浙江省农村2型糖尿病患者血脂水平及控制现状  

Blood lipid level and the control status among patients with type 2 diabetes mellitus in rural communities of Zhejiang Province

作　　者：胡如英[1] 王勇[2] 陈凯伦 何青芳[1] 潘劲[1] HU Ru-ying;WANG Yong;CHEN Kai-lun;HE Qing-fang;PAN Jin(Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou,Zhejiang 310051,China)

机构地区：[1]浙江省疾病预防控制中心,浙江杭州310051 [2]嘉善县疾病预防控制中心 [3]浙江中医药大学公共卫生学院

出　　处：《预防医学》2019年第11期1091-1096,共6页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：浙江省公益技术应用研究计划(2017C33090)

摘　　要：目的了解浙江省农村社区2型糖尿病(T2DM)患者血脂水平和控制情况,为T2DM患者血脂控制提供依据.方法采用整群抽样方法,抽取嘉善县、遂昌县和永康市2016年社区登记管理的10343例T2DM患者为研究对象,通过居民健康档案、糖尿病社区管理系统、体格检查和实验室检测收集人口学信息、血压、体质指数(BMI)、腰围、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)等资料,分析血脂水平及达标情况,采用Logistic回归模型分析血脂达标的影响因素.结果 T2DM患者的TC、TG、LDL-C和HDL-C达标率分别为29.84%、58.72%、48.25%和61.27%;4项血脂指标全达标率为11.76%,4项均未达标占9.22%.男性患者血脂指标单项达标率及4项全达标率均高于女性(P<0.05);年龄越大,4项血脂指标全达标率越高(P<0.05);BMI越大,4项血脂指标全达标率越低(P<0.05);中心性肥胖患者4项血脂指标全达标率低于正常患者(P<0.05).多因素Logistic回归分析结果显示,男性(OR=3.556,95%CI:3.070~4.119)、年龄(OR=1.130,95%CI:1.060~1.204)、腰围(OR=0.989,95%CI:0.980~0.998)、BMI(OR=0.768,95%CI:0.688~0.857)、收缩压(OR=0.991,95%CI:0.984~0.999)、HbA1c(OR=0.914,95%CI:0.876~0.953)、经常吸烟(OR=0.768,95%CI:0.639~0.924)和偶尔饮酒(OR=0.688,95%CI:0.536~0.884)是T2DM患者4项血脂指标全部达标的影响因素.结论浙江省农村社区T2DM患者血脂达标率总体偏低,应针对性别、超重、肥胖、吸烟、饮酒、血糖和血压等影响因素加强T2DM患者的血脂监测和干预.Objective To investigate thestatus and control of blood lipid level among patients with type 2 diabetes mellitus(T2 DM) in rural communities of Zhejiang Province,and to provide evidence for blood lipid control for T2 DM. Methods A sample of 10 343 patients with T2 DM managed by communities from Jiashan,Suichang and Yongkang in 2016 were recruited.Through the diabetes registry system,physical examination and laboratory tests,data of demographic features,blood pressure,body mass index(BMI),waist circumstance(WC),glycated hemoglobin(Hb A1 c),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL-C) were collected to learn the status of blood lipid control. Logistic regression analysis was conducted to explore the influencing factors for blood lipid control.Results The control rate of TC,TG,LDL-C and HDL-C in patients with T2 DM was 29.84%,58.72%,48.25% and 61.27%,respectively. About 11.76% of patients had all the four indicators in control,while 9.22% of patients failed in all. The higher control rates of all of the four indicators were seen in males than females,in older age,in lower BMI and in normal people than in central obese people(all P<0.05). The results of multivariate logistic regression analysis showed that sex(OR=3.556,95%CI:3.070-4.119),age(OR=1.130,95%CI:1.060-1.204),WC(OR=0.989,95%CI:0.980-0.998),BMI(OR=0.768,95%CI:0.688-0.857), systolic blood pressure(OR=0.991, 95% CI: 0.984-0.999), Hb A1 c level(OR=0.914, 95% CI: 0.876-0.953),smoking(OR=0.768,95%CI:0.639-0.924) and drinking(OR=0.688,95%CI:0.536-0.884) were associated with the control of TC,TG,LDL-C and HDL-C in patients with T2 DM. Conclusion The control rate of blood lipid is low in patients with T2 DM in rural communities of Zhejiang Province, surveillance and interventions should be focused on sex,overweight/obesity,smoking,alcohol intake,blood glucose and blood pressure.

关 键 词：2型糖尿病 血脂控制 农村 社区 

分 类 号：R587.1[医药卫生—内分泌]