摘要目的 了解2009—2015年医疗机构员工空腹血糖(FBG)水平与空腹血糖受损(IFG)患病率变化趋势,为员工血糖管理提供科学依据.方法 前瞻性队列研究,纳入2009年参加年度体检的1284名35~60岁医疗机构在职工作人员(随访7年,其中403名员工连续7年参加年度体检),监测其FBG和IFG动态变化,进一步分析FBG、IFG是否与年龄、性别、职业等因素相关;根据员工体检频次,分为高频组和低频组,初步探讨高频次体检是否对受检者血糖控制有益.结果 本组1284名研究对象中,男性479人(37.3%),女性805人(62.7%),平均年龄(45.9±5.5)岁.连续7年参加年度体检的员工(n=403)平均FBG水平逐年增高,从2009年4.92 mmol/L增加到2012年5.26 mmol/L,2015年升至5.60 mmol/L,7年间平均FBG增加0.68 mmol/L,差异有统计学意义(F=100.643,P<0.001);IFG检出率同样呈上升趋势,由2009年的3.7%增至2012年的7.7%,2015年则高达13.4%,经卡方趋势检验,差异有统计学意义(χ2=39.099,P<0.001).与基线(2009年)相比,2015年(n=1284)FBG水平和IFG检出率在男性组、女性组、各年龄段组和各职业组(医生、护士、医技和后勤组)均呈上升趋势(P均<0.05),且存在明显的性别和职业间差异;2009和2015年男性FBG水平均高于女性,性别差异值由2009年的0.33 mmol/L增大到2015年的0.48 mmol/L.2009—2015年间,基线代谢水平正常组中,体质指数(BMI)、FBG水平平均变化幅度在高频组和低频组差异无统计学意义(P均>0.05),而在基线代谢水平异常组中,高频次体检者FBG增高幅度较低频次体检者低(Z=-7.491,P<0.001).结论 连续动态监测显示医疗机构员工FBG水平和IFG检出率呈逐年升高趋势,尤其是男性员工.而规律年度体检或高频次体检并未如健康管理者所期望的那样,能够使受检者普遍获益,但对于基础代谢指标异常者,年度规律体检或高频率体检可能对员工血糖控制有益.

abstractsObjective To explore the fasting blood glucose (FBG) variation trends and the prevalence of impaired fasting blood glucose(IFG)among medical staff in Beijing, 2009-2015.Methods A prospective cohort study, using seven years of follow-up data, was conducted in a large-scale tertiary hospital in Beijing.A total of 1 284 medical staff aged 35 to 60 years were recruited.We divided them into 4 groups according to age and occupational categories,and the level of FBG was tested at the same time each year. Results The number of medical staff who completed all 7 annual FBG tests was 403. There was a stepwise increase in the levels of FBG (4.92 mmol/L, 5.26 mmol/L, and 5.60 mmol/L in the years 2009, 2012,and 2015,respectively;F=100.643,P<0.001).An increasing trend in the prevalence of IFG was also evident (3.7%, 7.7%, and 13.4% in the years 2009, 2012, and 2015, respectively; χ2=39.099, P<0.001). Compared with baseline levels(in 2009),the average levels of FBG and the prevalence of IFG in men and women, as well as in all occupational classes (doctors, nurses, technicians, and other medical employees), were significantly elevated by the year 2015 (all P<0.05). The levels of FBG in male medical staff were higher than that in female medical staff,in both 2009 and 2015(both P<0.001).Conclusion The trend of increasing FBG levels and IFG cases in medical staff,especially in men,has been a problem for hospitals. Health policy action is urgently needed to deflate the IFG bubbles.