Department of Public Health, College of Medicine and Health Sciences, Werabe University, Werabe, Ethiopia.
School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
PLoS One. 2021 Aug 23;16(8):e0256399. doi: 10.1371/journal.pone.0256399. eCollection 2021.
Hypertension (HTN) in patients with diabetes mellitus (DM) is a common problem that increases the risk of mortality and morbidity, and lowers the quality of life. Despite the disproportionately high burden of HTN in DM patients, determinants for the comorbidity have not been sufficiently explored. Therefore, this study aimed to identify the determinants of HTN among patients with type 2 diabetes mellitus on follow-up at Tikur Anbessa Specialized Hospital.
We conducted a hospital-based unmatched case-control study at Tikur Anbessa Specialized Hospital on 386 randomly selected patients with type 2 diabetes on follow-up (200 cases and 186 controls). We collected data by using a structured interviewer-administered questionnaire and data extraction form. To identify determinants of hypertension, a multivariable binary logistic regression was fitted, and the findings are presented using adjusted odds ratio (AOR) with 95% confidence interval (CI).
The mean reported age (±SD) of the cases and the controls was 60.3 (±9.9) and 55.3 (±11.3) years, respectively. The eight identified independent determinants of hypertension with AOR [95% CI] were obesity: 2.82 [1.43, 5.57], sedentary activity of ≥4hrs/day: 1.75 [1.10, 2.79], higher stress score: 1.05 [1.01, 1.10], serum creatinine above 1.1 mg/dl: 2.35 [1.13, 4.91], age: 1.05 [1.02, 1.08], being government employee as compared to private workers: 2.18 [1.06, 4.50] and family history of hypertension: 2.11 [1.26, 3.54]. Further, interaction of diabetes duration with insulin use: 1.03 [1.01, 1.07] was also a significant predictor of HTN among DM patients.
The finding calls for interventions for mitigating these determinants. Further research is needed to examine the interaction between diabetes duration and insulin use.
高血压（HTN）在糖尿病（DM）患者中是一个常见的问题，会增加死亡率和发病率，并降低生活质量。尽管 DM 患者中 HTN 的负担不成比例地高，但对合并症的决定因素尚未得到充分探讨。因此，本研究旨在确定在提克里安贝萨专科医院接受随访的 2 型糖尿病患者中 HTN 的决定因素。
我们在提克里安贝萨专科医院进行了一项基于医院的 386 例随机选择的 2 型糖尿病随访患者（200 例病例和 186 例对照）的病例对照研究。我们使用结构化访谈员管理的问卷和数据提取表收集数据。为了确定高血压的决定因素，我们拟合了多变量二元逻辑回归，结果以调整后的优势比（AOR）和 95%置信区间（CI）表示。
病例和对照组报告的平均年龄（±SD）分别为 60.3（±9.9）和 55.3（±11.3）岁。高血压的八个独立决定因素为：肥胖：2.82 [1.43, 5.57]；每天久坐活动≥4 小时：1.75 [1.10, 2.79]；压力评分较高：1.05 [1.01, 1.10]；血清肌酐>1.1mg/dl：2.35 [1.13, 4.91]；年龄：1.05 [1.02, 1.08]；与私营企业相比，政府雇员：2.18 [1.06, 4.50]；高血压家族史：2.11 [1.26, 3.54]。此外，糖尿病病程与胰岛素使用的相互作用：1.03 [1.01, 1.07]也是 DM 患者发生 HTN 的一个显著预测因素。
这一发现呼吁采取干预措施来减轻这些决定因素。需要进一步研究来检查糖尿病病程和胰岛素使用之间的相互作用。
