季节和气温变化对2型糖尿病患者空腹血糖的影响  

Effects of seasonal and temperature variations on fasting blood glucose levels in patients with type 2 diabetes mellitus

作　　者：梁彤彤 曹莉 李俊[1] 俞艳 严玉洁 许慧琳[1] LIANG Tongtong;CAO Li;LI Jun;YU Yan;YAN Yujie;XU Huilin(Minhang Center for Disease Control and Prevention,Shanghai 201101,China;Zhoupu Hospital Affiliated to Shanghai University of Medicine and Health Sciences;School of Public Health,Fudan University;Xinhong Community Health Service Center of Minhang District)

机构地区：[1]上海市闵行区疾病预防控制中心,201101 [2]上海健康医学院附属周浦医院 [3]复旦大学公共卫生学院 [4]上海市闵行区浦锦社区卫生服务中心

出　　处：《天津医药》2025年第3期252-256,共5页Tianjin Medical Journal

基　　金：上海市闵行区自然科学研究课题(2022MHZ024)。

摘　　要：目的探讨季节和气温变化对2型糖尿病(T2DM)患者空腹血糖(FPG)的影响。方法回顾性分析2020年1月1日—2023年10月31日上海市闵行区社区卫生服务中心管理的31994例T2DM患者临床资料及同期气象资料,分析季节和气温变化对T2DM患者FPG水平及血糖控制情况的影响。结果31994例患者共进行FPG检查72334人次,人均2.26次,春季、夏季、秋季和冬季分别为15558、34018、21929和829人次。T2DM患者夏、秋季的FPG水平低于冬、春季(P<0.05),血糖控制率高于冬、春季(Bonferroni校正P<0.008),春季与冬季及夏季与秋季相比的FPG水平及血糖控制率差异均无统计学意义。以FPG是否控制为因变量的多水平混合效应Logistic模型分析结果显示,T2DM患者冬季及春季的FPG不达标的风险较秋季分别高47%(aOR=1.465,95%CI:1.156~1.855)及51%(aOR=1.510,95%CI:1.384~1.645)。FPG水平和FPG异常率在2月达到高峰,9月达到低谷,均呈现随气温降低而升高的趋势,且存在滞后效应,Spearman秩相关检验结果显示,FPG水平和FPG异常率与滞后1个月的月均每日平均气温均呈负相关(rs分别为-0.951和-0.944,P<0.001)。结论T2DM患者FPG具有明显的冬、春季水平升高及血糖控制率降低的季节性特征,FPG水平和FPG异常率与月均每日平均气温呈负相关,且存在滞后性。Objective To explore the impact of seasonal and temperature variations on fasting blood glucose(FPG)in patients with type 2 diabetes(T2DM).Methods A retrospective analysis was conducted on clinical data of 31994 T2DM patients managed by community health service center in Minhang District,Shanghai,from January 1,2020 to October 31,2023.The effect of seasonal and temperature variations on FPG levels and blood glucose control was investigated in T2DM patients.Results A total of 72334 FPG tests were conducted in 31994 T2DM patients,with an average of 2.26 tests per person.The number of tests conducted in spring,summer,autumn and winter were 15558,34018,21929 and 829,respectively.The FPG levels of T2DM patients were lower in summer and autumn compared to those of winter and spring(P<0.05),while the FPG control rates were higher in summer and autumn compared to those of winter and spring(Bonferroni-corrected,P<0.008).There were no significant differences in FPG levels and blood glucose control rates between spring and winter,or between summer and autumn.The results of the multilevel mixed-effect Logistic model analysis with FPG control status as the dependent variable revealed that the risk of uncontrolled FPG in T2DM patients during winter and spring was 47%(aOR=1.465,95%CI:1.156-1.855)and 51%(aOR=1.510,95%CI:1.384-1.645),respectively,which was higher than that of autumn.The levels of FPG and the incidence of FPG abnormalities reached peak in February and reached the trough in September.Both the FPG levels and the incidence of FPG abnormal exhibited a trend of increasing with the decrease of temperature,and with a lag effect observed.Spearman rank correlation test indicated that there was a negative correlation between FPG levels and incidence of abnormal FPG and the monthly average daily temperature one month lagged(rs=-0.951,P<0.001 and rs=-0.944,P<0.001).Conclusion FPG levels of T2DM patients exhibit a pronounced seasonal pattern of elevation during winter and spring,accompanied by a reduction in blood glucose cont

关 键 词：糖尿病 2型 空腹血糖 血糖控制 季节 气温 

分 类 号：R446.1[医药卫生—诊断学] R587.1[医药卫生—临床医学]