城乡接合社区2型糖尿病患者体成分分析与血糖控制状况及影响因素研究

Body Composition Analysis and Blood Glucose Control and Its Influencing Factors of Type 2 Diabetic Patients in Urban-rural Fringe Community

目的:了解城乡接合社区2型糖尿病患者的人体成分与血糖控制状况,探讨血糖控制影响因素。方法:选择2016年10—12月在北京市朝阳区王四营社区卫生服务中心招募的132例糖尿病患者作为研究对象,以糖化血红蛋白(Hb A1c)<7%和Hb A1c≥7%为界点,将研究对象分为血糖控制良好组(68例)和血糖控制不佳组(64例),比较两组血糖、血脂、人体成分指标的差异,分析血糖控制不佳的影响因素。结果:132例研究对象的体质指数(BMI)、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、总胆固醇水平(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和血压的总体达标率分别为12.9%、50.8%、51.5%、38.6%、58.3%、47.7%、59.8%、20.5%。两组患者的FPG、Hb A1c、糖化血清蛋白(GSP)、胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、HDL-C、基础代谢率(BMR)、去脂体重(FFM)、肌肉重(MM)、体脂百分比(PBF)存在显著性差异(P<0.05)。多因素Logistic逐步回归分析结果显示,治疗策略(以生活方式干预作为参照,单种口服降糖药OR=4.565,95%CI:1.483~14.050,多种口服降糖药OR=11.312,95%CI:3.834~33.377)、HDL-C(OR=0.099,95%CI:0.022~0.444)、体脂百分比(OR=1.087,95%CI:1.022~1.157)是血糖控制不佳的影响因素。结论:城乡接合社区2型糖尿病患者的血糖和体脂控制情况欠佳,治疗策略、HDL-C、体脂百分比是血糖控制不佳的主要影响因素,应采取积极的综合措施开展干预。

[Objective]To understand the body composition and blood glucose control of type 2 diabetic patients in urban-rural fringe community and investigate the influence factors of blood glucose control.[Method]Totally 132 diabetic patients were recruited in Wang SiYing community health service center,Chaoyang district,Beijing from October to December 2016 as the research objects.The cut-off points were set as glycosylated hemoglobin(HbA1c)<7%and HbA1c≥7%.All subjects were divided into good blood glucose control group(68 cases)and poor blood glucose control group(64 cases).The differences of blood glucose,blood lipid and body composition indexes between the two groups were compared,and the influence factors of poor blood glucose control were also explored.[Result]For these 132 objects,the overall control rates of body mass index(BMI),fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and blood pressure were 12.9%,50.8%,51.5%,38.6%,58.3%,47.7%,59.8%and 20.5%,respectively.There were significant differences in FPG,HbA1c,glycated serum protein(GSP),HOMA-β,HOMA-IR,HDL-C,basal metabolic rate(BMR),fat free mass(FFM),muscle mass(MM)and percentage of body fat(PBF)between the two groups(P<0.05).The results of multivariate logistic regression analysis showed that the treatment strategy(lifestyle intervention as a reference,for single oral hypoglycemic drugs,OR=4.565,95%CI:1.483~14.050,for various oral hypoglycemic drugs,OR=11.312,95%CI:3.834~33.377),HDL-C(OR=0.099,95%CI:0.022~0.444)and percentage of body fat(OR=1.087,95%CI:1.022~1.157)were influence factors of poor blood glucose control.[Conclusion]The blood glucose control and body fat control of type 2 diabetic patients in urban-rural fringe community is poor.Treatment strategy,HDL-C and percentage of body fat are the influence factors of poor blood glucose control.Therefore,comprehensive measures should be actively taken for intervention.