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2型糖尿病成年人中高血压、血脂异常和心血管事件的社会不平等:沙特阿拉伯的一项横断面研究

Social Inequalities in Hypertension, Dyslipidemia, and Cardiovascular Events Among Adults with Type 2 Diabetes: A Cross-Sectional Study from Saudi Arabia.

作者信息

Alamro Nurah Maziad, Alahmari Abdulaziz Nasser, Batais Mohammed Ali, Alsaeed Talal Khalid, Alsalhi Abdulhadi Abdulaziz

机构信息

Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia.

Department of Family and Community Medicine, King Saud University Medical City, Riyadh 11451, Saudi Arabia.

出版信息

Healthcare (Basel). 2025 Jun 20;13(13):1480. doi: 10.3390/healthcare13131480.

Abstract

: The present study seeks to examine how social disparities relate to the prevalence of poor glycemic control (HbA1c ≥ 7%), comorbidities such as hypertension and dyslipidemia, and diabetes-related complications (microvascular or macrovascular) among Saudi patients diagnosed with type 2 diabetes. : A cross-sectional study was conducted among 574 patients with type 2 diabetes mellitus (T2DM) attending family medicine clinics at King Saud University Medical City in Riyadh. Participants were selected using a simple random sampling technique and interviewed via phone using a validated questionnaire. Data collected included demographic and clinical variables. Descriptive statistics and multivariate logistic regression analyses were performed to assess the association between socioeconomic status (SES) and cardiovascular complications, including stroke, dyslipidemia, hypertension, and acute coronary syndrome. : The analysis revealed that certain socioeconomic factors significantly increased the odds of cardiovascular complications among patients with T2DM. Being female was associated with higher odds of hypertension (OR = 2.29, = 0.014), dyslipidemia (OR = 2.59, = 0.012), acute coronary syndrome (ACS) (OR = 2.35, = 0.001), and stroke (OR = 2.17, = 0.003). Divorced or widowed participants had significantly increased odds of ACS (OR = 2.91, = 0.001) and stroke (OR = 2.83, = 0.002). A lower educational level (secondary school or less) was significantly associated with increased odds of hypertension (OR = 2.64, = 0.031), dyslipidemia (OR = 2.22, = 0.005), and stroke (OR = 2.88, = 0.042). Monthly income between 3001 and 6000 SAR was significantly associated with higher odds of ACS (OR = 2.61, = 0.003) and stroke (OR = 2.64, = 0.012). Participants with diabetes duration >15 years had higher odds of dyslipidemia (OR = 2.86, = 0.004) and stroke (OR = 2.89, = 0.005). Being retired or not working increased the odds of all four cardiovascular outcomes, with stroke showing the highest risk (OR = 3.18, < 0.001). Living outside the Riyadh region was also associated with elevated risk across outcomes, notably stroke (OR = 1.52, = 0.046). : The study concluded that notable social disparities exist among diabetic individuals affected by cardiovascular conditions, such as stroke and acute coronary syndrome (ACS), as well as risk factors for cardiovascular disease like dyslipidemia (DLD). These findings can inform targeted cardiovascular risk reduction strategies and address health inequities among diabetic populations in Saudi Arabia.

摘要

本研究旨在探讨社会差异如何与沙特阿拉伯被诊断为2型糖尿病患者的血糖控制不佳(糖化血红蛋白≥7%)患病率、高血压和血脂异常等合并症以及糖尿病相关并发症(微血管或大血管)相关。

在利雅得沙特国王大学医学城的家庭医学诊所对574例2型糖尿病(T2DM)患者进行了一项横断面研究。采用简单随机抽样技术选取参与者,并通过电话使用经过验证的问卷进行访谈。收集的数据包括人口统计学和临床变量。进行描述性统计和多因素逻辑回归分析,以评估社会经济地位(SES)与心血管并发症之间的关联,包括中风、血脂异常、高血压和急性冠状动脉综合征。

分析显示,某些社会经济因素显著增加了T2DM患者发生心血管并发症的几率。女性患高血压(OR = 2.29,P = 0.014)、血脂异常(OR = 2.59,P = 0.012)、急性冠状动脉综合征(ACS)(OR = 2.35,P = 0.001)和中风(OR = 2.17,P = 0.003)的几率更高。离婚或丧偶参与者发生ACS(OR = 2.91,P = 0.001)和中风(OR = 2.83,P = 0.002)的几率显著增加。较低的教育水平(中学及以下)与高血压(OR = 2.64,P = 0.031)、血脂异常(OR = 2.22,P = 0.005)和中风(OR = 2.88,P = 0.042)几率增加显著相关。月收入在3001至6000沙特里亚尔之间与ACS(OR = 2.61,P = 0.003)和中风(OR = 2.64,P = 0.012)几率更高显著相关。糖尿病病程>15年的参与者发生血脂异常(OR = 2.86,P = 0.004)和中风(OR = 2.89,P = 0.005)的几率更高。退休或无工作增加了所有四种心血管结局的几率,中风风险最高(OR = 3.18,P < 0.001)。居住在利雅得地区以外也与所有结局的风险升高相关,尤其是中风(OR = 1.52,P = 0.046)。

该研究得出结论,在受心血管疾病(如中风和急性冠状动脉综合征(ACS))以及心血管疾病危险因素(如血脂异常(DLD))影响的糖尿病个体中存在显著的社会差异。这些发现可为有针对性的心血管风险降低策略提供信息,并解决沙特阿拉伯糖尿病患者中的健康不平等问题。

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