Screening of various metabolic diseases in Suzhou Municipal Hospital

Suzhou Municipal Hospital currently provides one-stop screening services for seven common metabolic diseases: obesity, diabetes, hyperlipidemia, hyperuricemia, non-alcoholic fatty liver disease, polycystic ovary syndrome, and abnormal thyroid metabolism. The full set of basic screening costs 327 yuan (Suzhou The state employee medical insurance can reimburse 60%-90% according to the overall outpatient proportion), and high-risk groups can add items as needed, with a maximum cost of 1,180 yuan for the full set. After screening, it can be directly connected to the multidisciplinary intervention channel of endocrinology, nutrition, sports rehabilitation, and gynecology, without the need for secondary registration.

Last week, I accompanied Aunt Zhang, who lives in Gusu District, for a screening. She had been feeling weak and sleepy after eating, and she felt panicked for most of the day after drinking half a cup of milk tea. The community doctor suggested that she go to the municipal hospital for a complete metabolic screening. She originally thought she would have to visit three or four departments and wait for a week to get the results. Unexpectedly, after drawing three tubes of blood, doing a body fat test and abdominal ultrasound that morning, she got the full report in the afternoon, as well as a dedicated metabolic risk rating.

Don't tell me, the screening here is different from what I have seen in other hospitals before. Instead of just drawing blood, it will add a body composition analysis that can be completed in 1 minute. You stand on a scale-like machine and hold the handle, and the data such as visceral fat level, muscle mass, and basal metabolic rate will come out directly. Aunt Zhang only weighed 102 pounds and looked skinny, but her visceral fat level reached level 8, which was two levels higher than the average for women of the same age. The doctor pointed out on the spot that she had invisible abdominal obesity, which was the core reason for her recent discomfort. To put it bluntly, it was insulin resistance. The body was not sensitive to the insulin that lowers blood sugar. The sugar she eats cannot be properly consumed and accumulates around the internal organs. Over time, it is easy to develop into diabetes.

Regarding the frequency of metabolic screening, in fact, there is no completely unified standard in the industry: the guidelines of the Endocrinology Branch of the Chinese Medical Association recommend that high-risk groups with family history, abdominal obesity, and long-term late night drinking should be screened once a year. Some scholars in the field of preventive medicine believe that ordinary healthy people can be screened every 2-3 years. Over-screening may cause unnecessary anxiety. The current triage logic of Suzhou Municipal Hospital is also very flexible. After registration, patients will be given a three-minute preliminary screening questionnaire. Only those who meet high-risk indications will be recommended to take the full set. Ordinary healthy people who want to check only two single items of blood sugar and uric acid are perfectly fine, and the package will not be forced.

There has been a lot of discussion before about whether sex hormones and gynecological ultrasound should be routinely added to women's metabolic screening. Some experts believe that these two items will not only increase the cost for ordinary women, but may also cause unnecessary panic due to occasional hormone fluctuations. After all, not everyone has fertility needs.； But another school of thought believes that polycystic ovary syndrome is essentially a manifestation of metabolic abnormalities. The first symptom in many patients is metabolic problems, but not irregular menstruation. The current handling method of municipal hospitals is to ask female patients in advance about their menstrual status and birth plans. If they have irregular menstruation or have failed to conceive after more than six months of pregnancy preparation, they will proactively recommend additional related projects. The choice is completely left to the patients themselves.

What’s interesting is that in the past two years, more and more young people have requested metabolic screening. On the day I went there, nearly 40% of the people I met were 20-30 years old. There was a 24-year-old boy who came for a reexamination after a physical examination showed high uric acid. The result was 620 μmol/L. He didn’t feel anything at all. He said he was drinking beer and eating crayfish with friends the day before. There was also a 19-year-old skinny girl, less than 100 pounds, who was diagnosed with insulin resistance and mild hyperlipidemia. After asking, she found out that she stayed up until two or three o'clock every day, drank sparkling water as water, and ate takeout. Nowadays, academic circles are also debating whether adolescents should undergo routine metabolic screening. One group believes that adolescents have strong metabolic abilities and there is no need to increase additional medical expenses. The other group believes that there are too many chubby children with irregular schedules. Metabolic abnormalities in adolescence will directly affect the health of adults. Municipal hospitals now also offer adolescent-specific metabolic screening packages. The program will be adjusted for children under 14 years old. Only 2 tubes of blood will be drawn, which will not cause additional burden on the body.

Oh, by the way, after the screening, you don’t just get a report. If any abnormal indicators are found, the doctor can recruit a small multi-disciplinary team on the spot, including endocrinologists, nutritionists and sports rehabilitation specialists. They will not prescribe a bunch of medicines right away. Aunt Zhang found that her fasting blood sugar was high and her low-density lipoprotein was slightly above the standard. The doctor prescribed a low-GI diet plan for her for two weeks, asking her to walk 6,000 steps a day without taking medicine. She would just come back for a follow-up visit after two weeks. Now she has made adjustments as required for 10 days, and her fasting blood sugar has returned to the normal range when measured at home.

Finally, I would like to remind everyone that if you go for screening, remember to fast for 8-12 hours. It is best to make an appointment in advance with the metabolic screening specialist in the endocrinology department on the official account. There is no need to grab a specialist appointment. The doctors at the specialist hospital do screening and triage every day. They are very familiar with the project and can bill quickly. Also, don’t wear jumpsuits or overalls that are difficult to take off. To do the body composition analysis, you have to take off your shoes and socks and hold the handle. It’s too complicated to put on, and people are waiting in line. Last time I saw a little girl wearing overalls, and it took almost 5 minutes to get it done, and I even laughed.

Anyway, metabolic diseases are no longer a problem only for the elderly. Don’t think that you don’t take it seriously if you are young and have a normal weight. If you have been feeling inexplicably tired recently, losing your hair, or getting dizzy after drinking something sweet, don’t worry if you take the time to check it out. After all, early detection and early adjustment are better than having to take medicine for a long time in the future, right?