2型糖尿病慢性并发症影响因素的病例对照研究

李哲; 郭淑琴; 刘文宣; 张云良; 杨磊; 马文彬; 刘殿武; 唐龙妹

Abstract

李哲,郭淑琴,刘文宣,张云良,杨磊,马文彬,刘殿武,唐龙妹.2型糖尿病慢性并发症影响因素的病例对照研究[J].Chinese journal of Epidemiology,2005,26(4):1292-1296

2型糖尿病慢性并发症影响因素的病例对照研究

A case-control study on risk factors of type 2 diabetes mellitus related chronic complications in Baoding city

Received:May 11, 2009

DOI：

KeyWord: 2型糖尿病慢性并发症危险因素病例对照研究

English Key Word: Type 2 diabetes mellitus Chronic complications Risk factors Case-control study

FundProject:河北省卫生厅重大项目(08009)

Author Name	Affiliation	E-mail
LI Zhe	河北医科大学公共卫生学院流行病与卫生统计学教研室, 石家庄 050017	Liudianwu@hebmu.edu.cn
GUO Shu-qin	保定市第一中心医院
LIU Wen-xuan	河北医科大学公共卫生学院流行病与卫生统计学教研室, 石家庄 050017
ZHANG Yun-liang	保定市第一中心医院
YANG Lei	河北医科大学公共卫生学院流行病与卫生统计学教研室, 石家庄 050017
MA Wen-bin	保定市第一中心医院
LIU Dian-wu	河北医科大学公共卫生学院流行病与卫生统计学教研室, 石家庄 050017
TANG Long-mei	河北医科大学公共卫生学院流行病与卫生统计学教研室, 石家庄 050017

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Abstract:

目的研究影响2型糖尿病(T2DM)患者慢性并发症发生的主要因素.方法运用以医院为基础的频数匹配的病例对照研究方法,以性别、年龄和民族进行频数匹配,运用单因素和多因素方法分析总慢性并发症及糖尿病心血管并发症、糖尿病眼病、糖尿病神经病变发生的影响因素.结果 (1)T2DM总慢性并发症的危险因素及其OR值:高C反应蛋白(CRP)(OR=5.568)、血脂异常(OR=4.400)、高尿素氮(BUN)(OR=4.399)、高LDL-C(OR=3,594)、住院总时间(OR=2.612)、病前喜食油腻(OR=2.300)、高糖化血红蛋白(HbA1c%)(OR=1.747)、病后缺乏锻炼(OR=1.672)、糖尿病病程(OR=1.509)、精神压力大(OR=1.427);保护因素及其OR值:睡眠质量高(OR=0.606)、血糖控制佳(OR=O.517)、血脂控制佳(OR=0.299)、使用胰岛素(OR=0.155).糖尿病心血管并发症的主要危险因素为高BUN、高血压、高CRP、高LDL-C.糖尿病眼病的主要危险因素为高BUN、高CRP、病前喜食油腻.糖尿病神经病变的主要危险因素为喜食甜食.结论 (1)高CRP、血脂异常、高BUN、高LDL-C是导致T2DM慢性并发症发生的主要危险因素;使用胰岛素、血脂控制佳是T2DM慢性并发症的主要保护因素.(2)心血管并发症独有的危险因素为高LDL-C、精神压力大,神经病变独有的危险因素为病后缺乏锻炼、喜食甜食,眼病并无其独有的危险因素;心血管疾病、神经病变、眼病共同的危险因素为糖尿病病程,共同的保护因素为使用胰岛素.

English Abstract:

Objective To recognize the main risk factors and to provide evidence for prevention and intervention of type 2 diabetes chronic complications.Methods A hospital-based frequency matched case-control study including 200 type 2 diabetes mellitus(T2DM)chronic complications cases and 200 controls without T2DM chronic complications was carried out in Baoding city.Relationships between factors and T2DM chronic complications were analyzed by non-conditional uni-variate and multivariate logistic regression methodologies.Results High C-reactive protein(CRP)(OR=5.568),dyslipidemia(OR=4.400),high blood urea nitrogen(BUN)(OR=4.399),high low density lipoprotein-cholesterol(LDL-C)(OR=3.594),time of hospitalization(OR=2.612),grease food intake before developing DM(OR=2.300),high HbA1C% (OR=1.747),lack of exercise after the development of DM(OR=1.672),duration of DM(OR=1.509),mental stress(OR=1.427),high-quality sleep(OR=0.606),well control of blood glucose (OR=0.517),well control of blood fat(OR=0.299),insulin injections(OR=0.155)etc.were all significantly associated with T2DM chronic complications.Conclusion The main risk factors of T2DM chronic complications seemed to be related to high CRP,dyslipidemia,high BUN and high LDL-C.The main protective factors were insulin injections,well control of blood fat and blood glucose,good-quality of sleep,while the unique risk factors of cardiovascular disease seemed to be high LDL-C and mental stress.The unique risk factors of neuropathy were lack of exercise after developing DM and the amount of sweet food intake.The duration of DM appeared to be the common risk factor and the common protective factor on those three complications was insulin injection.

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