甘肃省平原风沙和黄土丘陵地区糖尿病周围神经病变患病率及影响因素分析  

Analysis of the prevalence and influencing factors of diabetic peripheral neuropathy in the plain sand and loess hilly areas of Gansu Province

作　　者：王云芳[1] 张琦[2] 洪豆豆 杨建宁 刘静[4] 权金星[1] Wang Yunfang;Zhang Qi;Hong Doudou;Yang Jianning;Liu Jing;Quan Jinxing(Department of Endocrinology,Gansu Provincial Hospital,Lanzhou 730000,China;Department of Geriatric Medicine,Gansu Provincial Hospital,Lanzhou 730000,China;First Clinical Medical College of Gansu University of Chinese Medicine,Lanzhou 730000,China;Metabolic Disease Diagnosis and Treatment Center,Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院内分泌科,兰州730000 [2]甘肃省人民医院老年医学科,兰州730000 [3]甘肃中医药大学第一临床医学院,兰州730000 [4]甘肃省人民医院代谢病诊疗中心,兰州730000

出　　处：《中华糖尿病杂志》2023年第11期1091-1098,共8页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：国家自然科学基金(81960173,82160166);甘肃省人民医院科研基金项目(2019-320)。

摘　　要：目的探讨甘肃省平原风沙和黄土丘陵地区糖尿病周围神经病变(DPN)的患病率及其影响因素。方法为横断面研究,选取甘肃省平原风沙和黄土丘陵地区2型糖尿病(T2DM)患者为研究对象。收集研究对象文化程度、年龄、糖尿病病程、糖尿病家族史和足部皲裂情况。DPN诊断标准依据《糖尿病神经病变诊治专家共识(2021年版)》。采用χ^(2)检验对平原风沙和黄土丘陵地区患者的DPN患病率进行比较,采用多因素logistic回归分析法分析DPN的影响因素。结果共纳入T2DM患者1532例,其中,平原风沙地区729例,黄土丘陵地区803例。DPN总患病率为53.7%(822/1532),与黄土丘陵地区相比,平原风沙地区DPN患病率更高[分别为42.3%(340/803)和66.1%(482/729),χ^(2)=86.871,P<0.001]。多因素logistic回归分析结果显示,高文化程度(OR=0.218,95%CI 0.215~0.382,P<0.001)是DPN保护因素,DPN高危风险随年龄增长而增加,病程≥10年(OR=1.562,95%CI 1.230~1.984,P<0.001)、HbA_(1c)≥7%(OR=1.300,95%CI 1.028~1.645,P=0.029)、有糖尿病家族史(OR=1.320,95%CI 1.052~1.654,P=0.016)、存在足部皲裂(OR=1.374,95%CI 1.069~1.766,P=0.013)和2700 m的较高海拔(OR=2.733,95%CI 2.172~3.438,P<0.001)是DPN的独立影响因素。结论甘肃省平原风沙地区DPN患病率显著高于黄土丘陵地区。除了年龄、病程、文化程度、HbA_(1c)等影响因素外,海拔也会增加DPN发生风险。Objective To explore the prevalence and influencing factors of diabetic peripheral neuropathy(DPN)in the plain sand and loess hilly area of Gansu Province.Methods This study was a cross-sectional study.Type 2 diabetes mellitus(T2DM)patients in the plain sand and loess hilly area of Gansu Province were selected as the subjects.Educational level,age,course of diabetes,family history of diabetes and foot chaps were collected.The diagnostic criteria for DPN are based on the Expert Consensus on Diagnosis and Treatment of diabetes Neuropathy(2021 Edition).χ^(2) test was used to compare the DPN prevalence between patients in plain sandstorm and loess hilly area,and a multivariate logistic regression model was used to analyze the influencing factors of DPN.Results A total of 1532 T2DM patients were included in the study,including 729 T2DM patients in the plain sandstorm area and 803 patients in the loess hilly area.The overall prevalence of DPN in the plain sandstorm and loess hilly areas of Gansu Province was 53.7%(822/1532).Compared to the loess hilly area,the incidence rate of DPN in the plain sandstorm area was higher,42.3%(340/803)and 66.1%(482/729),respectively.The logistic regression model showed that high education level(OR=0.218,95%CI 0.215-0.382,P<0.001)was a protective factor for DPN,and the high-risk risk of DPN increased with age(χ^(2)=86.671,P<0.001).The course of disease≥10 years(OR=1.562,95%CI 1.230-1.984,P<0.001),HbA_(1c)≥7%(OR=1.300,95%CI 1.028-1.645,P=0.029),diabetes family history(OR=1.320,95%CI 1.052-1.654,P=0.016),presence of foot chaps(OR=1.374,95%CI 1.069-1.766,P=0.013),and high altitude(2700 m)(OR=2.733,95%CI 2.172-3.438,P<0.001)were independent risk factors for DPN.Conclusions The incidence of DPN in the plain sandstorm area of Gansu Province was significantly higher than that in the loess hilly area.In addition to factors such as age,course of disease,education level,and HbA_(1c),altitude also increased the risk of DPN occurrence.

关 键 词：糖尿病 2型 糖尿病周围神经病变 平原风沙 黄土丘陵 

分 类 号：R587.2[医药卫生—内分泌] R745[医药卫生—内科学]