CAJ | 학술논문

目的探讨血脂异常在超重肥胖2型糖尿病患者中的患病率,并分析其相关危险因素.方法 2011年8月至2012年3月,对广东省各地区二级以上医院门诊就诊及住院的已确诊2型糖尿病且合并超重或肥胖的省内常住居民进行横断面调查.血脂异常诊断标准:(1)总胆固醇≥5.7 mmoL/L;(2)甘油三酯≥1.7 mmoL/L;(3)低密度脂蛋白胆固醇(LDL-C)≥3.6 mmoL/L;(4)女性高密度脂蛋白胆固醇(HDL-C)＜1.29 mmol/L或男性HDL-C＜ 1.03 mmol/L;满足以上1项或1项以上者即可诊断.结果本研究3593例超重肥胖2型糖尿病患者中,血脂异常总患病率为87.9％(3160/3593),高甘油三酯血症、低HDL-C血症、高胆固醇血症及高LDL-C血症的患病率分别为52.5％ (1888/3593)、54.1％ (1945/3593)、33.1％ (1188/3593)、27.4％(985/3593).血脂异常患者中,单纯型血脂异常患者占34.1％,混合型血脂异常患者占53.9％.二分类Logistic回归分析结果显示,女性(OR=1.593,95％ CI 1.233～2.057)、糖化血红蛋白(OR=1.120,95％ CI 1.054～1.191)、体质指数(OR=1.084,95％ CI1.022 ～1.150)、高血压(OR=1.331,95％ CI 1.033 ～1.714)、高尿酸血症(OR =2.270,95％ CI 1.642～3.138)、糖尿病家族史(OR=1.586,95％CI 1.186 ～2.120)是血脂异常的独立危险因素.结论血脂异常在超重肥胖2型糖尿病患者中的患病率很高,降压、降糖、减重、降低血尿酸有助于降低血脂异常的患病率,进而预防及延缓心血管并发症的发生发展,降低超重肥胖2型糖尿病的病死率.
목적 탐토혈지이상재초중비반2형당뇨병환자중적환병솔,병분석기상관위험인소.방법 2011년8월지2012년3월,대광동성각지구이급이상의원문진취진급주원적이학진2형당뇨병차합병초중혹비반적성내상주거민진행횡단면조사.혈지이상진단표준:(1)총담고순≥5.7 mmoL/L;(2)감유삼지≥1.7 mmoL/L;(3)저밀도지단백담고순(LDL-C)≥3.6 mmoL/L;(4)녀성고밀도지단백담고순(HDL-C)＜1.29 mmol/L혹남성HDL-C＜ 1.03 mmol/L;만족이상1항혹1항이상자즉가진단.결과 본연구3593례초중비반2형당뇨병환자중,혈지이상총환병솔위87.9％(3160/3593),고감유삼지혈증、저HDL-C혈증、고담고순혈증급고LDL-C혈증적환병솔분별위52.5％ (1888/3593)、54.1％ (1945/3593)、33.1％ (1188/3593)、27.4％(985/3593).혈지이상환자중,단순형혈지이상환자점34.1％,혼합형혈지이상환자점53.9％.이분류Logistic회귀분석결과현시,녀성(OR=1.593,95％ CI 1.233～2.057)、당화혈홍단백(OR=1.120,95％ CI 1.054～1.191)、체질지수(OR=1.084,95％ CI1.022 ～1.150)、고혈압(OR=1.331,95％ CI 1.033 ～1.714)、고뇨산혈증(OR =2.270,95％ CI 1.642～3.138)、당뇨병가족사(OR=1.586,95％CI 1.186 ～2.120)시혈지이상적독립위험인소.결론 혈지이상재초중비반2형당뇨병환자중적환병솔흔고,강압、강당、감중、강저혈뇨산유조우강저혈지이상적환병솔,진이예방급연완심혈관병발증적발생발전,강저초중비반2형당뇨병적병사솔.
Objective To explore the prevalence and risk factors for dyslipidemia in diabetics with overweight or obesity.Methods Diabetics with overweight or obesity were recruited from 62 tertiary and secondary hospitals in Guangdong Province between August 2011 and March 2012.Dyslipidemia was diagnosed as total cholesterol (TC) ≥ 5.7 mmol/L or triglycerides (TG) ≥ 1.7 mmol/L or low-density-lipoprotein cholesterol (LDL-C) ≥ 3.6 mmol/L or high-density-lipoprotein cholesterol (HDL-C) ＜ 1.29 mmol/L in females or HDL-C ＜ 1.03 mmol/L in males.Binary Logistic regression was used to assess the associations between dyslipidemia and associated risk factors.Results Dyslipidemia was detected in 3160/3593(87.9％)diabetics with overweight or obesity.And the prevalence of hypertriglyceridemia,low blood HDL-C,hypercholesterolemia and high blood LDL-C was 52.5％ (1888/3593),54.1％ (1945/ 3593),33.1％ (1188/3593) and 27.4％ (985/3593) respectively.Among those with dyslipidemia,patients with simple and mixed dyslipidemia accounted for 34.1％ and 53.9％ respectively.In binary Logistic regression analysis,the presence of dyslipidemia were associated with female gender (OR =1.593,95％ CI 1.233-2.057),hemoglobinA1 c (HbA1 c) (OR =1.120,95％ CI 1.054-1.191),body mass index (OR =1.084,95％ CI 1.022-1.150),hypertension (OR =1.331,95％ CI 1.033-1.714),history of diabetes (OR =1.586,95％ CI 1.186-2.120) and hyperuricacidemia (OR =2.270,95％ CI 1.642-3.138).Conclusions The prevalence of dyslipidemia is quite high in diabetics with overweight or obesity.The controls of blood pressure,serum uric acid level,blood glucose and body weight may reduce the prevalence of dyslipidemia,prevent and delay the development of cardiovascular complications and reduce the mortality of diabetics with overweight or obesity.