社区2型糖尿病伴发中心性肥胖的现状调查

Status Survey of Central Obesity Complicating Type 2 Diabetes in Community

目的了解浦东中部社区建立全科家庭医师责任制管理模式下的社区2型糖尿病及其伴发中心性肥胖的关系和血糖达标情况。方法调查上海浦东某社区纳入浦东疾病预防控制中心慢性病系统在册管理的2型糖尿病患者1 055例,共收回901例有效问卷,有效回收率85.40%,对患者性别、年龄、病程、血压、血脂[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、体质指数(BMI)、腰围、臀围、腰臀比等各项指标作基线调查,统计其相关性。结果 901例2型糖尿病患者中伴发中心性肥胖403例(44.73%,中心性肥胖组),未伴发中心性肥胖498例(55.27%,非中心性肥胖组)。中心性肥胖组与非中心性肥胖组患者病程分布比较,差异有统计学意义(χ~2=7.399,P=0.025)。非中心性肥胖组患者FPG、Hb A1c、血脂达标率均高于中心性肥胖组,差异均有统计学意义(P<0.05)。结论浦东中部社区全科医师家庭责任制管理模式下的2型糖尿病患者血糖达标过半,伴中心性肥胖者血糖、血脂达标率低,加强社区肥胖体型尤其是中心性肥胖的干预是社区糖尿病患者血糖达标的重要防治工作之一。

Objective To understand the correlation between Type 2 diabetes mellitus （T2DM） and concomitant central obesity as well as condition of reaching standard of blood glucose monitored by general family medical management in middle area of Pudong community. Methods There were 1 055 cases of T2DM patients recorded in chronic disease information system of Pudong center for disease control and prevention in Shanghai Pudong Lingqiao Community. Altogether 901 （ 85.40% ） valid questionnaires were included to investigate their gender, age, course, blood pressure, blood lipid （ TG, TC, LDL-C and HDL-C ）, DPG, HbA1 c, Body Mass Index （ BMI）, waistline, hipline, and WHR, all of which were conduc- ted the baseline survey and correlation analysis. Results Of the 901 patients with T2DM,there were 403 cases accompanying central obesity（44.73% ）,and 498 cases of non central obesity（55.27% ）. There were significant differences in course distribution between the patients with central obesity and non central obesity group （ χ2 = 7. 399, P = 0.025 ）. The rate of FPG, HbAlc and blood lipids in the non central obesity group was higher than those in the central obesity group （ P 〈 0.05 ）. Conclusion It was found that more than half of T2DM patients who had received the General Practitioner intervention had acceptable FPG and HbA1 c level, and accompanying central obesity had lower FPG and lipid level rate. To strengthen the community obesity intervention, especially central obesity intervention is one of the important preventions and treatments of diabetes patients.