上海市嘉定区马陆镇社区老年人糖化血红蛋白控制情况及影响因素分析

Control Status and Correlation Analysis of Glycosylated Hemoglobin among Elderly in Malu Community of Jiading District in Shanghai

目的:分析社区老年人群糖化血红蛋白(hemoglobin A one c,HbA1c)的控制情况及相关性。方法:选取2021年和2023年在上海市嘉定区马陆镇社区卫生服务中心参加健康体检的≥60岁老年人,其中2021年10 922人,2023年16 496人,分析Hb A1c的影响因素。结果:2021年不同体质指数(BMI)、总胆固醇(TC)、低密度脂蛋白(LDL)、肌酐(Cr)、尿酸体检老年人Hb A1c控制率差异均有统计学意义(χ^(2)值分别为58.648、59.429、42.384、14.670、4.822,P<0.05);2023年不同BMI、血清谷草转氨酶(AST)、TC、LDL、Cr、高密度脂蛋白(HDL)、总胆红素(TBIL)体检老年人Hb A1c控制率差异均有统计学意义(χ^(2)值分别为21.836、4.601、1 923.362、2 936.174、63.548、6.280、6.837,P<0.05)。Spearman相关性分析结果显示,2021年老年人Hb A1c与BMI、TC、LDL、Cr均呈正相关(r值分别为0.071、0.074、0.062、0.037,P<0.05),与尿酸、饮食习惯均呈负相关(r值分别为-0.021、-0.020,P<0.05);2023年老年人Hb A1c与TC、LDL、Cr、HDL均呈正相关(r值分别为0.341、0.422、0.062、0.020,P<0.05),与BMI、AST均呈负相关(r值分别为-0.027、-0.017,P<0.05)。logistic回归分析结果显示,2021年尿酸异常(OR=0.820)是Hb A1c控制的保护因素,BMI为超重(OR=1.195)、TC异常(OR=1.352)、Cr异常(OR=1.530)是Hb A1c控制的危险因素;2023年BMI为超重(OR=0.869)是血糖控制的保护因素,TC异常(OR=2.728)、LDL异常(OR=14.109)、Cr异常(OR=1.475)、TBIL降低(OR=4.175)是血糖控制的危险因素。结论:社区老年人糖化血红蛋白控制情况较好,BMI、TC、LDL、Cr、尿酸和TBIL对控制血糖具有重要的指导意义,在老年人健康管理中应特别关注,采取相应的措施提高HbA1c控制率。

OBJECTIVE To analyze the control status and correlation of HbA1c among the elderly population in Community.METHODS The elderly over 60 years old who participated in physical examination in Malu Community Health Service Center in 2021 and 2023 were selected as the research objects,and the correlation of HbA1c influencing factors was analyzed by T-test,χ^(2) test,Spearman correlation and multi-factor logistics.RESULTS The difference in control rates among different BMI groups,TC groups,LDL groups,Cr groups,and uric acid groups in 2021 is statistically significant(χ^(2)=58.648,59.429,42.384,14.670,4.822,P<0.05).There was a statistically significant difference in control rates among different BMI groups,AST groups,TC groups,LDL groups,Cr groups,HDL groups,and TBIL groups in 2023(χ^(2)=21.836,4.601,1923.362,2936.174,63.548,6.280,6.837,P<0.05).Spearman correlation analysis showed that in 2021,HbA1c was positively correlated with BMI,TC,LDL,and Cr(r=0.071,0.074,0.062,0.037,P<0.05),and negatively correlated with uric acid and dietary habits(r=-0.021,-0.020,P<0.05).In 2023,HbA1c was positively correlated with TC,LDL,Cr and HDL(r=0.341,0.422,0.062,0.020,P<0.05),and negatively correlated with BMI and AST(r=-0.027,-0.017,P<0.05).The results of multi-factor logistics analysis showed that in 2021,abnormal uric acid(OR=0.820)was a protective factor for HbA1c control,BMI was overweight(OR=1.195),TC was abnormal(OR=1.352)and abnormal Cr(OR=1.530)were risk factors for HbA1c control.In 2023,overweight BMI(OR=0.869)was a protective factor for HbA1c control,abnormal TC(OR=2.728),abnormal LDL(OR=14.109),abnormal Cr(OR=1.475),and decreased TBIL(OR=4.175)were risk factors for HbA1c control.CONCLUSION Elderly people in the community have better control over HbA1c,and BMI,TC,LDL,Cr,uric acid and TBIL have important guiding significance for the control of blood sugar.Special attention should be paid to the health management of the elderly,and corresponding measures should be taken to improve the control rate of HbA1c.