摘要
目的 分析上海市青浦区＞50岁2型糖尿病(type 2 diabetes mellitus,T2DM)患者的高血压患病情况,并分析其影响因素,为糖尿病患者的随访与管理提供理论支持.方法 分析上海市青浦区基本公共卫生服务项目资料数据,通过问卷调查、体格检查和血液生化指标检测等方式收集有关数据,并采用多因素logistic回归对患者高血压患病影响因素进行分析.结果 本研究共纳入T2DM患者20 525例,其中男性9 666例(47.09％),女性 10 859例(52.91％),年龄(68.42±8.91)岁.本研究中有 11 620例T2DM患者合并高血压,标准化后上海市青浦区T2DM患者合并高血压患病率为50.00％,其中,＞65岁老年人标化患病率为62.36％.多元logistic回归分析结果显示,女性(OR=2.02,95％CI:1.85～2.19)、高龄(OR=2.14,95％CI:1.97～2.34、OR=3.59,95％CI:3.25～3.96)、超重(OR=1.15,95％CI:1.06～1.25)、肥胖(OR=1.19,95％CI:1.05～1.36)、中心性肥胖(OR=1.28,95％CI:1.18～1.38)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)异常(OR=1.26,95％CI:1.14～1.39)、总胆固醇异常(OR=1.13,95％CI:1.03～1.23)、吸烟(OR=1.78,95％CI:1.54～2.05)、饮酒(OR=4.54,95％CI:3.96～5.20)、高血压家族史(OR=14.51,95％CI:12.59～16.71)是T2DM患者患高血压的危险因素,而消瘦(OR=0.58,95％CI:0.41～0.82)是T2DM患者患高血压的保护因素.结论 T2DM患者合并高血压的患病率较高,应重点关注糖尿病患者体质量、血脂水平、吸烟饮酒等可改变的风险因素,针对不同人员类型制定精准防控策略.
Abstract
Objective To investigate the prevalence of hypertension in type 2 diabetes mellitus(T2DM)patients over 50 years old in Qingpu District,Shanghai,and to explore the influencing factors of this comorbidity,so as to provide theoretical evidence for follow-up and management of diabetic patients.Methods Data for this is a cross-sectional study were extracted from the basic public health service documents in Qingpu District,Shanghai.Questionnaire interview,physical examination,and blood test were conducted to collect relevant data.Multivariable logistic regression was used to analyze the risk factors of hypertension in T2DM patients.Results A total of 20 525 patients with type 2 diabetes were enrolled,including 9 666 males(47.09％)and 10 859 females(52.91％),with a mean age of(68.42±8.91)years.There were 11 620 patients had co-existing hypertension.After standardization,the standardized prevalence of hypertension among diabetic patients in Qingpu District in Shanghai was 50.00％,which was 62.36％among people over 65 years old.Multivariable logistic regression analysis showed that being women(OR=2.02,95％CI:1.85-2.19),being the elderly(over 65 years old)[OR=2.14,95％CI:1.97-2.34,OR=3.59,95％CI:3.25-3.96,respectively],overweight(OR=1.15,95％CI:1.06-1.25),obesity(OR=1.19,95％CI:1.05-1.36),central obesity(OR=1.28,95％CI:1.18-1.38),HDL-C abnormalities(OR=1.26,95％CI:1.14-1.39),TG abnormalities(OR=1.13,95％CI:1.03-1.23),smoking(OR=1.78,95％CI:1.54-2.05),alcohol drinking(OR=4.54,95％CI:3.96-5.20),and positive family history of hypertension(OR=14.51,95％CI:12.59-16.71)were the major risk factors for co-occurring hypertension in T2DM patients,while weight loss was a protective factor against hypertension in T2DM patients(OR=0.58,95％CI:0.41-0.82).Conclusions The prevalence of hypertension in T2DM patients is high.The modifiable risk factors such as weight,blood lipid level,smoking and alcohol drinking should be the focus in formulating precision prevention and control strategies targeting people of different attributes.
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