常熟市社区2型糖尿病患者慢性并发症患病率及相关因素分析

The morbidity and influencing factors of chronic complications in patients with type 2 diabetes mellitus in Changshu

目的了解常熟市社区2型糖尿病(T2DM)患者慢性并发症的患病率及其相关危险因素,为糖尿病并发症的预防和治疗提供科学依据。方法于2013年12月至2014年1月采用多阶段分层整群抽样的方法,对常熟市已纳入基本公共卫生服务管理并登记的12个乡镇中11 539名T2DM患者进行问卷调查、体格检查和实验室检测。采用logistic回归分析影响糖尿病患者慢性并发症患病的相关因素。结果 T2DM患者慢性并发症患病率分别为:心血管疾病6.2%、脑血管疾病6.9%、肾病4.5%、眼科疾病11.8%、糖尿病足2.1%和神经病变2.7%,总患病率为25.6%。多因素logistic回归分析显示,年龄(以<60岁组为对照,60~组OR=1.474,95%CI:1.307~1.662,70~组OR=2.040,95%CI:1.790~2.326)、吸烟(OR=1.334,95%CI:1.180~1.508)、体质指数(OR=1.107,95%CI:1.005~1.220),糖化血红蛋白(以<7%组为对照,7%~组OR=1.116,95%CI:1.004~1.240,9%~组OR=1.183,95%CI:1.041~1.346)、糖尿病病程(以<5年组为对照,5~年组OR=1.475,95%CI:1.315~1.655,10~年组OR=1.858,95%CI:1.653~2.089)、高血压(OR=1.424,95%CI:1.237~1.638)、血酯异常(OR=1.377,95%CI:1.253~1.513)、高尿酸症(OR=1.354,95%CI:1.185~1.547)、糖尿病家族史(OR=1.194,95%CI:1.076~1.325)为糖尿病慢性并发症的独立影响因素。结论常熟市社区T2DM患者糖尿病慢性并发症患病率较高,必须严格控制吸烟、体质指数、糖化血红蛋白水平、高血压、血脂异常、高尿酸症等危险因素,以减少或延缓并发症的发生。

Objective To investigate the morbidity and risk factors of chronic diabetic complication in patients with type 2 diabetes mellitus （T2DM） in Changshu and to provide the evidence for the prevention and treatment. Methods From December of 2013 to January of 2014, the multi-stage stratified random sampling method was used to select 11 539 T2DM patients from 12 towns with national public health service management as the subjects. The investigation was conducted with the questionnaire, physical examination and laboratory test. The related factors of diabetic chronic complications were analyzed with multivariate logistic regression method. Results The morbidities of various chronic complications were 6.2% for angioeardiopathy, 6.9% for cerebral vascular diseases, 4.5% for renal diseases, 11.8% for eye diseases, 2.1% for diabetic feet and 2.7% for diabetic peripheral neuropathy （DPN）. Total morbidity of chronic complications was 25.6%. The multivariate logistic regression analysis showed that independent influencing factors of diabetic chronic complications were age （〈60 years old as control, 60-years old group OR = 1.474,95% CI： 1.307～1.662,70-years old group OR=2.040,95%CI： 1.790-2.326）, smoking（OR=1.334,95% CI： 1.180-1.508 ）, BMI （OR= 1.107,95% CI： 1.005-1.220）, HbAlc （〈7% as control, 7%-group OR = 1.116,95% CI： 1.004-1.240,9%-group OR= 1.183,95% CI： 1.041～1.346）, course of diabetes （〈5 years as control,5～years group OR=1.475,95% CI： 1.315～1.655,10～years group OR=1.858 ,95% CI： 1.653～2.089）, hypertension （OR=1.424,95% CI ： 1.237～1.638）, dyslipidemia（OR=1.377,95% C1 ： 1.253-1.513 ）, hypentricemia （0R=1.354,95% C1 ： 1.185～1.547） and family history of diabetes （OR=1.194 ,95% CI ： 1.076-1.325）. Conclusion The morbidity of chronic diabetic complications in T2DM patients of communities in Changshu city is higher. Risk factors （smoking, BMI, HbAk7 hypertension, dyslipidemia and hypenaricemia） should be controlled to reduce or postpone the complications.