Whittaker E, Read S H, Colhoun H M, Lindsay R S, McGurnaghan S, McKnight J A, Sattar N, Wild S H
Edinburgh Medical School, Edinburgh, UK.
Centre for Population Health Sciences, Edinburgh, UK.
Diabet Med. 2020 Aug;37(8):1395-1402. doi: 10.1111/dme.14297. Epub 2020 Apr 3.
To describe the association between socio-economic status and prevalence of key cardiovascular risk factors in people with type 2 diabetes in Scotland.
A cross-sectional study of 264 011 people with type 2 diabetes in Scotland in 2016 identified from the population-based diabetes register. Socio-economic status was defined using quintiles of the area-based Scottish Index of Multiple Deprivation (SIMD) with quintile (Q)1 and Q5 used to identify the most- and least-deprived fifths of the population, respectively. Logistic regression models adjusted for age, sex, health board, history of cardiovascular disease and duration of diabetes were used to estimate odds ratios (ORs) for Q1 compared with Q5 for each risk factor.
The mean (sd) age of the study population was 66.7 (12.8) years, 56% were men, 24% were in Q1 and 15% were in Q5. Crude prevalence in Q1/Q5 was 24%/8.8% for smoking, 62%/49% for BMI ≥ 30 kg/m , 44%/40% for HbA ≥ 58 mmol/mol (7.5%), 31%/31% for systolic blood pressure (SBP) ≥ 140 mmHg, and 24%/25% for total cholesterol ≥ 5 mmol/l, respectively. ORs [95% confidence intervals (CI)] were 3.08 (2.95-3.21) for current smoking, 1.48 (1.44-1.52) for BMI ≥ 30 kg/m , 1.11 (1.08-1.15) for HbA ≥ 58 mmol/mol (7.5%), 1.03 (1.00-1.06) for SBP ≥ 140 mmHg and 0.87 (0.84-0.90) for total cholesterol ≥ 5 mmol/l.
Socio-economic deprivation is associated with higher prevalence of smoking, BMI ≥ 30 kg/m and HbA ≥ 58 mmol/mol (7.5%), and lower prevalence of total cholesterol ≥ 5 mmol/l among people with type 2 diabetes in Scotland. Effective approaches to reducing inequalities are required as well as reducing risk factor prevalence across the whole population.
描述苏格兰2型糖尿病患者的社会经济状况与主要心血管危险因素患病率之间的关联。
一项横断面研究，于2016年从基于人群的糖尿病登记册中识别出264011名苏格兰2型糖尿病患者。社会经济状况采用基于地区的苏格兰多重贫困指数（SIMD）五分位数来定义，其中第1五分位数（Q1）和第5五分位数（Q5）分别用于识别最贫困和最不贫困的五分之一人群。使用针对年龄、性别、健康委员会、心血管疾病史和糖尿病病程进行调整的逻辑回归模型，来估计每个危险因素Q1与Q5相比的比值比（OR）。
研究人群的平均（标准差）年龄为66.7（12.8）岁，56%为男性，24%处于Q1，15%处于Q5。Q1/Q5中吸烟的粗患病率分别为24%/8.8%，BMI≥30kg/m²的为62%/49%，糖化血红蛋白（HbA）≥58mmol/mol（7.5%）的为44%/40%，收缩压（SBP）≥140mmHg的为31%/31%，总胆固醇≥5mmol/l的为24%/25%。当前吸烟的OR[95%置信区间（CI）]为3.08（2.95 - 3.21），BMI≥30kg/m²的为1.48（1.44 - 1.52），HbA≥58mmol/mol（7.5%）的为1.11（1.08 - 1.15），SBP≥140mmHg的为1.03（1.00 - 1.06），总胆固醇≥5mmol/l的为0.87（0.84 - 0.90）。
在苏格兰2型糖尿病患者中，社会经济贫困与吸烟、BMI≥30kg/m²和HbA≥58mmol/mol（7.5%）的较高患病率相关，与总胆固醇≥5mmol/l的较低患病率相关。需要采取有效的方法来减少不平等现象，并降低整个人群的危险因素患病率。
