2型糖尿病患者血糖控制与糖尿病相关健康素养关系研究  

Relationship between glycemic control and diabetes related health literacy among the patients with type 2 diabetes mellitus

作　　者：朱小柔 张幸[1] 沈莹 王陶陶 王冯彬[1,2] 胡康 吴士艳[1] 张勇 孙昕霙[1] ZHU Xiao-rou;ZHANG Xing;SHEN Ying;WANG Tao-tao;WANG Feng-bin;HU Kang;WU Shi-yan;ZHANG Yong;SUN Xin-ying(Department of Social Medicine and Health Education, School of Public Health, Peking Uni-)

机构地区：[1]北京大学公共卫生学院社会医学与健康教育系,北京100191 [2]北京市卫生和计划生育委员会科教处,北京100053 [3]北京市大兴区疾病预防控制中心,北京102600

出　　处：《中国健康教育》2018年第10期873-878,共6页Chinese Journal of Health Education

基　　金：国家自然科学基金(71673009)

摘　　要：目的探讨2型糖尿病(type2 diabetes mellitus, T2DM)患者血糖控制情况与糖尿病相关健康素养的关系。方法选取2017年大兴区社区诊断中18岁及以上T2DM患者558例纳入研究,对研究对象进行问卷调查(包括人口学特征、生活习惯、血糖控制措施、心理状况等)、体格检查、血生化检查(包括空腹血糖、糖化血红蛋白等)。使用单因素及多因素Logistic回归对HbA1c控制情况与健康素养及其他影响因素的关系进行分析。结果研究对象健康素养得分为(15. 73±7. 12)分,健康素养水平由低到高的4等分组血糖控制好的比例分别为32.21%、38.97%、39.71%和48.10%;Mantel-haenszel X^2检验和Spearman相关性分析结果均显示,健康素养与血糖控制情况不存在相关关系;多因素Logistic回归分析显示,调整年龄、性别后,健康素养与血糖控制情况相关(OR=1.18, P=0.045),进一步纳入其他协变量,健康素养的分类变量(OR=1.322, P=0.004)和连续变量(OR=1. 040, P=0. 010)均与血糖控制显著相关;各因子中仅反映文字及图阅读能力的因子1与血糖控制显著相关(OR=1. 152, P=0. 003)。结论 T2DM患者血糖控制情况与健康素养水平显著相关,健康素养越高的患者血糖控制越好。其中,仅反映文字及图阅读能力的健康素养与血糖控制显著相关。Objective To explore the relationship between glycemic control and diabetes-related health literacy among type 2 diabetes mellitus(T2 DM) patients. Methods A total of 558 patients aged 18 years and over in community diagnosis in Daxing district in 2017 were selected for questionnaire survey( demographic characteristics, lifestyle, blood glucose control measures), physical examination, blood biochemical examination(fasting blood glucose, glycosylation hemoglobin,etc.). Univariate and multivariate logistic regression were used to explore the relationship between HbAlc control and health literacy and other influencing factors. Results The patients ’ health literacy score was( 15. 73 ± 7. 12)points. The proportions of healthy literacy levels from low to high fourth-class group blood glucose control were 32. 21%,38.97%, 39.71%, and 48. 10%, respectively. Mantel-haenszel X^2 test and Spearman correlation analysis showed that there was no correlation between health literacy and glycemic control. Multivariate logistic regression analysis showed that after adjusting for age and gender, health literacy was associated with glycemic control( OR = 1.18, P = 0. 045). Further inclusion of other covariates, categorical variables of health literacy( OR = 1. 322, P = 0. 004) and continuous variables(OR = 1. 040,P = 0. 010) were significantly associated with glycemic control. Among the factors, only factor 1 reflecting the ability to read words and graphs was significantly associated with glycemic control( OR = 1. 152, P =0. 003). Conclusion The glycemic control in patients with T2 DM was significantly associated with the level of health literacy, and the better glycemic control was in patients with high levels of health. Only the health literacy that reflects the ability of reading and reading is significantly related to glycemic control.

关 键 词：2型糖尿病 健康素养 糖化血红蛋白 成人 

分 类 号：R193[医药卫生—卫生事业管理]