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中国成年人糖尿病患者 4 年随访期间的跌倒风险:来自中国健康与养老追踪调查的研究结果。

Risk of falls in 4 years of follow-up among Chinese adults with diabetes: findings from the China Health and Retirement Longitudinal Study.

机构信息

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China.

Gastrointestinal Department, West China Hospital, Sichuan University, Chengdu, China.

出版信息

BMJ Open. 2021 Jun 8;11(6):e043349. doi: 10.1136/bmjopen-2020-043349.

Abstract

OBJECTIVES

This study was to determine the incidence of falls and identify baseline factors increased risk for incident falls over time among people with diabetes.

DESIGN

This study was a secondary analysis using the baseline and 4 years of follow-up data from the China Health and Retirement Longitudinal Study (CHARLS).

SETTING

A nationally representative survey of 17 500 Chinese residents aged 45 years and older were recruited in the baseline national survey in 2011. These participants were followed up every 2 years.

PARTICIPANTS

A total of 1238 middle-aged and older adults with diabetes and no history of falls at baseline were included in the current study.

PRIMARY AND SECONDARY OUTCOME MEASURES

Information on incidence of falls and medical treatment resulting from falls were determined by self-report.

RESULTS

The findings showed that the incidence of falls was 29.4% during 4 years of follow-up. Participants with incident falls were younger, were more likely to be women, had lower education level and were less likely to be current drinkers. In addition, former drinkers were 2.22 times more likely to fall. Socially active individuals were 47% less likely to fall compared with those without social activities. Every 5 kg increase in grip strength was associated with a 13% lower risk of falls. A 10 mg/dL higher total cholesterol and 1 mg/dL higher blood urea nitrogen were associated with a 4% and 6% higher risk of falls. Finally, participants with depressive symptoms were 1.47 times more likely to fall compared with those without depressive symptoms.

CONCLUSIONS

These findings underscore the importance of developing a fall prevention programme for those with diabetes, and this programme should address potentially modifiable risk factors, including levels of total cholesterol, blood urea nitrogen, social activity, depressive symptoms and grip strength.

摘要

目的

本研究旨在确定糖尿病患者跌倒的发生率,并确定随时间推移增加跌倒风险的基线因素。

设计

本研究是对中国健康与退休纵向研究(CHARLS)基线和 4 年随访数据的二次分析。

地点

2011 年基线全国调查中招募了来自中国的 17500 名 45 岁及以上的具有代表性的居民,每两年进行一次随访。

参与者

共有 1238 名年龄在中年及以上且基线时无跌倒史的糖尿病患者纳入本研究。

主要和次要结果测量

通过自我报告确定跌倒发生率和因跌倒导致的医疗治疗信息。

结果

研究结果显示,在 4 年的随访期间,跌倒的发生率为 29.4%。发生跌倒的参与者更年轻,更可能是女性,教育程度较低,不太可能是当前饮酒者。此外,曾经饮酒者跌倒的可能性是前者的 2.22 倍。与没有社会活动的人相比,积极参与社交活动的人跌倒的可能性降低了 47%。握力每增加 5 公斤,跌倒的风险就降低 13%。总胆固醇每增加 10mg/dL,血尿素氮每增加 1mg/dL,跌倒的风险就增加 4%和 6%。最后,与没有抑郁症状的参与者相比,有抑郁症状的参与者跌倒的可能性高 1.47 倍。

结论

这些发现强调了为糖尿病患者制定跌倒预防计划的重要性,该计划应针对潜在的可改变的危险因素,包括总胆固醇、血尿素氮、社会活动、抑郁症状和握力水平。

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