深圳市糖尿病患者周围绿地利用与血糖控制的关系

Correlation between the utilization of green space and glucose control among diabetics in Shenzhen

目的探讨深圳市糖尿病患者血糖控制与周围绿地利用的关系,为绿地的健康效应提供依据。方法于2019年11月至2020年1月采用分层多阶段整群随机抽样方法,选取接受深圳市基本公共卫生服务管理满1年的35岁及以上糖尿病患者752例为研究对象,进行问卷调查、体格检查和实验室检测。以糖化血糖蛋白(HbA1C)<7%为血糖控制标准。采用SAS 9.4软件进行Mann-Whitney U检验和χ^(2)检验。采用多因素logistic回归模型分析周围绿地利用与糖尿病患者血糖控制的关联。结果研究对象的血糖控制率为65.2%(490/752),有86.44%的研究对象自报利用周围绿地,平均每周利用绿地的天数为6.0 d(P25,P75:2.0,7.0 d),平均每天利用绿地时间为60.0 min(P25,P75:30.0,120.0 min)。多因素logistic回归分析结果显示,调整混杂因素后,与不利用绿地组相比,利用绿地与糖尿病患者血糖控制呈正相关(OR=1.85,95%CI:1.03~3.33);与每周利用绿地0~1 d组相比,每周利用绿地6~7 d与血糖控制呈正相关(OR=2.10,95%CI:1.21~3.67),均有统计学意义(P<0.05)。按性别分层分析结果显示,男性糖尿病患者周围绿地利用与血糖控制呈正相关(OR=2.31,95%CI:1.13~4.75,P<0.05),女性糖尿病患者周围绿地利用与血糖控制的关联无统计学意义(P>0.05),周围绿地利用和性别之间对糖尿病患者血糖控制存在交互作用(交互检验P值<0.05)。结论绿地利用对糖尿病患者的血糖控制具有积极意义,绿地利用可以作为糖尿病患者血糖管理的一种途径。

Objective To explore the correlation between the utilization of green space and glucose control among diabetics in Shenzhen,and provide the evidence for the health effect of green space.Methods From November 2019 to January 2020,the stratified multi-stage cluster random sampling method was used to select 752 diabetics(≥35 years old)who received the service of basic public health management of Shenzhen for more than 1 year as the subjects.The investigation was performed by questionnaire,physical examination and laboratory test.The glycated blood glucose protein(HbA1C)<7%served as the standard of blood glucose control.The Mann-Whitney U test andχ^(2)test were used to analyze the data.The multivariate logistic regression model was used to analyze the the correlation between green space utilization and glucose control among diabetics.The used software was SAS 9.4.Results The rate of blood glucose control rate was 65.2%(490/752)in subjects,and 86.44%of the subjects self-reported that they used the green space around them,the average frequency of using green space was 6.0 days(P25-P75:2.0-7.0 days)per week while the average time of using green space was 60.0 min(P25-P75:30.0-120.0 min)per day.The multivariate logistic regression analysis showed that after adjusting the confounding factors,as compared with the group not using green space,the group using green space was associated with the positive correlation of blood glucose control in diabetics(OR=1.85,95%CI:1.03-3.33,P<0.05);as compared with the group using green space 0-1 day per week,the group using green space 6-7 days per week was associated with the positive correlation of blood glucose control(OR=2.10,95%CI:1.21-3.67,P<0.05).The results of analysis stratified by sex showed that in male patients with diabetes,there was a positive correlation between the use of green space and blood glucose control(OR=2.31,95%CI:1.13-4.75,P<0.05),while in female patients,there was no statistically significant correlation(P>0.05).There was an interaction between the use of green space and gender on blood glucose control in diabetics(P value of cross test<0.05).Conclusion The utilization of green space has active significance for the blood glucose control in diabetics.The utilization of green space can serve as a way to manage the blood glucose of diabetics.