2型糖尿病患者并发症及相关危险因素的研究

Study on chronic complications and relative risk factors in patients with type 2 diabetes mellitus

目的调查济宁市2型糖尿病住院及门诊患者中慢性并发症的患病率,分析其相关危险因素。方法采用随机抽样的方法收集济宁市三所医院的住院及门诊糖尿病患者330例,对患者慢性并发症资料进行分析。采用Logistic回归分析初步建立慢性并发症相关因素的数学模型。结果糖尿病患者并发症患病率分别为:脑血管病变24.85%、心血管病变23.71%、下肢血管病变3.97%、眼病变30.51%、肾脏病变12.43%、神经病变58.75%,总患病率为72.42%。多因素Logistic回归分析显示①年龄、体质量指数、胰岛素抵抗指数、高血压病程、收缩压、空腹血糖、总胆固醇、24 h尿白蛋白为糖尿病大血管并发症独立危险因素。高密度脂蛋白胆固醇、舒张压为大血管并发症独立保护因素;②糖尿病病程、糖化血红蛋白、空腹血糖、血总胆固醇、24 h尿白蛋白、收缩压、性别为糖尿病眼病独立危险因素;③糖尿病病程、年龄、血总胆固醇、空腹血糖为周围神经病变的独立危险因素;④糖尿病病程、收缩压、糖化血红蛋白、腰股比、高密度脂蛋白胆固醇为肾脏病变独立危险因素。结论糖尿病患者出现并发症的比例较高,腰股比是糖尿病肾脏病变的主要危险因素,糖化血红蛋白、空腹血糖是糖尿病视网膜病变的主要危险因素,空腹血糖、总胆固醇是糖尿病大血管并发症和糖尿病周围神经病变的主要危险因素。为了预防糖尿病慢性并发症,必须严格控制其危险因素。

Objective To investigate the morbidity rate of chronic complications in patients with type 2 diabetes mellitus in inpatient and outpatient department of hospitals in Jining, and to analyze relevant risk factors of chronic complications. Methods 330 patients with T2DM were selected randomly from 3 hospitals in Jining, and materials of chronic complications in these patients were analyzed. Multivariate Logistic regression analysis was carried out between risk factors and present of diabetic chronic complications. Results the morbidity rate of various chronic complications were as follows： the total prevalence rate 72.42% , cerebral vascular disease 24.85% , angioeardiopathy 23.71% , diabetic retinopathy 30.51% , DPN 58.75% , renal disease 12.43%, vascular disease of lower extremitied 3.97%. Multivariate Logistic regression analysis showed： （1）The duration of hypertension, age, body mass index, insulin resistance index, systolic blood pressure （SBP）, fasting plasma glucose （FPG）, total cholesterol（TC） and 24-hour urinary albumin were independent risk factors relative to diabetic macrovascular complications, however, high-density lipoprotein-cholesterol （HDL-C） and diastolic blood pressure （DBP） were independent protect factors relative to diabetic macrovaseular complications. （2）The duration of diabetes, HbA1c, SBP, FPG, TC, sex and 24-hour urinary albumin were independent risk factors relative to diabetic retinopathy. （3） The duration of diabetes, age, TC, and FPG were independent risk factors relative to DPN. （4）The duration of diabetes, SBP, HbA1c, and waist/thigh ratio, HDL-C were independent risk factors relative to diabetic nephropathy. Conclusion Waist/thigh ratio is the main risk factor of diabetic nephropathy. HbAle and FPG are main risk factors of diabetic retinopathy. FPG and TC are main risk factors of diabetic maerovascular complications and distal symmetric neuropathy. It is very important for preventing complications of type 2 diabetes to control risk factors.