重庆市老年人糖尿病的社区调查与健康状况分析

Community-based investigation on aged diabetes mellitus and analysis of the patient health conditions in Chongqing

目的 研究重庆市主城区老年人糖尿病(aged diabetes mellitus, ADM)的社区患病情况和特征。方法 采用普查、系统抽样调查和临床检查相结合的方法调查重庆市主城区7 个社区60 岁以上ADM患病状况和生活质量。结果 (1)社区ADM“知晓患病率”为2.85%;(2)高血压(HT)和白内障并发率分别为52.63%和16.27%,相对危险度(RR)分别为8.86和5.68(P<0.01),其中51.91%的ADM先患HT,先患DM者占28.42%;(3)与对照组比较,ADM患者生活习惯有显著改善,但健康状况自我认识和满意度较差(P<0.01);(4)患者BMI、WHR、血压、血糖、HbA1c和LDL C均显著高于对照组(P<0.05);(5)DM+HT组家庭功能评估(Family APGAR)积分≤3分及抑郁症自评(CES D)积分≥20分的比例显著高于DM组(P<0.05)。结论 社区内ADM知晓率低,患者代谢控制差,受老年状态的影响,尽管生活习惯有改善,但生活质量仍较差。

Objective To study the sociodemographic characteristics of aged diabetes mellitus(ADM) in central region of Chongqing.Methods Using screening combined with systemic sampling and clinical examination, the epidemiological features and quality of life of ADM in population aged 60 and over were surveyed in seven communities of central region in Chongqing.Results (1)The prevalence of diagnosed ADM was 2.83% in the communities. (2) The percent of complicated hypertension(HT) and cataract were 52.63% and 16.27%,respectively, and the relative risk(RR) indices were 8.86 and 5.68, respectively(all P values < 0.01).Of the patients, 51.91% suffered from HT first, but 28.42% developed DM ahead. (3) Compared with control, the living habits of ADM patients were improved significantly, but the self-sensation and perception to physical fitness and the satisfaction extent to health became worse(all P values less than 0.01). (4) BMI,waist/haunch ratio(WHR), blood pressure, fasting plasma glucose, HbA1c and LDL-C levels were higher than those of the control significantly(all P values < 0.05).(5) The percent of Family APGAR score ≤3 and CES-D score ≥ 20 significantly increased in DM+HT group than that in DM group(all P values < 0.05).Conclusion The rate of awareness on ADM was very low in community. The metabolic control is poor in ADM patients. Under the aging condition, the quality of life was worsening despite improved life habits in ADM.