上海市青浦区积分制管理糖尿病患者长期血脂异常的影响因素  

Influencing factors of chronic dyslipidemia in T2DM patients with diabetes point system management in Qingpu District,Shanghai

作　　者：吴周理 王森[1] 陆杰 任志华[1] 叶开友 汪月琴 吴雅 WU Zhouli;WANG Sen;LU Jie;REN Zhihua;YE Kaiyou;WANG Yueqin;WU Ya(Qingpu District Center for Disease Control and Prevention,Shanghai 201799,China)

机构地区：[1]上海市青浦区疾病预防控制中心,上海201799

出　　处：《公共卫生与预防医学》2025年第2期56-60,共5页Journal of Public Health and Preventive Medicine

基　　金：上海青浦区卫生健康委员会科学基金项目(w2021-42);上海青浦区卫生健康系统第五轮医苑新星培养项目(YY2023-42)

摘　　要：目的了解上海青浦区签约糖尿病积分制管理的T2DM患者长期血脂异常的影响因素,为T2DM患者血脂异常的综合干预和防控提供依据,进一步优化糖尿病积分制管理策略。方法2017-2023年青浦区糖尿病积分制签约的T2DM患者中,筛选长期血脂异常状态和血脂正常的患者,分别纳入病例组和对照组,按照年龄和性别进行1∶1匹配的病例对照研究,分析血脂异常的影响因素。结果多因素配对logistic回归分析结果显示,T2DM患者超重/肥胖、中心性肥胖和吸烟分别使血脂异常的风险增加1.93倍、2.27倍和2.16倍。长期服用降脂药物、5年及以上糖尿病病程、经常参加体育锻炼、知晓血脂状况、已婚状态可以降低T2DM患者发生血脂异常的风险(OR值分别为0.547、0.452、0.685、0.386、0.354)。现患并发症(脑卒中史、冠心病、肾功能不全)也与血脂异常存在关联(OR=1.802,95%CI:1.124~2.888)。结论青浦区糖尿病积分制管理应加强对血脂监测结果的反馈和解读,提高患者血脂管理的健康意识,积极采取生活方式干预和药物治疗的综合管理,以有效控制血脂,减少相关并发症的发生。Objective To understand the influencing factors of chronic dyslipidemia in T2DM patients who signed a contract for diabetes point system management in Qingpu District,and to provide a basis for comprehensive intervention and prevention and control of dyslipidemia in T2DM patients and to optimize the management strategy of Qingpu District diabetes point system.Methods Among the T2DM patients who signed the diabetes point system from 2017 to 2023,patients with chronic dyslipidemia and normal blood lipids were selected and included in the case group and the control group,respectively.A case-control study was conducted with 1:1 matching by age and gender to analyze the factors influencing dyslipidemia.Results Multifactorial paired logistic regression analysis showed that overweight/obesity and central obesity and smoking in T2DM patients increased the risk of dyslipidemia by 1.93,2.27,and 2.16 times,respectively.Long-term use of lipid-lowering drugs,duration of diabetes for 5 years or more,regular physical exercise,knowledge of blood lipid status,and married status could reduce the risk of dyslipidemia in T2DM patients(OR values were 0.547,0.452,0.685,0.386 and 0.354,respectively).Current complications(history of stroke,coronary heart disease,and renal insufficiency)were also associated with dyslipidemia(OR=1.802,95%CI:1.124-2.888).Conclusion The management of diabetes point system in Qingpu District should strengthen the feedback and interpretation of blood lipid monitoring results,improve patients′health awareness of blood lipid management,and actively take comprehensive management of lifestyle intervention and drug treatment to effectively control blood lipid and reduce the occurrence of related complications.

关 键 词：2型糖尿病 血脂异常 糖尿病积分制管理 健康生活方式 综合干预 

分 类 号：R181[医药卫生—流行病学]