2020—2021年兰州铁路地区职工血糖水平及影响因素分析

Blood glucose levels and related influencing factors among employees in Lanzhou railway bureau in 2020—2021

目的了解2020—2021年兰州铁路地区从业职工血糖水平及影响因素,为糖尿病的综合防治提供科学依据。方法采用概率抽样(PPS抽样)方法和配额抽样方法,按照部门职工人数规模、性别和年龄的人口学构成比进行抽取体检资料(整体按2∶1抽取),结合问卷调查资料,剔除资料不全者,保证调查资料的统一性,采用Excel 2007和SPSS 26.0统计软件进行统计学分析。结果2020—2021年兰州铁路地区从业职工空腹血糖异常患病率为12.27%,糖尿病前期为5.91%,糖尿病患病率为6.36%,后勤部门糖尿病前期和糖尿病患病率较高(19.82%和17.00%),血糖异常率、糖尿病前期和糖尿病患病率均随年龄的增长而有上升趋势(χ^(2)=2117.364、739.878、1285.321,P<0.01),且在≥50岁达到峰值(26.61%、11.66%和14.95%),男性血糖异常率大于女性(χ^(2)=276.122,P<0.01);多因素logistic回归分析结果显示,男性(OR=0.55,95%CI:0.46~0.65)、30~<40岁(OR=4.15,95%CI:3.15~5.46)、40~<50岁(OR=11.41,95%CI:8.85~14.72)、≥50岁(OR=22.77,95%CI:17.80~29.13)超重(OR=1.39,95%CI:1.26~1.55)、肥胖(OR=2,05,95%CI:1.82~2.35)、高血压(OR=1.48,95%CI:1.35~1.63)、高血脂(OR=1.73,95%CI:1.58~1.90)及常上夜班熬夜(OR=1.18,95%CI:1.04~1.22)与血糖异常相关联,而高文化程度(OR=0.86,95%CI:0.82~0.99)和运动锻炼(OR=0.85,95%CI:0.81~0.90)则是血糖异常的积极保护因子。结论后勤和货运部门职工空腹血糖异常率和糖尿病患病率较高,≥50岁职工空腹血糖异常率、糖尿病前期和糖尿病患病率尤其男性职工普遍较高,糖尿病有逐年攀升的潜在威胁,血糖水平影响因素众多,糖尿病防治前景不容乐观,应加强血糖异常群体的早期筛查和患者管理,针对主要影响因素制定有效的防控及干预措施。

Objective To understand the blood glucose levels and related influencing factors among employees in Lanzhou railway bureau,and to provide scientific basis for the comprehensive prevention and treatment of diabetes.Methods Physical examination records as well as questionnaire survey data of employees in Lanzhou railway bureau during 2020and 2021were retrieved and extracted using the probability sampling(pps sampling)and quota sampling method based on the demographical(number,age and gender)composition ratio of employees in each department.Employees with incomplete data were excluded.Excel and SPSS26.0were used for data analysis.Results During 2020and 2021,the overall prevalence of impaired fasting glucose(IFG)among employees was 12.27%.The incidence of pre-diabetes and diabetes were found to be5.91%and 6.36%,which were both higher among employees in department of facility(19.82%and17.00%).The IFG rate,pre-diabetes and diabetes morbidity increased with age(χ^(2)=2117.364,739.878,1285.321,P<0.01)and peaked among those aged over 50(26.61%,11.66%and 14.95%),they were higher in males than in females(χ^(2)=276.122,P<0.01).Multivariate logistic regression analysis showed that males(OR=0.55,95%CI:0.46-0.65),age of over 30years old(OR=4.15-22.77,95%CI:3.15-29.13),overweight(OR=1.39,95%CI:1.26-1.55),obesity(OR=2.05,95%CI:1.82-2.35),hypertension,abnormal blood lipids,night shift or staying up late(OR=1.18,95%CI:1.04-1.22)were associated with IFG,while higher education(OR=0.86,95%CI:0.82-0.99)and exercise(OR=0.85,95%CI:0.81-0.90)were positive protective factors.Conclusions Employees in facility and transportation department,male employees and those aged over 50years have higher rate of IFG,Pre-diabetes and diabetes,which also show up-ward trends.Multiple factors affect the glucose levels,therefore the prevention and treatment of diabetes is challenging.we should strengthen the early screening and management for those with IFG,and formulate effective intervention measures targeting the main influencing factors.