延安市郊区居民血糖异常危险因素的病例对照研究

A case control study on the risk factors of blood glucose abnormality in rural residents of Yan'an

目的了解延安市郊区居民血糖异常的危险因素,为尽早筛查高危病人和采取相应干预措施提供依据。方法 2016-10~12月在延安市郊区采用分层随机抽样的方法,将3个社区中已确诊的74例≥18岁的血糖异常者作为病例组,按照1∶4配对,在同社区随机抽取性别、婚姻状况相同,年龄匹配的296位血糖正常的社区居民作为对照组进行问卷调查和相关检测。结果甘油三脂偏高(OR=3.71,95%CI为1.77~7.75)和睡眠时间异常(OR=1.87,95%CI为1.06~3.28)是延安市郊区居民血糖异常的主要危险因素,两种因素同时存在会使血糖异常的风险升至正常者的8倍(OR=8.00,95%CI为2.73~23.41),饮酒史是血糖异常的保护因素(OR=0.41,95%CI为0.20~0.82)。血糖异常的男性中55.56%伴有血脂异常,血糖异常的女性中51.72%伴有睡眠异常,所有血糖异常居民中伴有2个及以上危险因素的比例为13.51%。结论延安市郊区居民应注意控制饮食,降低BMI和血脂并进行适当体育锻炼,保证合理的睡眠时间,同时通过社区健康教育和同伴行为干预,预防和改变血糖异常进而防止2型糖尿病的发生。

Objective To understand the risk factors of blood sugar abnormality of community residents in suburbs of Yan＇an,and to provide basis for early screening high risk patients and taking corresponding intervention measures.Methods From October to December in 2016,stratified random sampling was used in Yan＇an suburban community.74 patients with abnormal blood glucose of ≥18 years were diagnosed in the community. According to the 1： 4 pairing,at the same sex,marital status,age-matched 296 blood glucose normal community residents as a control group to conduct a questionnaire survey and related testing. Results High triglycerides（ OR = 3. 71,95% CI = 1. 77 ～ 7.75） and abnormal sleep time（ OR = 1. 87,95% CI = 1. 06 ～ 3. 28） were the main risk factors of blood glucose abnormalities in Yan＇an suburbs. The presence of both factors increased the risk of abnormal blood glucose to 8 times（ OR = 8. 00,95% CI = 2. 73 ～ 23. 41） of those who had normal blood glucose. The drinking history was the protective factor of abnormal blood glucose（ OR = 0. 41,95% CI = 0. 20 ～ 0. 82）. 55. 56% of the males with abnormal blood glucose were associated with dyslipidemia,51. 72% of abnormal blood glucose were associated with sleepabnormality,and 13. 51% of those with abnormal blood glucose were associated with 2 or more risk factors.Conclusion Yan＇an suburb community residents should pay attention to diet,reduce BMI and blood lipids and appropriate physical exercise,ensure reasonable sleep time,and through community health education and peer behavior intervention,prevention and reversal of abnormal blood sugar and thus prevent the occurrence of type 2 diabetes.