中国2型糖尿病患者的管理现状及其预测因素：一项全国性多中心研究：一项全国性多中心研究。

Management status and its predictive factors in patients with type 2 diabetes in China: A Nationwide Multicenter Study: A Nationwide Multicenter Study.

作者信息

Liu Lin, Lou Qingqing, Guo Xiaohui, Yuan Li, Shen Li, Sun Zilin, Zhao Fang, Dai Xia, Huang Jin, Yang Huiying, Mordes John P

机构信息

Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.

Department of Endocrinology, Peking University First Hospital, #8 Xishiku Street, Beijing, China.

出版信息

Diabetes Metab Res Rev. 2015 Nov;31(8):811-6. doi: 10.1002/dmrr.2757.

DOI:10.1002/dmrr.2757

PMID:26455830

Abstract

BACKGROUND

The prevalence of type 2 diabetes in China is increasing rapidly. Appropriate management of glycemia, blood pressure and dyslipidemia in this population is a major public health concern.

OBJECTIVE

The aim of this study was to assess metabolic control including glycated hemoglobin A1c (HbA1c ), blood pressure (BP) and low density lipoprotein cholesterol (LDL-c), in a large sample of patients with type 2 diabetes in China and to identify factors that correlated with the achievement of HbA1c, BP and LDL-c goals (ABCs).

METHOD

A nationwide survey was conducted in 50 medical centres across China from April to July of 2010. Baseline information on demographics, medical history, HbA1c , BP and LDL-c levels were measured in 5961 patients with type 2 diabetes.

RESULTS

Mean age, body mass index (BMI) and HbA1c were 59.5 ± 1.3 years, 24.5 ± 4.1 kg/m(2) and 8.3 ± 2.2%, respectively. With respect to generally accepted ABC treatment goals, 35.2% of participants had HbA1c <7%; 35.5% had BP < 140/80 mmHg, and 45.1% had LDL-c < 100 mg/dl. The proportion of patients who met all three targets was only 5.4%. Logistic regression revealed that smoking (P=0.000), higher BMI (P=0.001) and insulin use (P=0.000) were statistically significant predictors of failing to meet ABC targets.

CONCLUSION

The percentage of Chinese patients with type 2 diabetes who met recommended targets for HbA1c , BP and LDL-c in 2010 was low. Smoking, higher BMI and insulin use were the strongest determinants of failing to meet ABC targets.

摘要

背景

中国2型糖尿病的患病率正在迅速上升。对该人群进行适当的血糖、血压和血脂异常管理是一个主要的公共卫生问题。

目的

本研究旨在评估中国大量2型糖尿病患者的代谢控制情况，包括糖化血红蛋白A1c（HbA1c）、血压（BP）和低密度脂蛋白胆固醇（LDL-c），并确定与实现HbA1c、BP和LDL-c目标（ABC）相关的因素。

方法

2010年4月至7月在中国50个医疗中心进行了一项全国性调查。对5961例2型糖尿病患者测量了人口统计学、病史、HbA1c、BP和LDL-c水平的基线信息。

结果

平均年龄、体重指数（BMI）和HbA1c分别为59.5±1.3岁、24.5±4.1kg/m²和8.3±2.2%。就普遍接受的ABC治疗目标而言，35.2%的参与者HbA1c<7%；35.5%的参与者血压<140/80mmHg，45.1%的参与者LDL-c<100mg/dl。达到所有三个目标的患者比例仅为5.4%。逻辑回归显示，吸烟（P=0.000）、较高的BMI（P=0.001）和使用胰岛素（P=0.000）是未达到ABC目标的统计学显著预测因素。