目的 探讨特需病房2型糖尿病患者代谢综合征的患病率及其主要危险因素.方法 2010年1月至2012年7月特需病房住院的462例2型糖尿病患者及1 898例内分泌科普通病房住院的2型糖尿病患者为特需组和对照组,并进行体脂参数、血压、血糖、血脂谱、胰岛素、C肽等检查.结果 (1)特需组与对照组患者中男性[72.5％ (335/462)与56.6(1 075/1 898)],吸烟(40.5％与24.6％),饮酒(24.9％与10.7％)及高收入者(76.6％与12.7％)的比例高于对照组,两组比较差异有统计学意义(x2值分别为32.1、16.9、12.3、32.8,P均＜0.001).特需组与对照组的体质量指数(BMI)[(25.6±3.7) kg/m2与(24.8±3.5) kg/m2]、腰围[(91.0±9.5) cm与(89.1±10.3) cm]、丙氨酸氨基转移酶(ALT)[(27.8±19.7) U/L与(23.0±16.1)U/L]、γ-谷氨酰转移酶(γ-GT)[(34.1 ±26.3) U/L与(29.2±23.2) U/L]、甘油三酯(TG)[(2.35±2.31) mmol/L与(1.82±1.64) mmol/L]、血尿酸[(333.7±85.5) μmol/L与(317.1 ±85.2) μmol/L]、空腹C肽[(2.11±1.04)μ g/L与(1.74±1.05)μg/L]高于对照组,差异有统计学意义(F值分别为11.44、6.90、16.65、8.35、18.23、7.34、21.21,P均＜0.01),而两组年龄[(52.9±11.1)岁与(60.4±12.2)岁]、糖尿病病程[5(2,10)年与7(2,12)年]、收缩压[(126.7±15.2) mmHg(1 mmHg =0.133 kPa)与(131.9±17.3) mmHg]、血高密度脂蛋白胆固醇(HDL-C)[(1.02±0.32) mmol/L与(1.10±0.32) mmol/L],糖化血红蛋白[(8.44±1.99)％与(9.16±2.32)％],特需组则低于对照组,差异有统计学意义(F值分别为79.41、12.71、18.93、12.78、18.52,P均＜0.01).(2)特需组超重和/或肥胖、血脂紊乱及代谢综合征的患病率分别为55.6％、68.4％、60.2％,显著高于对照组的46.1％,52.9％,50.6％(x2值分别为7.59、18.76、7.18,P均＜0.01),高血压患病率为39.6％,低于对照组50.7％ (x2=10.15,P＜0.01).特需组代谢综合征患病率男女间差异无统计学意义(61.2％与57.5％,x2=0.01,P=0.92).按＜45岁,45 ～59岁,≥60岁分组后,随着年龄的升高,女性代谢综合征患病率有增高趋势(33.3％、48.0％、74.1％,x2=4.43,P=0.04),男性代谢综合征患病率各年龄组间差异无统计学意义(58.8％、62.5％、55.6％,x2=0.05,P=0.87).(3)Logistic多元回归分析显示,在特需组中,年龄[OR=1.071,95％ CI为1.027 ～1.117,P=0.001]、BMI[OR=1.391,95％ CI为1.112～1.739,P=0.013]、腰围[OR=1.126,95％ CI为1.039～1.222,P=0.004]、TG[OR=1.747,95％ CI为1.124 ～2.717,P=0.013]、舒张压[OR=1.111,95％CI为1.045～1.180,P=0.001]是发生代谢综合征的危险因素,而HDL-C[OR=0.048,95％CI为0.005 ～0.464,P=0.009]是代谢综合征的保护因素.结论 特需病房住院的2型糖尿病患者约3/5合并代谢综合征.年龄、BMI、腰围、舒张压、TG、HDL-C与代谢综合征的发生有关.
