文章摘要
叶润华,李静,姚仕堂,王继宝,曹东冬,章银娣,时允,李品银,许元武,魏华,肖桂芳,孙进廷,段星,王译葵,杨锦,何纳,丁盈盈,段松.德宏傣族景颇族自治州抗病毒治疗的HIV/AIDS糖尿病患病率及其相关因素分析[J].中华流行病学杂志,2019,40(6):654-659
德宏傣族景颇族自治州抗病毒治疗的HIV/AIDS糖尿病患病率及其相关因素分析
Prevalence and related factors on diabetes among HIV/AIDS receiving antiretroviral therapy in Dehong Dai and Jingpo Autonomous Prefecture
收稿日期:2018-12-21  出版日期:2019-06-17
DOI:10.3760/cma.j.issn.0254-6450.2019.06.010
中文关键词: 艾滋病病毒  糖尿病  患病率  影响因素
英文关键词: HIV  Diabetes  Prevalence  Related factors
基金项目:国家科技重大专项(2018ZX10715006,2018ZX17021102-004);国家重点地区艾滋病防治项目
作者单位E-mail
叶润华 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
李静 复旦大学公共卫生学院流行病学教研室 公共卫生安全教育部重点实验室, 上海 200032  
姚仕堂 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
王继宝 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
曹东冬 德宏傣族景颇族自治州人民医院, 芒市 678400  
章银娣 德宏傣族景颇族自治州人民医院, 芒市 678400  
时允 芒市人民医院 678400  
李品银 瑞丽市民族医院 678600  
许元武 陇川县人民医院 678700  
魏华 盈江县人民医院 679300  
肖桂芳 德宏傣族景颇族自治州中医院, 芒市 678400  
孙进廷 梁河县人民医院 679200  
段星 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
王译葵 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
杨锦 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400  
何纳 复旦大学公共卫生学院流行病学教研室 公共卫生安全教育部重点实验室, 上海 200032  
丁盈盈 复旦大学公共卫生学院流行病学教研室 公共卫生安全教育部重点实验室, 上海 200032 dingyy@fudan.edu.cn 
段松 德宏傣族景颇族自治州疾病预防控制中心, 芒市 678400 dhduansong@sina.com.cn 
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中文摘要:
      目的 了解云南省德宏傣族景颇族自治州(德宏州)抗病毒治疗的HIV/AIDS糖尿病患病情况及其相关因素。方法 利用我国艾滋病防治基本信息系统下载德宏州HIV/AIDS抗病毒治疗数据库,并于2017年7月至2018年6月对德宏州≥18岁正在抗病毒治疗的HIV/AIDS开展横断面调查,并采集其静脉血检测其糖化血红蛋白(HbA1c)。糖尿病判定标准为符合其中任意一项者(HbA1c≥6.5%、基线FPG≥7.0 mmol/L、最近1次FPG≥7.0 mmol/L)。采用logistic回归分析抗病毒治疗的HIV/AIDS患有糖尿病的相关因素。结果 共纳入4 376例HIV/AIDS,年龄(43.7±10.1)岁,男性占53.8%(2 356/4 376),HCV阳性率为24.1%(1 055/4 376),HIV确诊阳性时间(8.9±3.8)年,治疗时间(6.8±2.9)年。糖尿病患病率为11.4%(500/4 376)。多因素logistic回归分析结果显示,抗病毒治疗的HIV/AIDS患糖尿病的相关危险因素包括≥40岁、男性、HCV阳性、基线BMI≥24.0 kg/m2、最近1次TG≥1.70 mmol/L、初始抗病毒治疗药物为依非韦伦(EFV)。结论 德宏州抗病毒治疗的HIV/AIDS糖尿病患病率为11.4%。对于抗病毒治疗的HIV/AIDS,应加强中老年、男性、HCV阳性、超重和高TG等糖尿病相关危险因素的预防与控制工作,需进一步研究EFV与糖尿病患病风险的可能关联。
英文摘要:
      Objective To study the prevalence and correlates of diabetes among HIV/AIDS who were on antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefectures (Dehong), Yunnan province. Methods The database of HIV/AIDS receiving ART in Dehong was downloaded by using the basic information system of AIDS prevention and control in China. In this cross-sectional study, HIV/AIDS patients who were currently on ART and aged 18 years or above, were consecutively recruited, between July 2017 and June 2018, in Dehong. All the subjects underwent hemoglobin A1c (HbA1c) testing. Patient with diabetes was defined as meeting any of these indicators (HbA1c ≥ 6.5%, baseline FPG ≥ 7.0 mmol/L, FPG ≥ 7.0 mmol/L in the most recent visit). Both univariate and multivariate logistic regression analysis were carried on to evaluate the correlates of diabetes among the HIV/AIDS patients. Results In total of 4 376 HIV/AIDS patients were included for analysis, with the average age as (43.7±10.1) years, proportion of males as 53.8% (2 356/4 376) and the HCV positive rate as 24.1% (1 055/4 376). The mean years was (8.9±3.8) years after the HIV diagnosis was made, and the mean duration on treatment was (6.8±2.9) years. The prevalence of diabetes was 11.4% (500/4 376). Through multivariate logistic regression analysis, data showed that the risk factors of diabetes of HIV/AIDS on ART were:aged 40 years or above, being male, HCV positive, baseline body mass index ≥ 24.0 kg/m2, elevated TG ≥ 1.70 mmol/L in the most recent visit and baseline antiretroviral regimens under Efavirenz (EFV). Conclusions Prevalence rate of diabetes appeared higher in HIV/AIDS patients who were on ART in Dehong. Prevention and control measures should be targeted on HIV/AIDS patients who were with risk factors of diabetes as being elderly, male, HCV positive, overweight and higher TG. Further esearch is needed to evaluate the association between the use of EFV and diabetes.
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