锦州地区事业单位人员2型糖尿病危险因素病例对照研究

发布时间：2018-06-21 10:45

本文选题：2型糖尿病 + 血脂因素　；参考：《锦州医科大学》2017年硕士论文

【摘要】：目的研究血脂(甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白)及其相关因素(体重指数、收缩压、舒张压、家族史)与2型糖尿病(type2 diabetes mellitus,T2DM)发病之间的关系,侧重探讨血脂及血压因素的致病性及效力,辨析国内外相关研究结论不一致的原因,为2型糖尿病预防提供建议。方法采用1:1配比的病例对照研究法,于锦州市四家三级甲等医院体检中心选取286对研究对象作为研究样本。收集资料方法为问卷调查法及医学指标检测摘录法。调查资料工具采用自行设计的《事业单位人员基本信息采集表》和《体检报告》。选取依据体检血糖异常结果经建议确诊为新发T2DM者为病例组,对照依据匹配条件在体检中心大数据库中选取。资料统计分析采用SPSS 21.0统计分析软件,单因素分析方法为计量资料采用方差分析及t检验,计数资料采用X2检验;多因素分析方法采用条件Logistic回归分析。结果1、病例组与对照组人口学统计特征如:年龄、性别、民族、职业、文化程度等匹配因素资料进行均衡性检验,差异均无统计学意义(P0.05)。2、病例组与对照组甘油三酯、总胆固醇、低密度脂蛋白、高密度脂蛋白、收缩压、舒张压、体重指数及家族史各指标近3年实测值经单因素方差分析,差异均无统计学意义;经t检验及X2检验比较,差异均具有统计学意义(P0.05)。按性别分类分析后略有不同。3、条件Logistic回归分析:(1)甘油三酯、低密度脂蛋白、总胆固醇、体重、家族史、收缩压和舒张压均与T2DM发病有关(P0.05),相对危险度及95%置信区间分别为(ORTG=1.163,95%CI:1.009~1.341;ORLDL=1.776,95%CI:1.231~2.562;ORTC=1.694,95%CI:1.393~2.062;ORBMI=1.184,95%CI:1.101~1.273;OR家族史=1.375,95%CI:1.074~1.758;ORSBP=1.041,95%CI:1.031~1.050;ORDBP=1.013,95%CI:1.003~1.023)。(2)甘油三酯、总胆固醇、收缩压及舒张压与T2DM发病的相关性存在性别差异。男性人群中:(1)舒张压与T2DM发病无关(P=0.545),收缩压则有关(ORSBP=1.021,95%CI:1.009~1.033);(2)总胆固醇未进入模型,甘油三酯与T2DM发病有关(ORTG=1.245,95%CI:1.071~1.447)。女性人群中:(1)收缩压与T2DM发病无关(P=0.312),舒张压则有关(ORDBP=1.018,95%CI:1.005~1.032);(2)甘油三酯未进入模型,总胆固醇与T2DM发病有关(ORTC=2.418,95%CI:1.777~3.291)。结论1、锦州地区事业单位人群中,甘油三酯增高、总胆固醇增高、低密度脂蛋白增高、体重超重、家族史等可增加T2DM发病的风险。而高密度脂蛋白增高则可使该人群T2DM发病风险降低。2、锦州地区事业单位人群中,甘油三酯及总胆固醇对T2DM致病作用存在性别差异。男性人群中,甘油三酯增高可使T2DM发病风险增加,总胆固醇与T2DM发病无关;女性人群中,总胆固醇增高可使T2DM发病风险增加,甘油三酯与T2DM发病无关。3、锦州地区事业单位人群中,血压增高与T2DM存在弱关联,且致病作用存在性别差异。男性人群中,收缩压增高能增加T2DM发病风险,舒张压与T2DM发病无关;女性人群中,舒张压增高可增加T2DM发病风险,收缩压与T2DM发病无关。
[Abstract]:Objective to study the relationship between blood lipid (triglyceride, total cholesterol, high density lipoprotein, low density lipoprotein) and its related factors (body mass index, systolic pressure, diastolic pressure, family history) and the pathogenesis of type2 diabetes mellitus (T2DM), and focus on the pathogenicity and efficacy of blood lipid and blood pressure factors, and to differentiate and analyze the related research at home and abroad. The reasons for the inconsistency were to provide suggestions for the prevention of type 2 diabetes. Methods using the 1:1 matched case control study, 286 pairs of research objects were selected as the research samples in the medical center of four grade A hospitals in Jinzhou city. The methods of collecting data were collected by the questionnaire survey method and the excerpt of the medical index detection. The survey data tool was designed by itself. The basic information collection table of the personnel of the institution and the physical examination report were selected. The case group was selected according to the results of abnormal blood glucose in the medical examination center, which was selected according to the matching condition in the large database of the physical examination center. The statistical analysis of the data was used in the statistical analysis of the soft parts with SPSS 21, and the single factor analysis method was used for the measurement data. ANOVA