糖尿病伴感染性疾病与体质指数的相关性及其危险因素

The correlationship and analysis of risk factors between diabetes with infectious diseases and body mass index

目的探讨体质指数与糖尿病伴感染性疾病的相关性以及糖尿病伴感染性疾病的危险因素。方法用病例-对照研究方法分析长沙市中心医院2012年5月至2014年5月收治的590例糖尿病伴感染性疾病患者(观察组)和610例未合并感染性疾病的糖尿病患者(对照组)的体质指数(BMI),通过Logistic回归分析进行危险因素的多因素分析。结果观察组患者体质指数低于对照组(t=6.687、P<0.001);按BMI进行分层,两组患者分布差异有统计学意义(χ~2=50.128、P<0.001)。观察组患者以下呼吸道感染为主(占65.7%),其次为消化道感染(11.59%)、泌尿道感染(9.05%)、上呼吸道感染(7.78%)、皮肤(3.33%)以及其他部位感染(2.53%)。Logistic回归分析显示,体质指数升高是糖尿病伴感染性疾病的保护因素(OR=0.778,95%CI:0.648～0.934);而年龄增长、伴慢性阻塞性肺病和肝硬化是糖尿病伴感染性疾病的危险因素(OR=1.614,95%CI:1.365～1.908;OR=3.076,95%CI:1.745～5.424;OR=6.717,95%CI:0.740～60.951),但肝硬化作为危险因素在回归方程中无统计学意义。结论糖尿病伴感染性疾病与体质指数相关,但需要进一步细化分析其作用;糖尿病患者特别是高龄及合并慢性阻塞性肺病、肝硬化的患者应特别注意感染性疾病的发生。

Objective To investigate the correlationship between body mass index(BMI)and diabetes with infectious diseases and to analyze the risk factors of diabetes with infectious diseases.Methods The BMI of 590 diabetic patients with infectious diseases(observation group)and 610 diabetic patients without infectious diseases(control group)were analyzed by a case-control study from May 2012 to May 2014 in Changsha Central Hospital.Multivariate analysis of risk factors was performed by Logistic regression analysis.Results BMI of observation group was lower than that of the control group(t=6.687,P<0.001),and the distribution of BMI was significantly different between patients of the two groups(χ^2=50.128,P<0.001).The following respiratory tract infections(65.7%)was the most common,followed by digestive tract infection(11.59%),urinary tract infection(9.05%),upper respiratory tract infection(7.78%),skin(3.33%)and other sites(2.53%)in patients of observation group.Logistic regression analysis showed that the increase of BMI was the protective factor of diabetes mellitus with infectious diseases(OR=0.778,95%CI:0.648-0.934).Age,chronic obstructive pulmonary disease and liver cirrhosis were the risk factors of diabetes mellitus with infectious diseases(OR=1.614,95%CI:1.365-1.908;OR=3.076,95%CI:1.745-5.424;OR=6.717,95%CI:0.740-60.951),but liver cirrhosis as a risk factor has no statistical significance in the regression equation.Conclusions Diabetes with infectious diseases is related to BMI,but it is necessary to furtherly refine the analysis of the effect.In patients with diabetes,especially those who were elderly,complicated with chronic obstructive pulmonary diseases and liver cirrhosis should be paid special attention to the occurrence of infectious diseases.