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泰国全国性研究:糖尿病患者并发症相关血脂异常的流行情况。

Prevalence of dyslipidemia associated with complications in diabetic patients: a nationwide study in Thailand.

机构信息

Department of Military and Community Medicine, Phramongkutklao College of Medicine, 315 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand.

Health Informatics Program, School of Nursing and Health Professions of the University of San Francisco, 2130 Fulton St, San Francisco, CA, 94117, USA.

出版信息

Lipids Health Dis. 2019 Apr 6;18(1):90. doi: 10.1186/s12944-019-1034-3.

Abstract

BACKGROUND

Dyslipidemia is an important modifiable risk factor for cardiovascular disease. It is diagnosed by the presence of an abnormal lipid profile, primarily with elevated levels of plasma cholesterol, triglyceride, or both, or reduced levels of high-density lipoprotein cholesterol. However, some studies have reported increased risk of ischemic stroke with elevated low-density lipoprotein cholesterol (LDL-C) levels and increased risk of cardiovascular mortality independent of LDL-C levels in type 2 diabetes mellitus (T2DM) patients.

METHODS

In this cross-sectional study, data were included for Thai adults with diabetes from the Diabetes Mellitus/ Hypertension (DM/HT) study, 2010-2014 (data was collected by the Medical Research Network of the Consortium of Thai Medical Schools). The target population comprised T2DM patients who were treated at a hospital for more than 12 months. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated to determine factors associated with dyslipidemia.

RESULTS

In total, 140,557 participants (average age, 60 years) were enrolled, with a dyslipidemia prevalence of 88.9% in the cohort. The factors associated with dyslipidemia included female sex (aOR: 1.47, 95% CI: 1.38-1.56); age < 50 years (aOR: 1.16, 95% CI: 1.10-1.22); waist circumference ≥ 90 cm in males and ≥ 80 cm in females (aOR: 1.23, 95% CI: 1.16-1.31); treatment at a primary care unit (aOR: 1.28, 95% CI: 1.23-1.33); and a history of unknown stroke (aOR: 1.10, 95% CI: 1.02-1.19), coronary revascularization (aOR: 0.85, 95% CI: 0.79-0.91), diabetic nephropathy (aOR: 1.06, 95% CI: 1.01-1.12), or renal insufficiency (aOR: 1.08, 95% CI: 1.02-1.13).

CONCLUSIONS

Dyslipidemia is prevalent among Thai T2DMpatients and is associated with gender; age; obesity; central obesity; treatment at a primary care unit; and a history of unknown stroke, coronary revascularization, diabetic nephropathy, and renal insufficiency. Our study results will help increase the awareness of healthcare providers regarding dyslipidemia in diabetic patients. To reduce cardiovascular risk, healthcare professionals should provide regular follow-up and proper advice and ensure primary prevention of vascular complications. Improved education and increased self-awareness regarding the need to change behaviors and regular intake of medication would help decrease dyslipidemia prevalence among diabetic patients.

摘要

背景

血脂异常是心血管疾病的一个重要可改变的危险因素。它通过异常的血脂谱来诊断,主要表现为血浆胆固醇、甘油三酯或两者升高,或高密度脂蛋白胆固醇水平降低。然而,一些研究报告称,2 型糖尿病(T2DM)患者中,低密度脂蛋白胆固醇(LDL-C)水平升高与缺血性中风风险增加有关,而 LDL-C 水平以外的心血管死亡率风险增加。

方法

本横断面研究纳入了来自 2010 年至 2014 年糖尿病/高血压(DM/HT)研究的泰国成年糖尿病患者的数据(该数据由泰国医学院校联盟医学研究网络收集)。目标人群包括在医院接受治疗超过 12 个月的 T2DM 患者。计算调整后的优势比(aOR)和 95%置信区间(CI),以确定与血脂异常相关的因素。

结果

共有 140557 名参与者(平均年龄 60 岁)入组,队列中血脂异常的患病率为 88.9%。与血脂异常相关的因素包括女性(aOR:1.47,95%CI:1.38-1.56);年龄<50 岁(aOR:1.16,95%CI:1.10-1.22);男性腰围≥90cm,女性腰围≥80cm(aOR:1.23,95%CI:1.16-1.31);在初级保健单位治疗(aOR:1.28,95%CI:1.23-1.33);以及未知脑卒中史(aOR:1.10,95%CI:1.02-1.19)、冠状动脉血运重建(aOR:0.85,95%CI:0.79-0.91)、糖尿病肾病(aOR:1.06,95%CI:1.01-1.12)或肾功能不全(aOR:1.08,95%CI:1.02-1.13)。

结论

血脂异常在泰国 T2DM 患者中较为常见,与性别、年龄、肥胖、中心性肥胖、在初级保健单位治疗以及未知脑卒中史、冠状动脉血运重建、糖尿病肾病和肾功能不全有关。我们的研究结果将有助于提高医疗保健提供者对糖尿病患者血脂异常的认识。为了降低心血管风险,医疗保健专业人员应提供定期随访和适当的建议,并确保血管并发症的初级预防。加强教育和提高对改变行为和定期服药的自我意识,将有助于降低糖尿病患者的血脂异常发生率。

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