School of Nursing, Chitwan Medical College, Bharatpur, Nepal.
Departments of Endocrine Medicine, Chitwan Medical College, Bharatpur, Nepal.
PLoS One. 2023 May 25;18(5):e0286139. doi: 10.1371/journal.pone.0286139. eCollection 2023.
Metabolic syndrome (MetS) is associated with an increased incidence of chronic complications and mortality of diabetes patients. Prevention and treatment of MetS is important means of lowering the risk of cardiovascular diseases and mortality.
This study aimed to find out metabolic syndrome and life style factors among diabetes patients.
A cross-sectional survey was carried out among 296 patients with type 2 diabetes mellitus attending Chitwan Medical College Teaching Hospital. Consecutive sampling technique was used to select sample. Data were collected from 15th December 2021 to 15th March, 2022 using Interview Schedule, bio-physiological measurement and record review. Obtained data were analysed in SPSS version 20 for window using descriptive and inferential statistics. Chi-square test was applied to measure the association between the variables. Logistic regression analysis was performed to identify the factors associated with metabolic syndrome.
Findings revealed that the prevalence of MetS was 66.2% and 58.4% in patients according to International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria respectively. The most common MetS parameters were raised fasting plasma glucose (94.6%) and abnormal waist circumference (78.4% in IDF criteria) while the least prevalent parameter was reduced HDL level (43.2%). Majorities of the patients were non-vegetarian (85.5%), had poor dietary compliance (poor-46.3%, very poor-32.1%), overweight/obese (65.5%), and suffered from moderate stress (90.1%). Bivariate analysis showed that MetS as per NCEP ATP criteria was significantly associated with gender (p = 0.006), occupation (p = 0.007), presence of other co-morbid condition (<0.001) and sleep problem (p = <0.001). However, MetS as per IDF criteria was significantly associated with age (p = <0.028), duration of diabetes (p = <0.001), follow-up visit (p = <0.030), blood sugar monitoring (p = <0.009) and physical activity of diabetes patients (p = <0.001). Further logistic regression analysis revealed that sleep problem (AOR = 21.812;95%CI = 8.512,55.894) and presence of other comorbidities (AOR = 4.024;95%CI = 2.220,7.295) were the significant factors of metabolic syndrome.
Metabolic syndrome is high in patients with type 2 diabetes mellitus. Therefore, treating physicians and other health workers need to monitor MetS parameters regularly to reduce the risk of cardiovascular diseases, stroke and premature death.
代谢综合征（MetS）与糖尿病患者慢性并发症和死亡率的增加有关。预防和治疗代谢综合征是降低心血管疾病和死亡率风险的重要手段。
本研究旨在了解糖尿病患者的代谢综合征和生活方式因素。
对在奇特旺医学院教学医院就诊的 296 名 2 型糖尿病患者进行横断面调查。采用连续抽样技术选择样本。于 2021 年 12 月 15 日至 2022 年 3 月 15 日使用访谈表、生物生理测量和记录回顾收集数据。使用 SPSS 版本 20 for window 进行描述性和推断性统计分析获得的数据。卡方检验用于测量变量之间的关联。进行逻辑回归分析以确定与代谢综合征相关的因素。
研究结果显示，根据国际糖尿病联合会（IDF）和国家胆固醇教育计划成人治疗小组 III（NCEP ATP III）标准，代谢综合征的患病率分别为 66.2%和 58.4%。最常见的代谢综合征参数是空腹血糖升高（94.6%）和腰围异常（IDF 标准下为 78.4%），而最低的参数是高密度脂蛋白水平降低（43.2%）。大多数患者为非素食者（85.5%），饮食依从性差（差 46.3%，极差 32.1%），超重/肥胖（65.5%），中度压力（90.1%）。双变量分析显示，根据 NCEP ATP 标准，代谢综合征与性别（p=0.006）、职业（p=0.007）、存在其他合并症（<0.001）和睡眠问题（p<0.001）显著相关。然而，根据 IDF 标准，代谢综合征与年龄（p<0.028）、糖尿病病程（p<0.001）、随访（p<0.030）、血糖监测（p<0.009）和糖尿病患者的身体活动（p<0.001）显著相关。进一步的逻辑回归分析显示，睡眠问题（AOR=21.812；95%CI=8.512,55.894）和存在其他合并症（AOR=4.024；95%CI=2.220,7.295）是代谢综合征的显著因素。
2 型糖尿病患者代谢综合征发生率较高。因此，治疗医生和其他卫生工作者需要定期监测代谢综合征参数，以降低心血管疾病、中风和过早死亡的风险。