analysis and t test, X2 test was used for counting data, and conditional Logistic regression analysis was used in multi factor analysis. Results 1, the demographic characteristics of case group and control group such as age, sex, nationality, occupation and educational level were tested with no statistical significance (P0.05).2, case group and control group The measured values of triglyceride, total cholesterol, low density lipoprotein, high density lipoprotein, systolic pressure, diastolic pressure, body mass index and family history were analyzed by single factor variance in the last 3 years. The differences were statistically significant (P0.05) by t test and X2 test. A slight difference of.3, condition Lo after sex classification was found. Gistic regression analysis: (1) triglyceride, low density lipoprotein, total cholesterol, body weight, family history, systolic and diastolic pressure were associated with T2DM (P0.05), relative risk and 95% confidence interval were (ORTG=1.163,95%CI:1.009~1.341; ORLDL=1.776,95%CI: 1.231~2.562; ORTC=1.694,95%CI:1.393~2.062; ORBMI=1.184,95%CI:1.101~1.273; OR) Family history =1.375,95%CI:1.074~1.758; ORSBP=1.041,95%CI:1.031~1.050; ORDBP=1.013,95%CI:1.003~1.023). (2) the correlation between triglyceride, total cholesterol, systolic and diastolic pressure and the incidence of T2DM is gender differences. (1) diastolic pressure is not related to T2DM (P=0.545), and systolic pressure is related (ORSBP=1.021,95%CI:1.009~1.033); (2) Total cholesterol did not enter the model, triglyceride was associated with T2DM (ORTG=1.245,95%CI:1.071~1.447). (1) systolic pressure was not related to T2DM (P=0.312), diastolic pressure was related (ORDBP=1.018,95%CI:1.005~1.032); (2) triglyceride did not enter the model, total cholesterol was associated with T2DM (ORTC=2.418,95%CI:1.777~3.291). Conclusion 1, Among the Jinzhou regional institutions, the increase of triglyceride, the increase of total cholesterol, the increase of low density lipoprotein, the overweight and the family history can increase the risk of T2DM. The increase of high density lipoprotein can reduce the risk of T2DM in this population by.2. In the single population of Jinzhou, triglyceride and total cholesterol are responsible for the pathogenesis of T2DM. In male populations, increased triglyceride may increase the risk of T2DM, and total cholesterol is not related to T2DM; in women, increased total cholesterol may increase the risk of T2DM, and triglycerides are not associated with.3. In the Jinzhou regional institutions, there is a weak association between high blood pressure and T2DM, and the pathogenicity of T2DM. There is a gender difference. In the male population, the increased systolic pressure increases the risk of T2DM. Diastolic pressure is not related to T2DM; in women, the increased diastolic pressure increases the risk of T2DM, and systolic pressure is not related to the incidence of T2DM.
【学位授予单位】：锦州医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1

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