上海市虹口区社区2型糖尿病及其慢性并发症的流行病学调查

Epidemiological Investigation of Type 2 Diabetes Mellitus and its Chronic Complications in the Community of Hongkou District, Shanghai

目的调查上海市虹口区社区2型糖尿病及其慢性并发症的流行病学情况,为开展2型糖尿病及其慢性并发症的防治提供依据。方法选取2017-2019年上海市虹口区8家社区卫生中心参加2型糖尿病慢性并发症筛查的11190例患者为研究对象,分析患者基本资料及下肢血管搏动改变、足部皮肤改变、糖尿病性周围神经病变发生情况;另根据DPN诊断标准将患者分为3组,即五项检查全为全阴性者为组1,五项检查中有1项阳性者为组2,五项检查中≥2项阳性者为组3,比较各组基本资料及其与病情严重程度的关系。结果11190例患者中男5195例(46.43%),女性5995例(53.57%),年龄主要集中于60~79岁;不同性别年龄、BMI、腰围、舒张压、FPG、HbA1c、TC、TG、LDL、UA、UACR、ALT、γ-GT、AKP比较,差异有统计学意义(P<0.05);有7.60%的患者出现了足部血管搏动异常,91.33%的患者出现了足部皮肤改变;DPN五项检查中≥2项阳性者共786例(7.02%),男性DPN患病率为8.16%,高于女性的6.03%(P<0.05);组1、组2和组3年龄、收缩压、舒张压、FPG、HbA1c、TC、LDL、UACR、ALT、AST、γ-GT水平比较,差异有统计学意义(P<0.05)。结论上海市虹口区社区2型糖尿病患者以60岁以上老年人居多,不同性别年龄、BMI、腰围、舒张压、FPG、HbA1c、TC、TG、LDL、UA、UACR、ALT、AKP水平存在差异,且绝大部分患者存在足部皮肤改变和血管病变。糖尿病慢性并发症DPN的患病率偏高,有效控制患者收缩压、FPG、HbA1c、UACR水平可能会延缓DPN的发生发展。

Objective To investigate the epidemiology of type 2 diabetes mellitus and its chronic complications in Hongkou District, Shanghai, and provide evidence for the prevention and treatment of type 2 diabetes mellitus and its chronic complications. Methods A total of 11 190 patients who participated in the screening of chronic complications of type 2 diabetes mellitus in 8 community health centers in Hongkou District of Shanghai from2017 to 2019 were selected as the research objects.The basic data of patients and the occurrence of lower extremity vascular pulsation changes, foot skin changes and diabetic peripheral neuropathy were analyzed. According to DPN diagnostic criteria, the patients were divided into three groups:group 1(five tests were all negative), group 2(one test was positive) and group 3(≥ two tests were positive). The basic data of each group and its relationship with the severity of the disease were compared.Results Among the 11 190 patients, 5195 patients(46.43%) were males and 5995patients(53.57%) were females, mainly aged 60-79 years. There were significant differences in age, BMI, waist circumference, diastolic blood pressure, FPG, Hb A1c, TC, TG, LDL, UA, UACR, ALT, γ-GT and AKP among different genders(P <0.05). There were 7.60% of patients with abnormal foot vascular pulsation, 91.33% of patients with foot skin changes;there were 786 cases(7.02%) with ≥2 positive results in the five DPN examinations. The prevalence of DPN in males was 8.16%, which was higher than 6.03% in females(P <0.05). There were statistically significant differences in age, systolic blood pressure, diastolic blood pressure, FPG, HbA1c, TC, LDL, UACR, ALT, AST and γ-GT levels among group 1, group2 and group 3(P<0.05).Conclusion The majority of patients with type 2 diabetes in the community of Hongkou District in Shanghai are over 60 years old. There are differences in age, BMI, waist circumference, diastolic blood pressure, FPG, Hb A1 c, TC, TG, LDL, UA, UACR, ALT and AKP levels between different genders, and most patients have foot skin changes and vascular lesions. The prevalence of DPN is high. Effective control of systolic blood pressure, FPG, Hb A1c, UACR levels may delay the occurrence and development of DPN.