目的 探討特需病房2型糖尿病患者代謝綜閤徵的患病率及其主要危險因素.方法 2010年1月至2012年7月特需病房住院的462例2型糖尿病患者及1 898例內分泌科普通病房住院的2型糖尿病患者為特需組和對照組,併進行體脂參數、血壓、血糖、血脂譜、胰島素、C肽等檢查.結果 (1)特需組與對照組患者中男性[72.5％ (335/462)與56.6(1 075/1 898)],吸煙(40.5％與24.6％),飲酒(24.9％與10.7％)及高收入者(76.6％與12.7％)的比例高于對照組,兩組比較差異有統計學意義(x2值分彆為32.1、16.9、12.3、32.8,P均＜0.001).特需組與對照組的體質量指數(BMI)[(25.6±3.7) kg/m2與(24.8±3.5) kg/m2]、腰圍[(91.0±9.5) cm與(89.1±10.3) cm]、丙氨痠氨基轉移酶(ALT)[(27.8±19.7) U/L與(23.0±16.1)U/L]、γ-穀氨酰轉移酶(γ-GT)[(34.1 ±26.3) U/L與(29.2±23.2) U/L]、甘油三酯(TG)[(2.35±2.31) mmol/L與(1.82±1.64) mmol/L]、血尿痠[(333.7±85.5) μmol/L與(317.1 ±85.2) μmol/L]、空腹C肽[(2.11±1.04)μ g/L與(1.74±1.05)μg/L]高于對照組,差異有統計學意義(F值分彆為11.44、6.90、16.65、8.35、18.23、7.34、21.21,P均＜0.01),而兩組年齡[(52.9±11.1)歲與(60.4±12.2)歲]、糖尿病病程[5(2,10)年與7(2,12)年]、收縮壓[(126.7±15.2) mmHg(1 mmHg =0.133 kPa)與(131.9±17.3) mmHg]、血高密度脂蛋白膽固醇(HDL-C)[(1.02±0.32) mmol/L與(1.10±0.32) mmol/L],糖化血紅蛋白[(8.44±1.99)％與(9.16±2.32)％],特需組則低于對照組,差異有統計學意義(F值分彆為79.41、12.71、18.93、12.78、18.52,P均＜0.01).(2)特需組超重和/或肥胖、血脂紊亂及代謝綜閤徵的患病率分彆為55.6％、68.4％、60.2％,顯著高于對照組的46.1％,52.9％,50.6％(x2值分彆為7.59、18.76、7.18,P均＜0.01),高血壓患病率為39.6％,低于對照組50.7％ (x2=10.15,P＜0.01).特需組代謝綜閤徵患病率男女間差異無統計學意義(61.2％與57.5％,x2=0.01,P=0.92).按＜45歲,45 ～59歲,≥60歲分組後,隨著年齡的升高,女性代謝綜閤徵患病率有增高趨勢(33.3％、48.0％、74.1％,x2=4.43,P=0.04),男性代謝綜閤徵患病率各年齡組間差異無統計學意義(58.8％、62.5％、55.6％,x2=0.05,P=0.87).(3)Logistic多元迴歸分析顯示,在特需組中,年齡[OR=1.071,95％ CI為1.027 ～1.117,P=0.001]、BMI[OR=1.391,95％ CI為1.112～1.739,P=0.013]、腰圍[OR=1.126,95％ CI為1.039～1.222,P=0.004]、TG[OR=1.747,95％ CI為1.124 ～2.717,P=0.013]、舒張壓[OR=1.111,95％CI為1.045～1.180,P=0.001]是髮生代謝綜閤徵的危險因素,而HDL-C[OR=0.048,95％CI為0.005 ～0.464,P=0.009]是代謝綜閤徵的保護因素.結論 特需病房住院的2型糖尿病患者約3/5閤併代謝綜閤徵.年齡、BMI、腰圍、舒張壓、TG、HDL-C與代謝綜閤徵的髮生有關.
