Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
J Diabetes. 2011 Dec;3(4):337-47. doi: 10.1111/j.1753-0407.2011.00148.x.
The aim of the present study was to examine trends in the control of key risk factors for cardiovascular disease among adults with diagnosed diabetes in the US from 1999 to 2008.
Data for up to 2623 adults aged ≥20 years with diagnosed diabetes who participated in 2-year cycles of the National Health and Nutrition Examination Surveys from 1999 to 2008 were examined.
Significant improvements were seen in the control of HbA1c (37.0%-55.2%), blood pressure (35.2%-51.0%), and low-density lipoprotein-cholesterol (LDL-C; 32.5%-52.9%). Both men and women experienced significant improvement in HbA1c and LDL-C. Whites showed significant improvement in glycemic control, LDL-C control, and the control of all three risk factors. African Americans showed significant improvement in glycemic control and blood pressure control, and Mexican Americans showed significant improvement in glycemic control and the control of all three risk factors. Compared with Whites, African Americans (prevalence ratio [PR] = 0.84; 95% confidence interval [CI] 0.74-0.96) and Mexican Americans (PR = 0.82; 95% CI 0.72-0.92) had worse glycemic control, and Mexican Americans had worse control of LDL-C (PR = 0.70; 95% CI 0.57-0.87) and of all three risk factors (PR = 0.46; 95% CI 0.23-0.90). There was little change in the prevalence of not currently smoking, having C-reactive protein <3 g/L, and having a urinary albumin:creatinine ratio <30 mg/g. The prevalence of body mass index <30 kg/m(2) decreased from 45.4% to 37.6% (P(linear trend) = 0.045).
Significant improvements in recommended levels of HbA1c, blood pressure, and LDL-C occurred in diabetic adults in the US between 1999 and 2008.
本研究旨在探讨 1999 年至 2008 年期间美国确诊糖尿病患者心血管疾病关键风险因素控制的趋势。
对 1999 年至 2008 年参加国家健康和营养调查 2 年周期的年龄≥20 岁的多达 2623 名确诊糖尿病成年人的数据进行了检查。
HbA1c（37.0%-55.2%）、血压（35.2%-51.0%）和低密度脂蛋白胆固醇（LDL-C；32.5%-52.9%）的控制均有显著改善。男性和女性的 HbA1c 和 LDL-C 均有显著改善。白人在血糖控制、LDL-C 控制和所有三种风险因素的控制方面均有显著改善。非裔美国人在血糖控制和血压控制方面有显著改善，而墨西哥裔美国人在血糖控制和所有三种风险因素的控制方面有显著改善。与白人相比，非裔美国人（比值比[PR] = 0.84；95%置信区间[CI] 0.74-0.96）和墨西哥裔美国人（PR = 0.82；95%CI 0.72-0.92）的血糖控制较差，而墨西哥裔美国人 LDL-C（PR = 0.70；95%CI 0.57-0.87）和所有三种风险因素（PR = 0.46；95%CI 0.23-0.90）的控制较差。目前不吸烟、C 反应蛋白<3 g/L 和尿白蛋白/肌酐比值<30 mg/g 的比例变化不大。体重指数<30 kg/m2 的比例从 45.4%下降到 37.6%（P（线性趋势）= 0.045）。
1999 年至 2008 年期间，美国确诊糖尿病患者 HbA1c、血压和 LDL-C 等推荐水平显著改善。
