中国6省(直辖市)社区糖尿病患者共病患病情况及其影响因素分析

Prevalence and influencing factors of multimorbidity among community diabetic patients in six provincial-level administrative divisions of China

目的了解中国6省(直辖市)社区糖尿病患者的共病患病情况及其影响因素,为糖尿病患者的管理及共病的防控提供参考依据。方法于2021年12月—2022年3月采用多阶段分层随机抽样方法在广东、湖北、重庆、天津、黑龙江和甘肃6个省(直辖市)抽取6713例≥18岁2型社区糖尿病患者进行问卷调查,分析糖尿病患者的共病患病情况及其影响因素。结果中国6省(直辖市)最终纳入分析的6230例社区糖尿病患者中,共病患者3235例,共病患病率为51.93%;共病患病率居于前3位的疾病分别为高血压(44.77%)、冠心病(12.34%)和脑卒中(4.65%);糖尿病合并1、2和≥3种疾病患者分别为2190例(35.15%)、754例(12.10%)和291例(4.67%),其中糖尿病合并高血压患者最多(29.15%);多因素非条件logistic回归分析结果显示,年龄≥45岁、北方区域、饮酒和糖尿病病程≥10年是中国6省(直辖市)社区糖尿病患者共病患病的危险因素;已婚是中国6省(直辖市)社区糖尿病患者共病患病的保护因素。结论中国6省(直辖市)社区糖尿病患者共病患病率较高,年龄、婚姻状况、区域、饮酒情况和糖尿病病程为社区糖尿病患者共病患病的主要影响因素。

Objective To examine the prevalence and influencing factors of multimorbidity among community diabetic patients in six provincial-level administrative divisions(PLADs)of China for providing evidence to disease management and multimorbidity prevention in the patients.Methods Using stratified multistage random sampling,we selected 6713 adult patients(≥18 years)with type 2 diabetics registered in local basic public health service systems in urban communities and rural villages in Tianjin and Chongqing municipality and Guangdong,Hubei,Heilongjiang,Gansu province.Relevant information of the participants were collected via face-to-face surveys with a self-designed questionnaire from December 2021 to March 2022 and analyzed using descriptive statistics and logistic regression.Results Multimorbidity was reported by 3235(51.93%)of the 6230 patients with eligible responses.The top three most reported multimorbidities were hypertension(reported by 44.77%of the patients),coronary heart disease(12.34%)and stroke(4.65%)and the number(proportion)of the patients with one,two,and three or more multimorbidities were 2190(35.15%),754(12.10%),and 291(4.67%),respectively,with the most prevalent multimorbidity of diabetes and hypertension reported by 29.15%of the patients.Multivariate unconditional logistic regression analysis indicated that aged 45 years and older,living in northern regions,having alcohol consumption and a diabetes duration of 10 years and more were significant risk factors for multimorbidity;whereas,being married was a significant protective factor.Conclusion The prevalence of chronic disease comorbidity is relatively high and mainly influenced by age,marital status,living region,alcohol consumption and diabetes duration among community diabetic patients in urban and rural areas of six PLADs in China.