肿瘤疾病史对2型糖尿病患者治疗依从性及糖脂代谢指标的影响  

Influence of Tumor History on Treatment Compliance and Glycolipid Metabolism Indicators in Type 2 Diabetes Patients

作　　者：曾春莲[1] 谢倩 覃敏 Zeng Chunlian;Xie Qian;Qin Min(Department of Endocrinology,Leshan Central People's Hospital,Leshan 614000,Sichuan,China)

机构地区：[1]乐山市市中区人民医院内分泌科,四川乐山614000

出　　处：《肿瘤预防与治疗》2025年第1期56-60,共5页Journal of Cancer Control And Treatment

摘　　要：目的:探讨肿瘤疾病史对2型糖尿病(type 2 diabetes mellitus, T2DM)患者治疗依从性和糖脂代谢指标的影响。方法:选取2018年1月至2022年12月我院内分泌科收治的100例具有恶性肿瘤疾病史的T2DM患者作为病例组,采用1:2的比例选取同期入院性别、年龄、病程匹配的200例无肿瘤疾病史的T2DM患者作为对照组。对比两组患者的治疗依从性及肿瘤疾病史对糖脂代谢指标水平的影响,组间比较采用t检验、χ^(2)检验或秩和检验,相关性分析采用Spearman秩相关。结果:有恶性肿瘤疾病史的T2DM患者的Morisky服药依从性量表(The 8-item Morisky Medication Adherence Scale, MMAS-8)依从性评分明显低于无肿瘤疾病史的T2DM对照患者(6.01±1.76 vs 7.33±1.98,P<0.001);两组患者治疗依从构成之间存在差异(P<0.001)。有恶性肿瘤疾病史的T2DM患者的空腹血糖(fasting plasma glucose, FPG)、糖化血红蛋白(glycosylated hemoglobin A_(IC),HbA_(IC))明显高于无肿瘤疾病史的T2DM对照组,而高密度脂蛋白胆固醇(high-density liptein cholesterol, HDL-C)则低于对照组,差异均有统计学意义(均P<0.05)。恶性肿瘤疾病史与MMAS-8依从性评分、HDL-C呈负相关关系(r=-0.322,r=-0.165,P<0.05),与FPG、HbA_(IC)呈正相关关系(r=0.180,r=0.210,P<0.05)。结论:有恶性肿瘤疾病史的T2DM患者的治疗依从性更低,FPG、HbA_(IC)水平更高、HDL-C水平更低;应针对恶性肿瘤疾病史导致的肿瘤相关性高血糖的主要病因开展肿瘤相关性高血糖的评估及血糖控制工作。Objective:To explore the influence of tumor history on the treatment compliance and glucose and lipid metabolism in type 2 diabetes(T2DM)patients.Methods:100 T2DM patients with a history of malignant tumors in the department of endocrinology in our hospital from January 2018 to December 2022 were selected as the case group.A ratio of 1:2 was used to select 200 T2DM patients without history of tumors who were matched in sex,age,and course of disease during the same time of admission as the control group.The effects of tumor history on treatment compliance and on the levels of glucose and lipid metabolism indicators were compared between two groups.t-test,X^(2) test or rank sum test were used for intergroup comparison.Spearman rank correlation was used for correlation analysis.Results:The 8-item Morisky Medication Adherence Scale(MMAS-8)score of T2DM patients with a history of malignant tumors was significantly lower than that of T2DM patients without a history of tumors(6.01±1.76 vs 7.33±1.98,P<0.001).There was a difference in the degree of medication adherence between the two groups(P<0.001).The fasting plasma glucose(FPG)and glycated hemoglobin(HbA_(IC))of T2DM patients with a history of malignant tumors were significantly higher than those of the T2DM patients without a history of tumors,while the HDL-C of the former was lower than that of the latter,with statistical significance(all P<0.05).The history of malignant tumors was negatively correlated to MMAS-8 score and HDL-C(r=-0.322,r=-0.165,P<0.05),and was positively correlated to FPG and HbA_(IC)(r=0.180,r=0.210,P<0.05).Conclusion:T2DM patients with a history of malignant tumors have lower treatment compliance,higher levels of FPG and HbA_(IC),and lower levels of HDL-C.The evaluation and control of tumor-related hyperglycemia should be carried out based on the history of malignant tumors,the main cause of tumor-related hyperglycemia.

关 键 词：糖尿病 2型 恶性肿瘤 治疗依从性 糖代谢 脂代谢 

分 类 号：R730.6[医药卫生—肿瘤]