豫西社区糖尿病患者综合控制状况与维生素D缺乏相关性分析  

Analysis on the association between comprehensive control targets and deficiency of vitamin D among the diabetics managed in the communities of Western Henan

作　　者：王国杰 高莉[2] 黄斌 冯石献[2] 刘建涛 周刚[2] 杨国俊 WANG Guojie;GAO Li;HUANG Bin;FENG Shixian;LIU Jiantao;ZHOU Gang;YANG Guojun(Henan Medical College,Zhengzhou,Henan451191,China)

机构地区：[1]河南医学高等专科学校,河南郑州451191 [2]河南省疾病预防控制中心

出　　处：《河南预防医学杂志》2019年第12期886-890,共5页Henan Journal of Preventive Medicine

摘　　要：目的探讨豫西社区糖尿病患者体重、血糖、血压及血脂控制状况与维生素D(VitD)缺乏是否相关。方法从豫西灵宝市和洛阳市吉利区中随机选取4个乡镇和4个街道作为调查社区;从每个调查社区基本公共卫生服务管理登记的18~75岁糖尿病患者中随机抽取病例作为调查对象。综合控制评价指标包括体质指数、腰围、血压、空腹血糖、糖化血红蛋白、血脂和血压。结果在所调查的877例糖尿病患者中,各项控制评价指标达标率在24.7%~56.0%之间;在腰围、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)控制未达标组,VitD缺乏患病率分别为63.2%,65.6%, 69.5%,均高于达标组(56.0%、56.0%、54.6%;χ2值分别为3.92、8.26、20.58;P均<0.05)。在校正年龄、病程和社区类型后,男性糖尿病患者腰围、TG控制未达标均与VitD缺乏存在统计学意义的正关联,校正OR(95%CI)分别为1.6(1.0~2.4)、1.6(1.1~2.3);男女糖尿病患者HDL-C控制未达标均与VitD缺乏均存在具有统计学意义正关联,校正OR(95%CI)分别为1.6(1.1~2.5)、1.5(1.0~2.4)。结论所调查社区糖尿病患者综合控制达标率较低,Vit D缺乏增加了社区男性糖尿病患者TG和腰围控制未达标风险,以及男女患者HDL-C控制未达标风险。Objective To explore the association between control targets of weight, blood glucose, blood pressure andblood lipid and deficiency of Vitamin D among diabetics managed in the communities of Western Henan.Methods Four urban and four rural communities were randomly selected from the county of Lingbao and Jili district of Luoyang in Western Henan, and the diabetics were selected in random from the cases aged 18-75 years registered and managed for national basic service of public health in each selected community as study subjects. Assessment indicators for the control effectiveness included BMI, waist circumference(WC), fasting plasma glucose, HbA1 C, lipid profile, blood pressure.Results Among 877 study diabetics, the proportion of diabetics reaching the control target for each assessment indicator ranged from 24.7 % to 56.0 %.Prevalence rates of vitamin D deficiency among study diabetics without reaching the control targets of WC, triglycerides(TG)and high density lipoprotein cholesterol(HDL-C)were 63.2 %,65.6 %, 69.5 %,respectively, significantly higher than those reaching the control targets(56.0 %,56.0 %,54.6 %;χ2 equaling to 3.92, 8.26,20.58, respectively;all P<0.05). After adjusted with age, duration of disease and type of residential community, vitamin D deficiency was positively associated with poor control level of WC and TG in male diabetics, and adjusted ORs(95 %CI) were 1.6(1.0-2.4) and 1.6(1.1-2.3), respectively;the associations between vitamin D deficiency and HDL-C were found in both male and female diabetics, and adjusted ORs(95 %CI) were 1.6(1.1-2.5) and 1.5(1.0-2.4), respectively.Conclusions The proportions of diabetics reaching the control targets for the assessment indicators in the study communities were low, and vitamin D deficiency increased the risk of failure to reach the control targets for WC and TG among the males, and for HDL-C among both of males and females.

关 键 词：糖尿病 维生素D 血糖 血压 血脂 中心性肥胖 

分 类 号：R587.1[医药卫生—内分泌]