Abstract:Objective To learn the prevalence of dyslipidemia and its influencing factors among patients with type 2 diabetes mellitus (T2DM) in rural areas of Zhejiang Province, and to provide evidence for dyslipidemia control. Methods A sample of 10 343 patients with T2DM managed by communities from three counties (Jiashan,Suichang and Yongkang) were recruited. Through the residents’ health record system and specific investigation, demographic features,physical examination results of blood pressure,height, weight, 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 analyze the spectrum of dyslipidemia. A logistic regression model was established to explore the associated factors of dyslipidemia. Results The prevalence rate of dyslipidemia among the patients with T2DM in rural communities was 66.91%. The prevalence rates of higher level of TC, TG, LDL-C were 41.76%, 41.28%, 15.89%, respectively, while the prevalence rateof lower level of HDL-C was 16.92%. The prevalence rates of purely high TC,high TC with TG and purely high TG were 11.84%,11.75% and 11.47%,respectively. Higher level of TG with lower level of HDL-C was common in males (11.32%) and higher level of TC with TG was common in females (14.60%). The results from multivariate logistic regression analysis indicated that females(OR=1.499,95%CI:1.352-1.663),age(OR=0.992,95%CI:0.988-0.996),poor control of HbA1c(OR=1.241,95%CI:1.141-1.351), abdominal obesity(OR=1.169,95%CI:1.064-1.285),overweight(OR=1.384,95%CI:1.257-1.524)and obesity(OR=1.582,95%CI:1.352-1.852)were associated with dyslipidemia. Conclusions The prevalence of dyslipidemia is relatively higher among the patients with T2DM in rural communities of Zhejiang Province. Higher level of TC and TG contributed to most dyslipidemia. The patients with T2DM who are females,have poor control of plasma glucose and suffer from obesity should be under surveillance.
胡如英, 王勇, 何青芳, 潘劲, 陆风, 王蒙, 周晓燕. 浙江省农村2型糖尿病患者血脂异常及影响因素分析[J]. 预防医学, 2020, 32(7): 649-654.
HU Ruying, WANG Yong, HE Qingfang, PAN Jin, LU Feng, WANG Meng, ZHOU Xiaoyan. Prevalence and influencing factors of dyslipidemia among patients with type 2 diabetes mellitus in rural communities of Zhejiang Province. Preventive Medicine, 2020, 32(7): 649-654.
[1] 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. [2] 胡如英,王勇,陈凯伦,等.浙江省农村2型糖尿病患者血脂水平及控制现状分析[J].预防医学,2019,31(11):1091-1096. [3] 张周斌,薛振香,吴雪霁,等.新疆喀什地区维吾尔族糖尿病人群血脂异常及控制情况分析[J].中华流行病学杂志,2017,38(6):702-708. [4] 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. [5] 赵水平. 《中国成人血脂异常防治指南(2016年修订版)》要点与解读[J].中华心血管病杂志,2016,44(10):827-829. [6] 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. [7] 何宇纳,赵文华,赵丽云,等.中国2010—2012年成年人代谢综合征流行特征[J].中华流行病学杂志,2017,38(2):212-215. [8] 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. [9] 甘惠文,陈雪萍,徐雪明.社区2型糖尿病患者合并脂代谢异常的情况分析[J].上海医药,2019,40(8):47-49. [10] 方凯,马爱娟,李航,等.北京市40~79岁居民糖尿病与空腹血糖受损流行病学现状及其危险因素研究[J].中国全科医学杂志,2019,22(9):1014-1020. [11] 付饶,朱颖俐,侯筑林,等.481例社区居民2型糖尿病患者血脂异常现况分析[J].中国卫生工程学,2015,14(6):514-517,520. [12] COCATE P G,NATALI A J,DE OLIVEIRA A,et al.Red but not white meat consumption is associated with metabolic syndrome,insulin resistance and lipid peroxidation in Brazilian middle-aged men[J].Eur J Prev Cardiol,2015,22(2):223-230. [13] 诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-953. [14] REN J,GRUNDY S M,LIU J,et al.Long-term coronary heart disease risk associated with very-low-density lipoprotein cholesterol in Chinese:the results of a 15-year Chinese multi-provincial cohort study (CMCS)[J].Atherosclerosis,2010,211(1):327-332. [15] 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. [16] International Diabetes Federation Guideline Development Group.Glo-bal guideline for type 2 diabetes[J].Diabetes Res Clin Pract,2014,104(1):1-52. [17] American Diabetes Association.Standards of Medical Care in Dia-betes-2014[J].Diabetes Care,2014,37(Suppl.1):S14-S80. [18] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,22(8):2-42. [19] 郑剑勇,黄秀敏,苏依所,等.成人体质指数与血脂异常的相关性分析[J].预防医学,2017,29(8):790-792. [20] LI R,SHI L,JIA J,et al.Differentiating the associations of waist circumference and body mass index with cardiovascular disease risk in a Chinese population[J].Asia Pac J Public Health,2015,27(2):457-467. [21] 冯静,刘欢,许丹,等.肥胖2型糖尿病患者合并血脂异常和高血压情况分析[J].中国全科医学杂志,2019,22(Suppl.1):64-67.