上海市城区中老年2型糖尿病合并高血压患者超重和肥胖流行现状

The prevalence of overweight and obesity in elderly residents with type 2 diabetes mellitus and hypertension in urban area of Shanghai

目的了解上海市城区中老年2型糖尿病合并高血压患者超重和肥胖现状,为制定肥胖和肥胖相关慢性病防治策略提供科学依据。方法利用分层整群随机抽样方法从上海市某城区10个街道中随机抽取4个街道,将2010-2014年纳入该区慢病管理系统的4 716名50岁及以上的2型糖尿病合并高血压患者作为研究对象。通过面对面调查收集人口学资料、既往病史、糖尿病并发症和临床症状、饮食习惯、糖尿病用药及健康教育等信息,采用标准方法测量身高、体重、腰围、臀围和血压等指标。采用SAS 9.2软件进行χ~2检验和Cochran-Armitage趋势检验。结果中老年2型糖尿病合并高血压患者中,男、女性的体质指数(BMI)分别为(24.70±2.94)、(24.87±3.52)kg/m^2,腰围分别为(89.16±9.02)、(85.37±9.26)cm。男性患者的超重率(45.94%)高于女性(41.70%),而女性肥胖率(16.88%)高于男性(12.66%),差异有统计学意义(P<0.01)。女性患者中心性肥胖率(49.90%)高于男性(45.90%),差异有统计学意义(P<0.01)。女性不同年龄组超重率和肥胖率差异有统计学意义(P<0.05),50~<55岁组超重率和肥胖率均最高,而男性各年龄组超重率和肥胖率差异无统计学意义(P>0.05);男性和女性超重率和肥胖率在不同血压情况和饮食情况各组间的差异均有统计学意义(P<0.05)。男性和女性中心性肥胖率均随血压等级升高而升高,趋势性检验有统计学意义(P<0.01)。结论上海市城区中老年2型糖尿病合并高血压患者超重率和肥胖率较高,应采取针对性的措施控制该人群的血压水平,加强饮食干预,降低肥胖相关慢性病的发生风险。

Objective To investigate the prevalence and distribution of overweight and obesity in elderly residents（≥50 years old） with type 2 diabetes mellitus（T2 DM） and hypertension in urban area of Shanghai, and to provide the basis for prevention and control of chronic diseases related to the obesity and obesity. Methods The stratified and random cluster sampling method was used to select 4 716 elderly T2 DM patients（≥50 years old） with hypertension from 4 subdistricts among 10 subdistricts of a district in Shanghai as the subjects. The investigation was conducted by collecting the information of demographic data, diseases history, diabetes complications, clinical symptoms, eating habits, diabetes medications and health education; and measuring the height, weight, waist, hip circumference and blood pressure. Chi-squared test and Cochran-Armitage trend test were used to analyze the data, the used software was SAS 9.2. Results Among 4 716 subjects, the BMI of males and females were（24.70±2.94）and（24.87±3.52） kg/m-2, the waist circumferences of males and females were（89.16±9.02） and（85.37±9.26） cm, respectively.The overweight rate（45.94%） in males was significantly higher than that（41.70%） in females; but the obesity rate（16.88%） in females was significantly higher than that（12.66%） in males（P〈0.01）. Moreover, the central obesity rate（49.90%） in females was significantly higher than that（45.90%） in males（P〈0.01）.There were significant differences of overweight rate and obesity rate in different age subgroups of females（P〈0.05）, the overweight rate and obesity rate in 50-55 years old subgroup of females were the highest. However, there were no significant differences of overweight rate and obesity rate in different age subgroups of males（P〉0.05）. There were significant differences of overweight rates and obesity rates in males and females with different level of hypertension and different eating habits（P〈0.05）. The central obesity rates in males and females significantly increased with hypertension level（P〈0.01）. Conclusion The overweight rate and obesity rate in elderly T2 DM patients with hypertension were higher. The effective measures（controlling of hypertension and intervening of food habits） should be taken to reduce the risk of chronic diseases related to obesity.