姑苏区2型糖尿病患病和血糖控制情况及其影响因素调查

发布时间：2018-06-25 21:41

本文选题：2型糖尿病 + 患病风险　；参考：《苏州大学》2015年硕士论文

【摘要】：目的描述并分析姑苏区居民2型糖尿病患病情况、患者血糖控制情况及其影响因素和社区筛查新检出患者的人群结构,为该区2型糖尿病的防治工作提供依据。方法采取多阶段整群随机抽样的方法,随机抽取姑苏区21个社区作为调查现场,将居住在调查点6个月以上的18周岁及以上居民为研究对象。排除使用糖皮质激素、胰腺疾病、妊娠、1型及其他类型糖尿病、近期风疹病毒感染史。纳入统计12585人。由培训合格的调查员采用统一设计的病例调查表,收集调查对象的人口统计学信息、生活方式危险因素、疾病史及血糖、腰围等体格检查资料。根据2型糖尿病诊断标准,利用横断面调查的方法,计算2型糖尿病的患病率,采用单因素及多因素logistics回归的方法分析该区人群糖尿病患病的危险因素。按照《国家基本公共卫生服务规范》定义的血糖控制,采用单因素分析的方法分析影响患者血糖控制的相关因素,计算OR及95%CI。此外,利用描述性研究的流行病学方法分析此次筛查新检出的2型糖尿病患者的人口学特征。结果1.姑苏区2型糖尿病患病率为9.53%(1199/12585),按照江苏省2010年人口标化患病率为6.54%,按照全国2010年人口标化患病率为5.97%。2.姑苏区居民2型糖尿病患病风险单因素分析发现,老龄(OR=14.47,95%CI:11.46-18.28)、男性(OR=1.15,95%CI:1.02-1.30)、家族遗传(OR=6.82,95%CI:6.01-7.74)、吸烟(OR=1.20,95%CI:1.05-1.37)、超重(不包括肥胖)(OR=1.74,95%CI:1.53-1.98)肥胖(OR=2.10,95%CI:1.74-2.54)、腹型肥胖(OR=2.49,95%CI:2.20-2.82)是2型糖尿病患病的危险因素。3.姑苏区居民2型糖尿病患病风险多因素分析发现,年龄(OR=1.67,95%CI:1.58-1.76)、腰围(OR=1.44,95%CI:1.23-1.69)、BMI(OR=1.13,95%CI:1.02-1.26)、2型糖尿病家族史(OR=8.81,95%CI:7.49-10.40)、高血压病(OR=2.36,95%CI:2.04-2.74)和高脂血症(OR=1.63,95%CI:1.33-1.99)对2型糖尿病发病存在显著影响,故老龄、腹型肥胖、BMI≥24Kg/m2、2型糖尿病家族史、高血压病和高脂血症是2型糖尿病患病的危险因素。4.姑苏区2型糖尿病血糖控制不良率为34.78%(352/1012)。影响血糖控制率的主要因素是腰围(男性≥92cm,女性≥87cm)(OR=1.82,95%CI:1.27-2.63)、运动量(t=2.30,P=0.022)、病程(t=-3.69,P=0.000)及治疗手段(趋势χ2=9.84,P=0.002)。5.姑苏区2型糖尿病患者中,仍有15.60%(187/1199)的患者是通过此次调查新检出的患者,这类人群同其他已明确诊断的患者相比,有如下特征:自己认为健康程度不错、年龄集中在中年,没有定期自身常规体检、对周边社区卫生服务机构不熟知。6.将姑苏区合并前三区的区域标记为A、B、C,三地2型糖尿病患病率分别为10.03%、8.94%、9.37%,三地患病率无统计学意义(χ2=2.14,P=0.34)。影响A区域居民2型糖尿病患病的危险因素按OR值从高到低前三位依次为糖尿病家族史(OR=11.12,95%CI:8.35-14.82)、合并高血压病(OR=2.30,95%CI:1.79-2.30)和合并高脂血症(OR=1.66,95%CI:1.19-2.31);B区域该顺位为糖尿病家族史(OR=10.07,95%CI:6.36-15.95)、合并高血压病(OR=2.30,95%CI:1.53-3.54)和腰围(OR=1.90,95%CI:1.22-2.95);而C区域该顺位同A区域。结论1.姑苏区2型糖尿病患病率低于江苏省及全国水平。家族遗传史、合并高血压病、高脂血症、超重与腹型肥胖及老龄是姑苏区居民2型糖尿病的患病危险因素。影响血糖控制率的主要因素是腹型肥胖、运动量、病程及治疗手段。2.姑苏区仍有15.60%的2型糖尿病患者被漏诊,提示要加强中年人群糖尿病筛查的力度。3.姑苏区不同地区2型糖尿病的患病危险因素及患者血糖控制情况有所不同,应根据实际情况,开展针对性的防控工作。
[Abstract]:Objective to describe and analyze the prevalence of type 2 diabetes in the residents of Suzhou District, the control of blood sugar and its influencing factors and the population structure of the newly detected patients in community screening, and provide the basis for the prevention and treatment of type 2 diabetes in this area. Methods 21 communities in the Suzhou District were randomly selected as the investigation site. To exclude the use of glucocorticoid, pancreatic disease, pregnancy, type 1 and other types of diabetes, and the history of recent rubella virus infection. 12585 people were included in the survey by a qualified investigator trained by the trained investigators to collect the population of the respondents. Study information, life style risk factors, disease history and blood sugar, waist circumference and other physical examination data. According to the diagnostic standard of type 2 diabetes, the prevalence rate of type 2 diabetes was calculated by cross-sectional survey. The risk factors of diabetes in the population were analyzed by single factor and multiple factor logistics regression. A single factor analysis was used to analyze the related factors affecting patients' blood glucose control, OR and 95%CI. were calculated by the method of single factor analysis, and the demographic characteristics of the newly detected type 2 diabetic patients were analyzed by descriptive epidemiological methods. Results 1. the prevalence rate of type 2 diabetes in the District of Suzhou was found to be 9.53% (1199/12585), according