2型糖尿病患者代谢指标达标情况和微血管并发症患病情况及后者的影响因素分析

Analysis of compliance of metabolic indicators and prevalence of microvascular complications in type 2 diabetes mellitus patients and the influencing factors of the latter

目的探讨2型糖尿病(T2DM)患者代谢指标达标情况和微血管并发症患病情况及后者的影响因素。方法选取2019年1月至2021年12月于首都医科大学附属北京安贞医院门诊或住院诊治的T2DM患者,以最终回收有效调查问卷的1324例患者为观察对象。分析代谢指标[糖化血红蛋白(HbA1c)、血压、低密度脂蛋白胆固醇(LDL-C)]达标情况、微血管并发症[糖尿病肾病(DN)、糖尿病周围神经病变(DPN)]的患病情况及其与其他指标的关系,同时分析DN、DPN的影响因素。结果代谢指标HbA1c、血压、LDL-C达标情况与性别关系不明显(P>0.05);3项代谢指标与年龄、糖尿病病程、体重指数均有明显关系,同时HbA1c、血压与腹型肥胖有明显关系(均P<0.05),年龄60~<80岁者HbA1c、血压、LDL-C达标率最低,分别为23.3%(161/691)、11.7%(81/691)、31.0%(214/691)。女性、年龄60~<80岁、糖尿病病程≥10年、体重指数24~<28 kg/m2、HbA1c未达标、血压未达标的患者DN患病率更高,同时多因素Logistic回归分析结果显示这几项是DN的危险因素(均P<0.05);糖尿病病程≥10年、体重指数24~<28 kg/m2的患者DPN患病率更高,除此二者之外腹型肥胖也是DPN的危险因素(均P<0.05)。结论T2DM患者的血糖、血压、血脂达标率均有待提升;糖尿病病程≥10年、体重指数24~<28 kg/m2是T2DM患者发生DN、DPN的危险因素,应加强管理。

Objective To investigate the compliance of metabolic indicators and prevalence of microvascular complications in type 2 diabetes mellitus(T2DM)patients and the influencing factors of the latter.Methods From January 2019 to December 2021,T2DM patients diagnosed and treated in Beijing Anzhen Hospital,Capital Medical University were selected,and 1324 patients who completed effective questionnaires were observed.The compliance of metabolic indicators[glycosylated hemoglobin(HbA1c),blood pressure,low-density lipoprotein cholesterol(LDL-C)],the prevalence of microvascular complications[diabetic nephropathy(DN),diabetic peripheral neuropathy(DPN)]and their relationship with other indicators,as well as influencing factors of DN and DPN were analyzed.Results There was no significant relationship of HbA1c,blood pressure,LDL-C to gender(P>0.05).The above three metabolic indicators were significantly related to age,diabetes mellitus duration and body mass index,and HbA1c and blood pressure were significantly related to abdominal obesity(all P<0.05).The compliance rates of HbA1c,blood pressure and LDL-C were the lowest in patients aged 60-<80 years,which were 23.3%(161/691),11.7%(81/691)and 31.0%(214/691)respectively.The prevalence rate of DN was higher in women,patients aged 60-<80 years,with diabetes mellitus duration≥10 years,body mass index 24-<28 kg/m2,HbA1c not up to standard,and blood pressure not up to standard.At the same time,multivariate Logistic regression analysis showed that those were risk factors of DN(all P<0.05).The prevalence of DPN was higher in patients with diabetes mellitus duration≥10 years and body mass index 24-<28 kg/m2.Those two and abdominal obesity were risk factors of DPN(all P<0.05).Conclusion The compliance rates of plasma glucose,blood pressure and blood fat in T2DM patients need to be improved.The diabetes mellitus duration≥10 years and body mass index 24-<28 kg/m2 are the risk factors of DN and DPN in T2DM patients,and management should be strengthened.