목적 탐토특수병방2형당뇨병환자대사종합정적환병솔급기주요위험인소.방법 2010년1월지2012년7월특수병방주원적462례2형당뇨병환자급1 898례내분비과보통병방주원적2형당뇨병환자위특수조화대조조,병진행체지삼수、혈압、혈당、혈지보、이도소、C태등검사.결과 (1)특수조여대조조환자중남성[72.5％ (335/462)여56.6(1 075/1 898)],흡연(40.5％여24.6％),음주(24.9％여10.7％)급고수입자(76.6％여12.7％)적비례고우대조조,량조비교차이유통계학의의(x2치분별위32.1、16.9、12.3、32.8,P균＜0.001).특수조여대조조적체질량지수(BMI)[(25.6±3.7) kg/m2여(24.8±3.5) kg/m2]、요위[(91.0±9.5) cm여(89.1±10.3) cm]、병안산안기전이매(ALT)[(27.8±19.7) U/L여(23.0±16.1)U/L]、γ-곡안선전이매(γ-GT)[(34.1 ±26.3) U/L여(29.2±23.2) U/L]、감유삼지(TG)[(2.35±2.31) mmol/L여(1.82±1.64) mmol/L]、혈뇨산[(333.7±85.5) μmol/L여(317.1 ±85.2) μmol/L]、공복C태[(2.11±1.04)μ g/L여(1.74±1.05)μg/L]고우대조조,차이유통계학의의(F치분별위11.44、6.90、16.65、8.35、18.23、7.34、21.21,P균＜0.01),이량조년령[(52.9±11.1)세여(60.4±12.2)세]、당뇨병병정[5(2,10)년여7(2,12)년]、수축압[(126.7±15.2) mmHg(1 mmHg =0.133 kPa)여(131.9±17.3) mmHg]、혈고밀도지단백담고순(HDL-C)[(1.02±0.32) mmol/L여(1.10±0.32) mmol/L],당화혈홍단백[(8.44±1.99)％여(9.16±2.32)％],특수조칙저우대조조,차이유통계학의의(F치분별위79.41、12.71、18.93、12.78、18.52,P균＜0.01).(2)특수조초중화/혹비반、혈지문란급대사종합정적환병솔분별위55.6％、68.4％、60.2％,현저고우대조조적46.1％,52.9％,50.6％(x2치분별위7.59、18.76、7.18,P균＜0.01),고혈압환병솔위39.6％,저우대조조50.7％ (x2=10.15,P＜0.01).특수조대사종합정환병솔남녀간차이무통계학의의(61.2％여57.5％,x2=0.01,P=0.92).안＜45세,45 ～59세,≥60세분조후,수착년령적승고,녀성대사종합정환병솔유증고추세(33.3％、48.0％、74.1％,x2=4.43,P=0.04),남성대사종합정환병솔각년령조간차이무통계학의의(58.8％、62.5％、55.6％,x2=0.05,P=0.87).(3)Logistic다원회귀분석현시,재특수조중,년령[OR=1.071,95％ CI위1.027 ～1.117,P=0.001]、BMI[OR=1.391,95％ CI위1.112～1.739,P=0.013]、요위[OR=1.126,95％ CI위1.039～1.222,P=0.004]、TG[OR=1.747,95％ CI위1.124 ～2.717,P=0.013]、서장압[OR=1.111,95％CI위1.045～1.180,P=0.001]시발생대사종합정적위험인소,이HDL-C[OR=0.048,95％CI위0.005 ～0.464,P=0.009]시대사종합정적보호인소.결론 특수병방주원적2형당뇨병환자약3/5합병대사종합정.년령、BMI、요위、서장압、TG、HDL-C여대사종합정적발생유관.
