浙江省农村2型糖尿病患者血脂异常及影响因素分析  

Prevalence and influencing factors of dyslipidemia among patients with type 2 diabetes mellitus in rural communities of Zhejiang Province

作　　者：胡如英[1] 王勇[2] 何青芳[1] 潘劲[1] 陆风 王蒙 周晓燕 HU Ruying;WANG Yong;HE Qingfang;PAN Jin;LU Feng;WANG Meng;ZHOU Xiaoyan(Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou,Zhejiang 310051,China;不详)

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

出　　处：《预防医学》2020年第7期649-654,共6页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：国家重点研发计划(2016YFC0901200,2016YFC0901205);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2型糖尿病(T2DM)患者血脂异常情况,并分析其影响因素,为预防农村T2DM患者血脂异常提供依据。方法选取嘉善县、遂昌县所有社区和永康市6个社区2016年社区登记管理的10343例T2DM患者为研究对象。从居民健康档案和社区慢性病管理系统导出人口学信息,测量血压、身高、体重和腰围,实验室检测糖化血红蛋白(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),分析血脂异常谱。采用多因素Logistic回归模型分析T2DM患者血脂异常的影响因素。结果农村T2DM患者血脂异常率为66.91%,TC升高率、TG升高率、LDL-C升高率和HDL-C降低率分别为41.76%、41.28%、15.89%和16.92%。血脂异常以单纯TC升高、TC升高合并TG升高和单纯TG升高为主,异常率分别为11.84%、11.75%和11.47%。男性血脂异常以TG升高合并HDL-C降低为主,异常率为11.32%;女性血脂异常以TC升高合并TG升高为主,异常率为14.60%。多因素Logistic回归分析结果显示,女性(OR=1.499,95%CI:1.352~1.663)、年龄(OR=0.992,95%CI:0.988~0.996)、HbA1c控制不佳(OR=1.241,95%CI:1.141~1.351)、中心性肥胖(OR=1.169,95%CI:1.064~1.285)、超重(OR=1.384,95%CI:1.257~1.524)和肥胖(OR=1.582,95%CI:1.352~1.852)均与血脂异常存在统计学关联。结论浙江省农村T2DM患者血脂异常率总体偏高,以单纯TC升高、TC升高合并TG升高和单纯TG升高为主;应重点监测血糖控制不佳、肥胖和女性居民的血脂异常情况。Objective To learn the prevalence of dyslipidemia and its influencing factors among patients with type 2 diabetes mellitus(T2DM)in rural areas of Zhejiang Province,and to provide evidence for dyslipidemia control.Methods A sample of 10343 patients with T2DM managed by communities from three counties(Jiashan,Suichang and Yongkang)were recruited.Through the residents’health record system and specific investigation,demographic features,physical examination results of blood pressure,height,weight,waist circumstance(WC),glycated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)were collected to analyze the spectrum of dyslipidemia.A logistic regression model was established to explore the associated factors of dyslipidemia.Results The prevalence rate of dyslipidemia among the patients with T2DM in rural communities was 66.91%.The prevalence rates of higher level of TC,TG,LDL-C were 41.76%,41.28%,15.89%,respectively,while the prevalence rate of lower level of HDL-C was 16.92%.The prevalence rates of purely high TC,high TC with TG and purely high TG were 11.84%,11.75% and 11.47%,respectively.Higher level of TG with lower level of HDL-C was common in males(11.32%)and higher level of TC with TG was common in females(14.60%).The results from multivariate logistic regression analysis indicated that females(OR=1.499,95%CI:1.352-1.663),age(OR=0.992,95%CI:0.988-0.996),poor control of HbA1c(OR=1.241,95%CI:1.141-1.351),abdominal obesity(OR=1.169,95%CI:1.064-1.285),overweight(OR=1.384,95%CI:1.257-1.524)and obesity(OR=1.582,95%CI:1.352-1.852)were associated with dyslipidemia.Conclusions The prevalence of dyslipidemia is relatively higher among the patients with T2DM in rural communities of Zhejiang Province.Higher level of TC and TG contributed to most dyslipidemia.The patients with T2DM who are females,have poor control of plasma glucose and suffer from obesity should be under surveillance.

关 键 词：2型糖尿病 血脂异常 影响因素 农村 

分 类 号：R587.1[医药卫生—内分泌] R195[医药卫生—内科学]