基于移动医疗APP探究1型糖尿病儿童血糖水平与父母受教育水平的相关性

The association between blood glucose levels of children with type 1 diabetes mellitus and parental educational levels based on mobile health APP

目的探究移动医疗APP中1型糖尿病(T1DM)儿童血糖水平与父母受教育水平的相关性。方法收集中国T1DM登记管理项目入组且注册使用糖糖圈®的T1DM患儿资料及注册后每季度上传的血糖监测信息。根据父母受教育水平将患儿分为低教育组(中学及以下)和高教育组(大专及以上),比较两组间不同时点的血糖水平,采用Spearman相关分析和多因素logistic回归分析评估T1DM患儿血糖水平与父母受教育水平的相关性。结果共纳入满足条件的T1DM患儿2263例,女1246例(55.1%),年龄7.9(4.4,11.4)岁,病程0.07(0.02,0.46)年,高教育组和低教育组分别为1513例和750例。注册后3年内,低教育组患儿各时段血糖均逐渐升高(除早餐后2 h血糖外,均P<0.05)。与低教育组相比,高教育组第3年各时段血糖更低(除凌晨血糖外,均P<0.05)。多因素logistic回归分析结果显示,校正病程、治疗方案等因素后,父母受教育水平仍是患儿餐前血糖、睡前血糖、凌晨血糖的独立相关因素(餐前血糖:OR=0.385,95%CI:0.164~0.874,P=0.025;睡前血糖:OR=0.444,95%CI:0.204~0.949,P=0.038;凌晨血糖:OR=0.226,95%CI:0.582~0.747,P=0.020)。结论我国T1DM患儿血糖水平与父母受教育水平呈负相关,开展T1DM儿童糖尿病管理应考虑其父母的受教育水平。

Objective To explore the correlation between blood glucose level and parental education level in children with type 1 diabetes mellitus(T1DM)based on mobile health APP.Methods The data of T1DM children enrolled in China′s T1DM registration management program and registered to use TangTangquan®were collected,as well as the blood glucose monitoring information uploaded quarterly after registration.Children were divided into low education group(middle school or below)and high education group(junior college or above)according to their parents′education level.Blood glucose levels were compared between the two groups at different time points.Spearman correlation analysis and multivariate logistic regression analysis were used to evaluate the correlation between blood glucose level and parents′education level in children with T1DM.Results A total of 2263 eligible children with T1DM were included and 1246 were female(55.1%).The median age was 7.9(4.4,11.4)years and T1DM duration was 0.07(0.02,0.46)years.Among them,1513 cases were in the low-education group while 750 cases were in the high-education group.Within three years after registration,the glucose levels of each interval in the low-education group were increasing gradually(all P<0.05 except post-breakfast glucose).The glucose levels of each interval in the high-education group in the third year were lower than those in the low-education group(all P<0.05 except nocturnal glucose).The result of multivariate logistic regression analysis showed that after the adjustment of factors including T1DM duration and treatment,parental educational levels were still the separate related factors of premeal glucose,bedtime glucose and nocturnal glucose(premeal glucose:OR=0.385,95%CI:0.164-0.874,P=0.025;bedtime glucose:OR=0.444,95%CI:0.204-0.949,P=0.038;nocturnal glucose:OR=0.226,95%CI:0.582-0.747,P=0.020).Conclusions The blood glucose levels of children with T1DM were negatively associated with parental educational levels.It is suggested that parental educational levels should be taken into consideration in the management of T1DM for children.