上海社区糖尿病患者健康素养与糖脂代谢指标及生活质量的相关性  

Associations of health literacy with metabolic status and quality of life among comunity patients with type 2 diabetes in Shanghai

作　　者：杨丽苹 宋海虹 沈珏 高金丽 张志萍 钱柳玉 龚欢 YANG Liping;SONG Haihong;SHEN Jue;GAO Jinli;ZHANG Zhiping;QIAN Liuyu;GONG Huan(Songnan Community Health Center,Shanghai 200441,China;Miaohang Community Health Center,Shanghai 200443,China;Yanghang Community Health Center,Shanghai 201901,China)

机构地区：[1]上海市宝山区淞南镇社区卫生服务中心,上海200441 [2]上海市宝山区庙行镇社区卫生服务中心,上海200443 [3]上海市宝山区杨行镇社区卫生服务中心,上海201901

出　　处：《上海预防医学》2024年第11期1051-1059,共9页Shanghai Journal of Preventive Medicine

基　　金：上海市宝山区科学技术委员会科研项目(21-E-34)。

摘　　要：【目的】了解上海社区2型糖尿病患者健康素养现状,分析其与糖脂代谢测量指标及生活质量水平的相关性,为制定有效干预措施提供依据。【方法】以上海市内分泌代谢病临床医学中心的糖尿病流行病学研究队列(淞南社区)的被二级以上医院确诊的糖尿病患者为研究对象,于2023年3—6月对该队列进行随访观察。采用糖尿病相关健康素养简易评价表和生活质量量表对患者进行评估,并检测血糖、血脂等代谢指标。采用Pearson相关系数评估健康素养水平与代谢测量指标及生活质量水平的相关关系,采用logistic回归模型估计患者健康素养水平与代谢状况及生活质量关联的OR值及95%CI。【结果】调查的932名糖尿病患者健康素养水平较低,平均得分仅(65.2±13.4)分,男性(62.6±13.8)分,女性(67.9±12.5)分。生活质量平均得分为(44.1±9.2)分,男性(44.0±9.5)分,女性(44.2±8.9)分。糖化血红蛋白(HbA1c)、总胆固醇(TC)和甘油三酯(TG)的达标率分别为51.6%、30.3%和64.8%。男性患者TC达标率为37.6%,高于女性的22.8%。不同年龄、文化程度、病程、体重指数(BMI)水平患者的HbA1c达标率差异有统计学意义(P<0.05);不同年龄、家庭年收入、病程、家族史患者的空腹血糖(FPG)达标率差异有统计学意义(P<0.05);TG和高密度脂蛋白胆固醇(HDL-C)达标率在所有变量上的差异均无统计学意义(P>0.05);在无并发症的患者中,低密度脂蛋白胆固醇(LDL-C)达标率高于有并发症的患者(P<0.05)。健康素养与心理维度、治疗维度、生活质量得分呈负相关(r=-0.14,P<0.05)。调整可能的混杂因素后发现,患者健康素养水平与生活质量有关联,但是与代谢指标无关联。【结论】社区糖尿病患者健康素养水平与生活质量水平间存在相关性,需要进一步探讨影响患者生活质量及糖脂代谢指标的因素。[Objective]To investigate the current status of health literacy among type 2 diabetes mellitus patients in Shanghai communities,to analyze its correlation with glycemic and lipid metabolic indicators and quality of life(QoL),and to provide an evidence for the development of effective intervention measures.[Methods]A follow⁃up survey was conducted among diabetic patients diagnosed at hospitals above the secondary level from March to June,2023,who were part of a diabetes cohort study jointly established by Songnan Community in Baoshan District and the Shanghai Institute of Endocrinology.Patients were assessed using a simplified evaluation form for diabetes-related health literacy and a QoL scale,and metabolic indicators such as blood glucose and blood lipids were measured.Pearson correlation coefficients were employed to assess the relationship between health literacy levels and metabolic indicators as well as QoL.Logistic regression models were used to estimate the odds ratios(OR)and 95%confidence intervals(CI)for the associations between patients’health literacy levels,metabolic status,and QoL.[Results]Among the 932 diabetic patients surveyed,the health literacy level was low,with an average score of(65.2±13.4)points of which(62.6±13.8)points for males and(67.9±12.5)points for females.The average QoL score was(44.1±9.2)points of which(44.0±9.5)points for males and(44.2±8.9)points for females.The achievement rates of HbA1c,total cholesterol(TC),and triglycerides(TG)were 51.6%,30.3%,and 64.8%,respectively.The TC achievement rate among male patients(37.6%)was significantly higher than that among females(22.8%).Significant differences in HbA1c achievement rates were observed across age groups,education levels,disease durations,and BMI levels(P<0.05).Similarly,significant differences were found in FPG achievement rates across different age groups,annual household incomes,disease durations,and family histories(P<0.05).No statistically significant differences were noted in TG and HDL-C achievement rates across

关 键 词：2型糖尿病 健康素养 生活质量 代谢指标 生活质量特异性量表 糖尿病特异性生活质量量表 

分 类 号：R1[医药卫生—公共卫生与预防医学] R587.1