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糖化血红蛋白监测的频率与 2 型糖尿病患者的血糖控制呈负相关。

Frequency of glycated hemoglobin monitoring was inversely associated with glycemic control of patients with Type 2 diabetes mellitus.

机构信息

School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.

出版信息

J Endocrinol Invest. 2012 Mar;35(3):269-73. doi: 10.3275/7743. Epub 2011 May 23.

Abstract

BACKGROUND

The frequency of monitoring glycated hemoglobin (HbA(1c)) and its impact on glycemic control of Chinese Type 2 diabetes mellitus (T2DM) patients have not been well understood.

AIM

To explore the current status of the glycemic control, the frequency of HbA(1c) monitoring, and their relationship in T2DM outpatients in urban China.

SUBJECTS AND METHODS

A cross-sectional study was carried out in 15 hospitals purposely sampled from 4 cities of China. T2DM outpatients were consecutively recruited, and underwent a face-to-face interview in outpatient consulting rooms using a self-developed structured questionnaire to collect information. All consented patients were invited to have a free HbA(1c) test.

RESULTS

Among 1511 subjects, the average level of HbA(1c) was 8.1±1.6% with the ideal percents of 13.6% and 24.8% (HbA(1c)<6.5% and <7.0%, respectively). Less than 1/3 (339/1157) had received 2 or more HbA(1c) tests per yr, and they had a significantly lower average of HbA(1c) than those having only 1 or no test per yr (F=5.012, p=0.007). After adjustment for possible confounders including age, gender, and city, there was a significantly inverse association with adjusted odds ratios of 2.56 [95% confidence interval (CI): 1.71, 3.86] and 1.67 (95% CI: 1.11, 2.50), respectively, between the frequency of monitoring HbA(1c) (null, once vs ≥2 times per yr) and worse glycemic control (HbA(1c)≥7.0%).

CONCLUSIONS

Glycemic control of T2DM outpatients was poor in urban China. Frequency of HbA(1c) monitoring is seriously insufficient in majority of patients. Lower frequency of HbA(1c) monitoring is significantly associated with poor glycemic control.

摘要

背景

糖化血红蛋白(HbA(1c))监测频率及其对中国 2 型糖尿病(T2DM)患者血糖控制的影响尚不清楚。

目的

探讨中国城市 T2DM 门诊患者的血糖控制现状、HbA(1c)监测频率及其相关性。

受试者和方法

本研究采用横断面研究方法,在全国 4 个城市的 15 家医院进行。连续招募 T2DM 门诊患者,在门诊诊室采用自行设计的结构化问卷进行面对面访谈,收集患者信息。所有同意参加的患者均免费进行 HbA(1c)检测。

结果

在 1511 例患者中,HbA(1c)平均水平为 8.1±1.6%,HbA(1c)<6.5%和<7.0%的理想比例分别为 13.6%和 24.8%。仅有 1/3(339/1157)的患者每年接受 2 次或 2 次以上 HbA(1c)检测,他们的 HbA(1c)平均水平明显低于每年仅接受 1 次或未接受 HbA(1c)检测的患者(F=5.012,p=0.007)。校正年龄、性别和城市等混杂因素后,HbA(1c)监测频率(无、每年 1 次与每年≥2 次)与血糖控制较差(HbA(1c)≥7.0%)之间呈显著负相关,调整后的比值比分别为 2.56(95%CI:1.71,3.86)和 1.67(95%CI:1.11,2.50)。

结论

中国城市 T2DM 门诊患者血糖控制较差。大多数患者 HbA(1c)监测频率严重不足。HbA(1c)监测频率较低与血糖控制不佳显著相关。

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