1型和2型糖尿病患者的血清脂质管理：一项基于医院的队列研究。
Serum lipid management in patients with type 1 and type 2 diabetes: a hospital-based cohort study.
作者信息
Hasegawa Yukiko, Nakagami Tomoko, Oya Junko, Isago Chisato, Kurita Moritoshi, Tanaka Yuki, Ito Arata, Tsuzura Reika, Hirota Naoki, Miura Junnosuke, Uchigata Yasuko
机构信息
Diabetes Center, Tokyo Women's Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku, Tokyo, 162-8666 Japan.
出版信息
Diabetol Int. 2018 Jul 28;10(1):67-76. doi: 10.1007/s13340-018-0365-z. eCollection 2019 Jan.
INTRODUCTION
Serum lipid management is important for patients with diabetes; however, it has not been examined in our specialized diabetes clinic.
AIMS
The aim of the study was to assess the percentage of patients who did not achieve management targets (MT) for low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) and triglycerides (TG), and explore factors related to failure to achieve lipid MT in Japanese patients with type 1 (T1D) and type 2 diabetes (T2D).
METHODS
This cross-sectional study included 795 patients (35% men) with T1D and 4018 patients (60% men) with T2D attending our diabetes center. MTs for serum lipids were in accordance with the guidelines of the Japan Atherosclerosis Society. Logistic regression analysis was performed to identify factors related to failure to achieve MTs for serum lipids.
RESULTS
The percentages of men/women who did not achieve MT for LDL-C were 34.1/31.8% in T1D and 40.5/52.7% in T2D. The corresponding values for TG were 35.1/14.0% in T1D and 50.1/47.9% in T2D, and for HDL-C were 2.5/0% in T1D and 8.6/2.9% in T2D. Increase in body mass index (BMI) and glycated hemoglobin (HbA1c) were significantly and independently associated with failure to achieve lipid MT in patients with T1D and T2D for both sexes.
CONCLUSIONS
The percentages of our patients who did not achieve serum lipid MT were relatively high in T1D and T2D, and higher HbA1c and BMI were associated with failure to achieve serum lipid MTs. More attention should be paid to lipid management in patients with diabetes especially who have higher HbA1c and BMI in our facility.
引言
血清脂质管理对糖尿病患者很重要；然而，在我们的专科糖尿病诊所尚未对此进行过研究。
目的
本研究旨在评估未达到低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和甘油三酯（TG）管理目标（MT）的患者百分比，并探讨日本1型糖尿病（T1D）和2型糖尿病（T2D）患者未达到脂质MT的相关因素。
方法
这项横断面研究纳入了在我们糖尿病中心就诊的795例T1D患者（35%为男性）和4018例T2D患者（60%为男性）。血清脂质的MT符合日本动脉粥样硬化学会的指南。进行逻辑回归分析以确定与未达到血清脂质MT相关的因素。
结果
T1D中未达到LDL-C MT的男性/女性百分比分别为34.1%/31.8%，T2D中为40.5%/52.7%。T1D中TG的相应值为35.1%/14.0%，T2D中为50.1%/47.9%，HDL-C的相应值在T1D中为2.5%/0%，T2D中为8.6%/2.9%。体重指数（BMI）和糖化血红蛋白（HbA1c）的升高与T1D和T2D患者未达到脂质MT显著且独立相关。
结论
在T1D和T2D中，我们的患者未达到血清脂质MT的百分比相对较高，较高的HbA1c和BMI与未达到血清脂质MT相关。在我们的机构中，应更加关注糖尿病患者尤其是HbA1c和BMI较高患者的脂质管理。
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