West China School of Medicine, Sichuan University, Chengdu, 610041, China.
Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Lipids Health Dis. 2019 Jan 12;18(1):13. doi: 10.1186/s12944-018-0945-8.
Diabetes is often accompanied by dyslipidemia. Lipid control is very important in the management of diabetes. There are limited real world data on the lipid control in diabetic inpatients in southwest China.
An observational study was conducted to assess the characteristics of lipid profiles and lipid control. Diabetic patients from February 2009 to December 2013 at West China Hospital of Sichuan University were identified.
A total of 56,784 inpatients were included and 85.9% of them had at least one lipid panel. The proportions of inpatients with optimal low-density lipoprotein cholesterol (LDL-C) level (< 2.59 mmol/L), optimal triglyceride (TG) level (< 1.70 mmol/L), optimal high-density lipoprotein cholesterol (HDL-C) level (men ≥1.04 mmol/L; women ≥1.30 mmol/L) and optimal non-high-density lipoprotein cholesterol (non-HDL-C) level (< 3.37 mmol/L) were 61.1, 64.6, 49.9 and 64.5%, respectively. Only 23.1% of inpatients obtained optimal levels for all the above four lipid parameters. Of diabetic inpatients with ischemic heart disease, the proportions of inpatients with optimal LDL-C level (< 1.81 mmol/L), optimal TG level (< 1.70 mmol/L), optimal HDL-C level (men ≥1.04 mmol/L; women ≥1.30 mmol/L) and optimal non-HDL-C level (< 2.59 mmol/L) were 38.0, 66.3, 48.1 and 48.7%, respectively. Of diabetic inpatients with cerebrovascular disease, the proportions were 28.3, 64.8, 49.9 and 38.1%, respectively. Older people and men were more likely to obtain optimal lipid levels. However, inpatients between 46 and 64 years were least likely to obtain optimal LDL-C levels.
The lipid control of diabetic inpatients in southwest China is worrisome. Individualized strategies of lipid management should be taken to bridge the gap between the recommendations of clinical guidelines and the real situation of clinical practice.
糖尿病常伴有血脂异常。血脂控制在糖尿病管理中非常重要。关于中国西南地区糖尿病住院患者的血脂控制情况，目前仅有有限的真实世界数据。
采用观察性研究评估血脂谱特征和血脂控制情况。纳入 2009 年 2 月至 2013 年 12 月期间在四川大学华西医院的住院糖尿病患者。
共纳入 56784 例住院患者，其中 85.9%的患者至少进行了一次血脂检测。低密度脂蛋白胆固醇（LDL-C）水平<2.59mmol/L、甘油三酯（TG）水平<1.70mmol/L、高密度脂蛋白胆固醇（HDL-C）水平（男性≥1.04mmol/L；女性≥1.30mmol/L）和非高密度脂蛋白胆固醇（non-HDL-C）水平<3.37mmol/L 的患者比例分别为 61.1%、64.6%、49.9%和 64.5%。仅有 23.1%的患者同时达到了以上四个血脂参数的最佳水平。在患有缺血性心脏病的糖尿病患者中，LDL-C 水平<1.81mmol/L、TG 水平<1.70mmol/L、HDL-C 水平（男性≥1.04mmol/L；女性≥1.30mmol/L）和 non-HDL-C 水平<2.59mmol/L 的患者比例分别为 38.0%、66.3%、48.1%和 48.7%。在患有脑血管疾病的糖尿病患者中，这一比例分别为 28.3%、64.8%、49.9%和 38.1%。年龄较大和男性更有可能达到最佳血脂水平。然而，46-64 岁的患者最不可能达到 LDL-C 最佳水平。
中国西南地区糖尿病住院患者的血脂控制情况令人担忧。应采取个体化的血脂管理策略，以弥合临床指南推荐与临床实践真实情况之间的差距。
