Sharma Niharikaa, Sharma Surendra Kumar, Maheshwari Vitthal D, Sharma Krishna Kumar, Gupta Rajeev
Department of Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India.
Department of Endocrinology, Galaxy Specialty Centre, Jaipur, Rajasthan, India.
Indian J Endocrinol Metab. 2015 Sep-Oct;19(5):667-72. doi: 10.4103/2230-8210.163206.
To determine the association of educational status (ES), as a marker of socioeconomic status, with the prevalence of microvascular complications in diabetes.
Successive patients (n = 1214) presenting to our centre were evaluated for sociodemographic, anthropometric, clinical, and therapeutic variables. Subjects were classified according to ES into Group 1 (illiterate, 216); Group 2 (<primary, 537), Group 3 (<higher secondary, 312), and Group 4 (any college, 149). Descriptive statistics are reported.
Mean age of patients was 52 ± 10 years, duration of diabetes 7 ± 7 years, and 55% were men. Prevalence of various risk factors was smoking/tobacco 25.5%, obesity body mass index ≥25 kg/m(2) 64.0%, abdominal obesity 63.4%, hypertension 67.5%, high fat diet 14.5%, low fruits/vegetables 31.8%, low fibre intake 60.0%, high salt diet 16.9%, physical inactivity 27.5%, coronary, or cerebrovascular disease 3.0%, and microvascular disease (peripheral, ocular or renal) in 20.7%. Microvascular disease was significantly greater in illiterate (25.9%) and low (23.6%) compared to middle (15.0%) and high (14.7%) ES groups (P < 0.05). Age- and sex-adjusted logistic regression analysis revealed that in illiterate and low ES groups respectively, prevalence of smoking/tobacco use (odds ratio 3.84, confidence intervals 2.09-7.05 and 2.15, 1.36-3.41); low fruit/vegetable (2.51, 1.53-4.14 and 1.99, 1.30-3.04) and low fibre intake (4.02, 2.50-6.45 and 1.78, 1.23-2.59) was greater compared to high ES. Poor diabetes control (HbA1c >8.0%) was significantly greater in illiterate (38.0%), low (46.0%) and middle (41.0%) compared to high (31.5%) ES subjects (P < 0.05).
There is a greater prevalence of the microvascular disease in illiterate and low ES diabetes patients in India. This is associated with the higher prevalence of smoking/tobacco use, poor quality diet and sub-optimal diabetes control.
确定作为社会经济地位标志的教育程度（ES）与糖尿病微血管并发症患病率之间的关联。
对连续到我们中心就诊的患者（n = 1214）进行社会人口统计学、人体测量学、临床和治疗变量评估。根据教育程度将受试者分为1组（文盲，216人）；2组（小学以下，537人），3组（高中以下，312人）和4组（大专及以上，149人）。报告描述性统计数据。
患者平均年龄为52±10岁，糖尿病病程为7±7年，男性占55%。各种危险因素的患病率分别为：吸烟/使用烟草25.5%，肥胖（体重指数≥25 kg/m²）64.0%，腹型肥胖63.4%，高血压67.5%，高脂肪饮食14.5%，低水果/蔬菜摄入量31.8%，低纤维摄入量60.0%，高盐饮食16.9%，身体活动不足27.5%，冠心病或脑血管疾病3.0%，微血管疾病（外周、眼部或肾脏）20.7%。与中等（15.0%）和高等（14.7%）教育程度组相比，文盲组（25.9%）和低教育程度组（23.6%）的微血管疾病患病率显著更高（P < 0.05）。年龄和性别调整后的逻辑回归分析显示，与高等教育程度组相比，文盲组和低教育程度组中吸烟/使用烟草的患病率（比值比分别为3.84，置信区间2.09 - 7.05和2.15，1.36 - 3.41）；低水果/蔬菜摄入量（2.51，1.53 - 4.14和1.99，1.30 - 3.04）以及低纤维摄入量（4.02，2.50 - 6.45和1.78，1.23 - 2.59）更高。与高等教育程度组（31.5%）相比，文盲组（38.0%）、低教育程度组（46.0%）和中等教育程度组（41.0%）的糖尿病控制不佳（糖化血红蛋白>8.0%）情况显著更严重（P < 0.05）。
在印度，文盲和低教育程度的糖尿病患者中微血管疾病的患病率更高。这与吸烟/使用烟草的患病率较高、饮食质量差以及糖尿病控制不佳有关。
