and spatial autocorrelation analysis respectively.

Results

The crude mortality, age-standardized mortality and probability of premature death caused by diabetes among residents in Pudong New Area between 2010 and 2020 were 37.90/100 000, 16.90/100 000 and 0.52%, respectively. The crude mortality rate, the age-standardized mortality rate and the probability of premature death caused by diabetes had been on the rise in Pudong New Area between 2010 and 2020 (APC for crude mortality rate=5.59%, Z=13.887, P=0.001, APC for age-standardized mortality rate=2.06%, Z=4.547, P=0.001, APC for the probability of premature death=1.50%, Z=2.476, P=0.035). The trend surface analysis showed that the crude and standardized mortality of diabetes in Pudong New Area gradually decreased from north to south, the probability of premature death was high in the middle and low in the north and south, the APC of crude death rate, standardized death rate and premature death probability was gradually decreasing from north to south. In the east-west direction, the crude death rate of diabetes, the standardized death rate and the probability of premature death all showed a trend of high at both ends, and the rate of crude death, standardized death rate and APC showed a trend of high at the middle and low at the two ends. The results of global spatial autocorrelation analysis showed that the crude death rate of diabetes, standardized death rate and premature death probability of residents in Pudong New Area were spatially positively correlated (Pcrude death rate<0.001, Pstandardized death rate<0.001, Ppremature death probability=0.003). The results of local spatial autocorrelation analysis showed that the high-high clustering area of the crude death rate of diabetes and the standardized death rate was located in the west of Pudong New Area, both of which contained 6 streets and 1 town, and there were partial geographic overlaps. The standardized low mortality rate-the low agglomeration areas were Chuansha New Town and Xuanqiao Town in the middle of Pudong New Area. The area in the west of Pudong New Area with three streets and two towns was a high-high concentration area with a high probability of early death.

Conclusion

The status of diabetes death in Pudong New Area during 2010 to 2020 was at a high level and showed an upward trend over the years. The crude and standardized mortality of diabetes in the western urban area of Pudong New Area were relatively high, and the mortality among residents living in the urban fringe rose at a relatively high speed in Pudong New Area. More attention should be paid to the status of diabetes in these subgroups.

Key words: Diabetes mellitus, Mortality, Probability of premature death, Tendency, Spatial epidemiology, Shanghai

摘要: 背景

随着社会经济的发展,糖尿病发病率的快速增长已成为一个重要的公共卫生问题,但目前糖尿病城乡分布的研究依然较少。

目的

了解2010—2020年浦东新区居民糖尿病死亡率与早死概率现状的空间流行病学特征,为制定区域内糖尿病防控策略提供参考。

方法

2021年5月,以上海市浦东新区户籍居民死亡数据库为基础,从中筛选2010—2020年报告的糖尿病死亡资料进行分析。分别计算浦东新区各街道、镇居民糖尿病死亡的粗死亡率、标化死亡率、早死概率及年变化百分比(APC)分析浦东新区糖尿病死亡现状与变化趋势,利用地理信息系统(GIS)绘制糖尿病死亡的空间分布图并分别开展趋势面分析与空间自相关分析。

结果

2010—2020年浦东新区居民糖尿病粗死亡率为37.90/10万,标化死亡率为16.90/10万,早死概率为0.52%。2010—2020浦东新区居民糖尿病粗死亡率、标化死亡率及早死概率呈上升趋势(APC粗死亡率=5.59%,Z=13.887,P=0.001;APC标化死亡率=2.06%,Z=4.547,P=0.001;APC早死概率=1.50%,Z=2.476,P=0.035)。趋势面分析结果显示,浦东新区居民糖尿病粗死亡率与标化死亡率由北向南逐步降低,早死概率在南北方向上呈中间高两端低的趋势,粗死亡率、标化死亡率及早死概率的APC由北向南呈逐步下降的趋势;在东西方向上,糖尿病粗死亡率、标化死亡率与早死概率均呈两端高中间低的趋势,粗死亡率、标化死亡率及早死概率APC呈中间高两端低的趋势。全局空间自相关分析结果显示,浦东新区居民糖尿病粗死亡率、标化死亡率与早死概率均呈空间正相关(P粗死亡率<0.001,P标化死亡率<0.001,P早死概率=0.003)。局部空间自相关分析结果显示,糖尿病粗死亡率与标化死亡率的高-高聚集区域为浦东新区西部,均包含6个街道与1个镇且存在部分地理重叠;标化死亡率低-低聚集区为浦东新区中部的川沙新镇与宣桥镇;浦东新区西部包含3个街道及2个镇的区域为早死概率的高-高聚集区。

结论

2010—2020年上海市浦东新区居民糖尿病死亡率处于较高水平并呈上升趋势,浦东新区西部城区居民糖尿病粗死亡率和标化死亡率较高,中部城郊结合地区居民糖尿病死亡率上升速度较快,应引起关注。

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关键词: 糖尿病, 死亡率, 早死概率, 变化趋势, 空间流行病学, 上海

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