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巴西圣埃斯皮里图州糖尿病相关截肢的分析。

Analysis of Diabetes Mellitus-Related Amputations in the State of Espírito Santo, Brazil.

机构信息

Programa de Mestrado em Políticas Públicas e Desenvolvimento Local, Escola Superior de Ciências da Santa Casa de Misericórdia (EMESCAM), Vitória/Espírito Santo 29045-402, Brazil.

Programa de Pós-graduação em Ciências Médicas. Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil.

出版信息

Medicina (Kaunas). 2020 Jun 11;56(6):287. doi: 10.3390/medicina56060287.

Abstract

Diabetes mellitus (DM) stands out among the most important public health problems worldwide since it represents a high burden on health systems and is associated with higher hospitalization rates, and a higher incidence of cardiovascular diseases. Amputations are among the most common complications, leading to disability and increasing care costs. This research aims to analyze the prevalence of DM-related amputations, comorbidities and associated risk factors in the diabetic population residing in the State of Espírito Santo, Brazil. This is a quantitative, exploratory, cross-sectional study with a time series design and the use of secondary data registered and followed by the system of Registration and Monitoring of Hypertension and Diabetes-SisHiperdia. The sample consisted of 64,196 diabetic patients, out of them, 3.9% had type 1 DM, 10.9% with type 2 DM, and 85.2% with DM coexisting with hypertension. Most were female (66.6%), aged 40 to 59 years (45.6%), and 60 years and older (45.2%). The prevalence of DM-related amputations in the analyzed sample was 1.2% in type 1 DM, 1.5% in type 2 DM, and 2.2% in concomitant DM and hypertension. Higher amputation rates were observed in males in the age group above 60 years in type 1 DM and type 2 DM and were slightly higher in the age groups up to 29 years in DM with hypertension. A higher prevalence of amputation was related to smoking, physical inactivity, acute myocardial infarction (AMI), stroke, chronic kidney disease (CKD), and diabetic foot (DF) in all types of DM. The present study showed a significant prevalence of DM-related amputations. An increased prevalence was evidenced when correlated with smoking, physical inactivity, AMI, stroke, CKD, and DF with significant statistical associations, except for a sedentary lifestyle in type 1 DM.

摘要

糖尿病(DM)是全球最重要的公共卫生问题之一,因为它对卫生系统造成了沉重负担,与更高的住院率以及更高的心血管疾病发病率相关。截肢是最常见的并发症之一,导致残疾和增加医疗费用。本研究旨在分析巴西圣埃斯皮里图州糖尿病患者中与糖尿病相关的截肢、合并症和相关危险因素的流行情况。 这是一项定量、探索性、横断面研究,采用时间序列设计和使用高血压和糖尿病登记和监测系统(SisHiperdia)登记和随访的二级数据。 样本由 64196 名糖尿病患者组成,其中 3.9%为 1 型糖尿病,10.9%为 2 型糖尿病,85.2%为同时患有糖尿病和高血压。大多数为女性(66.6%),年龄在 40 至 59 岁(45.6%),60 岁及以上(45.2%)。在分析样本中,1 型糖尿病、2 型糖尿病和同时患有糖尿病和高血压的患者中,与糖尿病相关的截肢发生率分别为 1.2%、1.5%和 2.2%。在 1 型和 2 型糖尿病中,60 岁以上男性截肢率较高,而在高血压合并糖尿病中,29 岁以下年龄组的截肢率略高。在所有类型的糖尿病中,吸烟、身体活动不足、急性心肌梗死(AMI)、中风、慢性肾脏病(CKD)和糖尿病足(DF)与截肢率升高相关。 本研究显示与糖尿病相关的截肢有显著的流行率。当与吸烟、身体活动不足、AMI、中风、CKD 和 DF 相关联时,流行率增加,除了 1 型糖尿病中久坐的生活方式外,与统计学上显著相关。

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