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2型糖尿病患者血糖控制与内脏脂肪素水平的关系

[Relationship between glycemic control and visceral adiposity index among the patients with type 2 diabetes mellitus].

作者信息

Cao Y Y, Tang X, Sun K X, Liu Z K, Xiang X, Juan J, Song J, Duan Q Z, Zhaxi D J, Hu Y N, Yang Y F, Shi M Y, Tian Y H, Huang S P, Liu X F, Li N, Li J, Wu T, Chen D F, Hu Y H

机构信息

Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.

Fangshan District Center for Disease Control and Prevention, Beijing 102401, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2017 Jun 18;49(3):446-450.

Abstract

OBJECTIVE

To explore the relationship between glycemic control and visceral adiposity index (VAI) among type 2 diabetes mellitus (T2DM) patients.

METHODS

A community-based epidemiological field study for patients with T2DM aged ≥ 40 years was conducted in China.Every participant underwent physical examinations, biochemical tests of fasting glucose, glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and so on, and a questionnaire, including anthropometric characteristics, lifestyle, disease history, family history, and medication use. Those participants with HbA1c ≥7.0% were classified as the poorly controlled in our analysis of relationship between glycemic control and VAI. Anthropometric characteristics, lifestyle, and biochemical indexes of the participants were compared among the groups of different VAI levels. Logistic models were applied in multiple analysis adjusting for possible confounders.

RESULTS

A total of 1 607 patients with T2DM were recruited in our analysis with a mean age of (59.4±8.1) years and an average T2DM duration of (7.0±6.4) years. Among them, 78.3% were on hypoglycemic therapy. The cutoff points of quartiles of VAI were calculated for the males and females, respectively. According to the ascending order of the quartiles of VAI, the participants were divided into four groups, i.e. Q1, Q2, Q3, and Q4. The poor glycemic control rate for these groups were 60.6%, 65.7%, 70.1%, and 71.0%, respectively (Trend χ=12.20, P<0.001). After adjustment for age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), LDL-C, smoking, cardio-cerebral vascular disease (CVD) history, hypoglycemic therapy, T2DM duration, and family history of diabetes, the Logistic regression models showed that the glycemic control rate was significantly associated with VAI levels among the patients with T2DM. Compared with the participants in group Q1, the ORs of poor glycemic control for those in groups Q2, Q3, and Q4 were 1.239 (95%CI 0.918 to 1.672), 1.513 (95%CI 1.117 to 2.050), and 1.535 (95%CI 1.128 to 2.088), respectively (trend P=0.003). With each quartile increase in VAI, the OR of poor glycemic control was 1.162 (95%CI 1.054 to 1.282).

CONCLUSION

The glycemic control among the patients with T2DM is significantly associated with VAI. High level of VAI is an indicator of poor glycemic control.

摘要

目的

探讨2型糖尿病(T2DM)患者血糖控制与内脏脂肪指数(VAI)之间的关系。

方法

在中国开展了一项针对年龄≥40岁的T2DM患者的社区流行病学现场研究。每位参与者均接受了体格检查、空腹血糖、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等生化检测,并填写了一份问卷,内容包括人体测量学特征、生活方式、疾病史、家族史及用药情况。在我们分析血糖控制与VAI之间的关系时,将HbA1c≥7.0%的参与者归类为血糖控制不佳。比较了不同VAI水平组参与者的人体测量学特征、生活方式及生化指标。应用Logistic模型进行多因素分析,对可能的混杂因素进行校正。

结果

我们的分析共纳入了1607例T2DM患者,平均年龄为(59.4±8.1)岁,T2DM平均病程为(7.0±6.4)年。其中,78.3%的患者正在接受降糖治疗。分别计算了男性和女性VAI四分位数的切点。根据VAI四分位数的升序,将参与者分为四组,即Q1、Q2、Q3和Q4。这些组的血糖控制不佳率分别为60.6%、65.7%、70.1%和71.0%(趋势χ²=12.20,P<0.001)。在对年龄、性别、收缩压(SBP)、舒张压(DBP)、LDL-C、吸烟、心脑血管疾病(CVD)史、降糖治疗、T2DM病程及糖尿病家族史进行校正后,Logistic回归模型显示,T2DM患者的血糖控制率与VAI水平显著相关。与Q1组的参与者相比,Q2、Q3和Q4组血糖控制不佳的OR值分别为1.239(95%CI 0.918至1.672)、1.513(95%CI 1.117至2.050)和1.535(95%CI 1.128至2.088)(趋势P=0.003)。随着VAI每增加一个四分位数,血糖控制不佳的OR值为1.162(95%CI 1.054至1.282)。

结论

T2DM患者的血糖控制与VAI显著相关。高水平的VAI是血糖控制不佳的一个指标。

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