Objective To investigate the prevalence and risk factors of metabolic syndrome (MS) in patients with type 2 diabetes in special care unit.Methods Two thousand three hunrded and sixty patients with type 2 diabetes were selected as our subject in The Sixth People's Hospital Affiliated to Shanghai Jiaotong University from Jan.2010 to Jul.2012.Among these patients,462 patients from special care unit were served as special care group and 1 898 patients from endocrinology ward were assigned to control group.The disease history information was recorded and physical examination and biochemical tests,including blood lipids,blood pressure,fasting glucose,glycosylated hemoglobin,serum insulin,C peptide were measured.Results (1) In special care group,there were 335 male (72.5％) and the prevalence of smoking,alcohol drinking and the proportion of the high income people were 40.5％,24.9％,76.6％ respectively,higher than that of control group (56.6％,24.6％,10.7％,12.7％ ;x2 =32.1,16.9,12.3,32.8 ;P ＜ 0.01).The body mess index (BMI),levels of waist circumference,alanine aminotransferase (ALT),gamma glutamyhransferase (γ-GT),triglyceride (TG),serum uric acid and fasting C peptide in special care group were ((25.6 ± 3.7) kg/m2,(91.0 ± 9.5) cm,(27.8 ±19.7) U/L,(34.1 ±26.3) U/L,(2.35 ±2.31) mmol/L,(333.7 ±85.5) μmol/L,(2.11 ±1.04) μg/L) higher than those of control group ((24.8 ± 3.5) kg/m2,(89.1 ± 10.3) cm,(23.0 ± 16.1) U/L,(29.2 ±23.2) U/L,(1.82 ±1.64) mmol/L,(317.1 ±85.2) μ mol/L,(1.74 ± 1.05) μg/L;F =11.44,6.90,16.65,8.35,18.23,7.34,21.21 ; P ＜ 0.01).The age,duration of diabetes,systolic blood pressure,level of serum high-density lipoprotein-cholesterol (HDL-C),and glycosylated hemoglobin were ((52.9 ± 11.1) years,5 (2,10) years,(126.7 ± 15.2) mmHg,(1.02 ± 0.32) mmol/L,(8.44 ± 1.99) ％) lower than those of control group((60.4 ± 12.2) years,7 (2,12) years,(131.9 ± 17.3) mmHg,(1.10 ± 0.32) mmol/L,(9.16 ±2.32)％;F =79.41,12.71,18.93,12.78,18.52; P ＜ 0.01); (2) The rate of overweight/obesity,dyslipidemia and MS prevalence rates in special care group were 55.6％,68.4％,60.2％,significantly higher than the control group(46.1％,52.9％,50.6％ ;x2 =7.59,18.76,7.18,P ＜ 0.01).While the prevalence of hypertension in special care group was significantly lower than control group(39.6％ vs 50.7％,x2 =10.15,P =0.01).There was on significant difference between male and female in term of the prevalence of the MS in the special care group(61.2％ vs 57.5％,x2 =0.01,P =0.92).According to age,patients in special care group were divided into three groups and that were ＜45 years group,45-59 years group and ≥60 years group.With the increase of age group of female,the prevalence of MS was increasing(33.3％,48.0％,74.1％ ;x2 =4.43,P =0.04).Among the male patients,there was no significant different was seen among three groups (58.8％,62.5％,55.6％ ;x2 =0.05,P =0.87).(3) Multiple Logistic regression analysis showed that the independent risk factors of MS in special care group including age(OR =1.071,95％ CI(1.027-1.117),P =0.01),BMI (OR =1.391,95％ CI(1.112-1.739) ; P =0.013),waist circumference (OR =1.126,95％ CI(1.039-1.222) ; P =0.004),TG (OR =1.747,95 ％ CI(1.124-2.717) ; P =0.013) and diastolic blood pressure (OR =1.111,95％CI(1.045-1.180);P =0.001).HDL-C(OR=0.048,95％CI(0.005-0.464) ;P =0.009) were protective factors of MS in special care group.Conclusion Approximately 3/5 patients with diabetes in special care unit got MS.The factors including age,BMI,waist circumference,diastolic blood pressure,TG,HDL-C were related to MS occurrence.
