城市社区2型糖尿病流行现状、影响因素及其饮食干预等效果的流行病学探索

发布时间：2018-04-20 21:10

本文选题：2型糖尿病 + 流行　；参考：《南昌大学》2009年硕士论文

【摘要】： 目的:探索当前城市社区居民糖尿病(Diabetes Mellitus,DM)的流行特点及其影响因素,并观察饮食和行为干预对2-DM患者血生化指标的影响,为进一步研究DM流行规律和综合防控提供科学参考。方法:采用整群随机抽样,对青山湖社区常住居民1310人的DM流行现况进行了调查(包括问卷、体检、空腹血糖及血脂等生化指标检查),并在上述基础上对确诊的66例2-DM患者的影响因素实施了镶嵌病例研究,且采用前瞻性随访观察66例2-DM患者为期一个月的饮食和行为干预的效果,即对干预前后的某些生化指标进行比较。结果:(1)青山湖社区人群2-DM总患病率为5.04%,高于全国平均水平,其中男性为6.42%,女性为4.31%。随着年龄的增长,DM的患病率逐渐增高.(2)在所有被查对象中超重及肥胖率(BMI≥24)为42.90%,且两性人群随着BMI增加,其DM患病率上升。超重者其SBP、DBP、Tc、TG、LDL、FBG均较BMI正常者高,而HDL较正常者低。(3)病例对照研究的单因素与多因素非条件Logistic回归分析,显示BMI与2-DM有关联,其OR值为2.548,两者关系密切。文化程度偏低者DM患病率明显高于文化程度高者,病因学分析提示,受教育程度越低,发生DM的危险性越高,其OR值为1.785。家族史研究表明,有DM家族史者其患该病的危险是无家族史的1.88倍,与目前大多数研究结果相近,有学者的病例对照研究报告提示,家族史作为2型DM的独立危险因素(OR=2.612)。TG也是2型DM的危险因素(OR=2.785)。(4)IFG率为7.63%,随着年龄增加,IFG受损率呈逐渐升高的趋势,肥胖者IFG受损率明显高于正常人群。(5)经为期一个月的饮食和行为干预的随访观察,对2-DM患者自我感受和某些生化指标的改善有一定效果,如FBG明显下降。结论:(1)该人群2-DM患病率为5.04%,高于全国平均水平,男性患病率高于女性,随着年龄加大患病率上升,已婚者患病率偏低,文化程度偏低的患病率偏高,在职业上表现为公务员(脑力劳动者)高,个人经济收入低的人群中患病率较高;肥胖、高血压人群中DM患病率明显高于其他人群。(2)与DM患病相关的主要危险因素有TG偏高、BMI异常、文化程度偏低和DM家族史。(3)对66例2-DM患者实施为期一个月的饮食和行为控制,结果表明其在临床表现和自我感觉方面有不同程度的改善,且FBG、Cr与干预前比较有明显下降。
[Abstract]:Objective: to explore the epidemic characteristics and influencing factors of diabetes mellitus (DM) in urban community residents, and to observe the effect of diet and behavior intervention on the blood biochemical indexes of 2-DM patients, so as to provide scientific reference for further study on the prevalence of DM and comprehensive prevention and control. Methods: the prevalence of DM in 1310 residents of Qingshan Lake community was investigated by cluster random sampling (including questionnaire, physical examination). Fasting blood glucose, blood lipid and other biochemical indexes were examined. On the basis of the above, inlaid case study was carried out on the influencing factors of 66 patients with 2-DM. The effects of dietary and behavioral intervention for one month in 66 patients with 2-DM were observed prospectively, that is to say, some biochemical indexes before and after intervention were compared. Results the total prevalence of 2-DM in Qingshanhu community was 5.04, which was higher than the national average, among which 6.42 were male and 4.31 in female. The prevalence rate of overweight and obesity in all subjects was 42.90. The prevalence of DM in both sexes increased with the increase of BMI. The results of univariate and multivariate Logistic regression analysis showed that there was a correlation between BMI and 2-DM (OR = 2.548, OR = 2.548). The prevalence of DM was significantly higher in those with lower education level than in those with high education. Etiological analysis indicated that the lower the level of education, the higher the risk of DM, and the OR value was 1.785. Family history studies have shown that people with DM family history are 1.88 times more likely to develop the disease than those with no family history, which is close to the results of most current studies. Family history, as an independent risk factor for type 2 DM, was also a risk factor of type 2 DM, and the IFG rate was 7.63. The damage rate of IFG increased gradually with age. The rate of IFG damage in obese patients was significantly higher than that in normal subjects. (5) after one month's follow-up observation of diet and behavior intervention, there was a certain effect on the improvement of self-feeling and some biochemical indexes in patients with 2-DM, such as the decrease of FBG. Conclusion the prevalence rate of 2-DM in this population is 5.04, which is higher than the national average. The prevalence rate of male is higher than that of female. With the increase of age, the prevalence rate of married people is lower, and the prevalence rate of education is lower than that of female. In the professional performance of civil servants (mental workers) high, low personal income of the population with a higher prevalence; obesity, The main risk factors related to the prevalence of DM in hypertension population were higher than those in other groups. The main risk factors associated with DM were abnormal TG, low education and family history of DM. 66 patients with 2-DM were treated with diet and behavior control for one month. The results showed that its clinical manifestation and self-feeling were improved to some extent, and FBGG Cr decreased significantly compared with that before intervention.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R587.1;R181.3

【引证文献】