to the population standardized prevalence rate of 6.54% in Jiangsu Province in 2010, according to the single factor analysis on the risk of type 2 diabetes in the residents of 5.97%.2. in 2010, the age (OR=14.47,95%CI:11.46-18.28), the male (OR=1.15,95% CI:1.02-1.30), the family heredity (OR=6.82,95%CI:6.01-7.74), and smoking (OR=1) were found. .20,95%CI:1.05-1.37), overweight (not including obesity) (obesity) (OR=1.74,95%CI:1.53-1.98) obesity (OR=2.10,95%CI:1.74-2.54), abdominal obesity (OR=2.49,95%CI:2.20-2.82) is a risk factor for type 2 diabetes mellitus, the multifactor analysis of the risk of type 2 diabetes in the residents of the.3. District of Suzhou, the age (OR=1.67,95%CI:1.58-1.76), and the waistline (OR=1.44,95%CI:1.23-1) .69), BMI (OR=1.13,95%CI:1.02-1.26), family history of type 2 diabetes (OR=8.81,95%CI:7.49-10.40), hypertension (OR=2.36,95%CI:2.04-2.74) and hyperlipidemia (OR=1.63,95%CI:1.33-1.99) have a significant impact on the onset of type 2 diabetes, so aging, abdominal obesity, family history of BMI more than 24Kg/m2,2, hypertension and hyperlipidemia are type 2 sugar. The risk factor of urinary disease in.4. was 34.78% (352/1012). The main factors affecting the control rate of blood sugar were waist circumference (male > 92cm, female > 87cm) (OR=1.82,95%CI:1.27-2.63), exercise (t=2.30, P=0.022), t= -3.69, P=0.000, and treatment methods (trend Chi 2=9.84, P=0.002) 2 type of caunu District Among the patients with diabetes, 15.60% (187/1199) of the patients were newly detected by the survey. Compared with other patients who had been diagnosed, the group had the following features: good health, age in middle age, regular routine examination, and no knowledge of.6. in the surrounding community health services. The prevalence of type 2 diabetes in the first three areas was A, B, C, and three, and the prevalence rate of type 2 diabetes was 10.03%, 8.94%, 9.37%, and three had no statistical significance (x 2=2.14, P=0.34). The risk factors affecting the prevalence of type 2 diabetes in the A region were followed by the family history of diabetes (OR=11.12,95%CI:8.35-14.82) in sequence of the OR value from the high to the low in the first three, with the combination of hypertension. Disease (OR=2.30,95%CI:1.79-2.30) and hyperlipidemia (OR=1.66,95%CI:1.19-2.31); the B region is a family history of diabetes (OR=10.07,95%CI:6.36-15.95), combined with hypertension (OR=2.30,95%CI:1.53-3.54) and waist circumference (OR=1.90,95%CI:1.22-2.95), while the C region is the same as A area. Conclusion the prevalence rate of type 2 diabetes in 1. Suzhou district is lower than that of Jiangsu. Provincial and national levels. Family history of heredity, hypertension, hyperlipidemia, overweight and abdominal obesity and aging are the risk factors for type 2 diabetes in the District of Suzhou. The main factors affecting the control rate of blood sugar are abdominal obesity, exercise, course of disease and treatment, and 15.60% of patients with type 2 diabetes still have missed diagnosis in.2.'s district. To strengthen the strength of diabetes screening in middle-aged people.3., the risk factors of type 2 diabetes in different areas and the control of blood glucose in different areas of the District of Suzhou are different. The prevention and control work should be carried out according to the actual situation.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1

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