Abstract:Objective To investigate thestatus and control of blood lipid level among patients with type 2 diabetes mellitus(T2DM)in rural communities of Zhejiang Province,and to provide evidence for blood lipid control for T2DM. Methods A sample of 10 343 patients with T2DM managed by communities from Jiashan,Suichang and Yongkang in 2016 were recruited. Through the diabetes registry system,physical examination and laboratory tests,data of demographic features,blood pressure,body mass index(BMI),waist circumstance(WC),glycated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)were collected to learn the status of blood lipid control. Logistic regression analysis was conducted to explore the influencing factors for blood lipid control. Results The control rate of TC,TG,LDL-C and HDL-C in patients with T2DM was 29.84%,58.72%,48.25% and 61.27%,respectively. About 11.76% of patients had all the four indicators in control,while 9.22% of patients failed in all. The higher control rates of all of the four indicators were seen in males than females,in older age,in lower BMI and in normal people than in central obese people(all P<0.05). The results of multivariate logistic regression analysis showed that sex(OR=3.556,95%CI:3.070-4.119),age(OR=1.130,95%CI:1.060-1.204),WC(OR=0.989,95%CI:0.980-0.998),BMI(OR=0.768,95%CI:0.688-0.857),systolic blood pressure(OR=0.991,95%CI:0.984-0.999),HbA1c level(OR=0.914,95%CI:0.876- 0.953),smoking(OR=0.768,95%CI:0.639-0.924)and drinking(OR=0.688,95%CI:0.536-0.884)were associated with the control of TC,TG,LDL-C and HDL-C in patients with T2DM. Conclusion The control rate of blood lipid is low in patients with T2DM in rural communities of Zhejiang Province,surveillance and interventions should be focused on sex,overweight/obesity,smoking,alcohol intake,blood glucose and blood pressure.
胡如英, 王勇, 陈凯伦, 何青芳, 潘劲. 浙江省农村2型糖尿病患者血脂水平及控制现状[J]. 预防医学, 2019, 31(11): 1091-1096.
HU Ru-ying, WANG Yong, CHEN Kai-lun, HE Qing-fang, PAN Jin. Blood lipid level and the control status among patients with type 2 diabetes mellitus in rural communities of Zhejiang Province. Preventive Medicine, 2019, 31(11): 1091-1096.
[1] International Diabetes Federation. Q&A:Key points for IDF Diabetes Atlas 2017[J]. Diabetes Res Clin Pract,2018,135:235-236. [2] KHAVANDI M,DUARTE F,GINSBERG H N,et al. Treatment of dyslipidemias to prevent cardiovascular disease in patients with type 2 diabetes[J]. Currcardiol Rep,2017,19(1):7. [3] 中国胆固醇教育计划委员会.高甘油三酯血症及其心血管风险管理专家共识[J]. 中华心血管病杂志,2017,45(2):108- 115. [4] LATHIEF S,INZUCCHI S E. Approach to diabetes management in patients with CVD[J]. Trends Cardiovasc Med,2016,26(2):165-179. [5] 中华医学会内分泌学分会脂代谢学组.中国2型糖尿病合并血脂异常防治专家共识(2017年修订版)[J]. 中华内分泌代谢杂志,2017,33(11):925-936. [6] 杨光燃,袁申元,傅汉菁,等.北京社区2型糖尿病患者血脂异常情况分析:北京社区糖尿病研究8[J]. 中华全科医师杂志,2012,11(10):748-752. [7] 何欢,李勇,王畅,等.吉林省社区成人糖尿病患者血脂异常现况分析[J]. 卫生研究,2014,43(5):743-748. [8] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J]. 中华糖尿病杂志,2018,10(1):4-67. [9] 中国高血压防治指南修订委员会.中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志,2019,24(1):24-56. [10]中华人民共和国卫生部疾病控制司.中国成人超重和肥胖症预防控制指南[M]. 北京:人民卫生出版社,2006. [11]李剑虹,米生权,李镒冲,等.2010年我国成年人血脂水平及分布特征[J]. 中华预防医学杂志,2012,46(7):607-612. [12]COLHOUN H M,BETTERIDGE D J,DURRINGTON P N,et al. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study(CARDS):multicentre randomised placebo-controlled trial[J]. Lancet,2004,364(9435):685-696. [13]苏健,覃玉,沈冲,等.江苏省社区管理2型糖尿病患者综合控制情况分析[J]. 中华内分泌代谢杂志,2018,34(2):112-120. [14]史超,陈良,王颖珏,等.上海某社区2型糖尿病控制达标状况分析[J]. 上海医药,2017,38(24):42-43,62. [15]李春红,卢亚琴.社区2 型糖尿病患者血脂控制现状的调查探究[J]. 实用糖尿病杂志,2017,14(2):42. [16]吴逸,丁荣,王炎炎,等.老年2型糖尿病患者血脂异常状况及其影响因素[J].中国老年学杂志,2017,37(3):609-611. [17]CHINES A,PAN K,RYAN K A,et al. A pooled analysis of the effects of conjugated estrogens/bazedoxifene on lipid parameters in postmenopausal women from the selective estrogens,menopause,and response to therapy(SMART)Trials[J]. J Clin Endocrinol Metab,2015,100(6):2329-3238. [18]苏健,向全永,吕淑荣,等.成年人体质指数、腰围与高血压、糖尿病和血脂异常的关系[J]. 中华疾病控制杂志,2015,19(7):696-700. [19]张洁,何青芳,王立新,等.浙江省成人高血压合并糖尿病患病率及心血管病风险分析[J]. 预防医学,2018,30(2):109-112. [20]朱雯,李辉,王永,等.宁波市居民代谢综合征现况调查[J]. 预防医学,2017,29(7):653-659. [21]刘瑶霞,陈树,陈平,等.中国老年糖尿病患者血脂异常现况调查及影响因素分析(GDCR研究基线2)[J]. 中国糖尿病杂志,2018,26(8):647-652. [22]马军,彭毅,樊光辉.吸烟与男性急性冠状动脉综合征患者高敏C反应蛋白、脂蛋白(a)及血脂水平的关系[J]. 中国心血管杂志,2017,22(5):337-342. [23]郭帅军,余小鸣,张芯,等.大学生吸烟、饮酒等健康危险行为的聚集现象分析[J]. 北京大学学报(医学版),2013,45(3):382-386. [24]JANG H G,JANG W M,PARK J H,et al. Alcohol consumption and the risk of type 2 diabetes mellitus:effect modification by hypercholesterolemia:the Third Korea National Health and Nutrition Examination Survey(2005) [J],Asia Pac J Clin Nutr,2012,21(4):588-593. [25]YANG W,LU J,WENG J,et al. Prevalence of diabetes among men and women in China[J]. N Engl J Med,2010,362(12):1090-1101.