摘要
目的探讨肥胖因素对社区2型糖尿病患者的综合干预的影响。方法遵循患者自愿参加的意愿，2008年到本社区中心就诊的2型糖尿病患者172例，在合理药物治疗的基础上，结合健康教育、定期复查及生活方式等强化干预方式，进行为期3年的干预。并定期对所有2型糖尿病患者的体质指数（BMI）、血压、血脂、空腹血糖、餐后2h血糖、糖化血红蛋白（HbAlc）、肝肾功能等指标进行监测和记录。结果①T2DM合并肥胖患者的BMI、腰围、糖化血红蛋白比非肥胖患者水平高，高密度脂蛋白比非肥胖患者低，差异有统计学意义（P〈0．05）；②校正年龄、性别的影响，Logistic分析显示肥胖患者发生空腹血糖、糖化血红蛋白控制未达标的风险分别是非肥胖者的2．31倍（95％CI：1．12～4．78），1．98倍（95％CI：1．07—3．68）；③他DM肥胖患者干预后的体质指数、收缩压、糖化血红蛋白低于干预前，高密度脂蛋白高于干预前，差异有统计学意义（P〈0．01）；④GLM分析显示，BMI影响空腹血糖、糖化血红蛋白、高密度脂蛋白的干预效果，差异有统计学意义（P〈0．05）。结论肥胖因素可能影响糖尿病患者的干预效果，通过社区长期强化管理，并有针对性对肥胖因素进行干预，可能有利于社区T2DM患者的管理效果。
Objective To explore the effect of obesity on comprehensive intervention of patients with Type 2 diabetes mellitus （T2DM） in community. Methods From 2008,172 patients with T2DM received a comprehensive intervention of 3 years that in-eluded rational medication, health education, regular physical examination and, regulations of life-style. The body mass index （ BMI）, blood pressure, blood lipid, fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin （ HbA1c ）, liver function and renal function indicators were also tested regularly. Results ①The waist circumference, BMI, HbA1 c level of T2DM patients with obesity were higher than nomal patients, the level of high density lipoprotein was lower than non-obese ones, the difference was statistically significant（ P 〈 0.05 ）. ②After adjusted for age and gender factois, Logistic analysis showed that the risk for occurring uncontrolled fasting blood glucose and glyeosylated hemoglobin in obesity ones was 2.31 times （95 % CI：1. 12 - 4.78） and in non-obese ones was 1.98 times（95% CI： 1.07 -3.68 ）. ③The BMI, systolic blood pressure, glycated hemoglobin of T2DM obese patients were lower than those before the intervention, but the high density lipoprotein was higher, the difference was statistically significant（ P 〈 0.01 ）. ④GLM analysis showed that BMI effected fasting blood glucose, glycosylated hemoglobin, high density lipoprotein intervention effect, and was statistically significance （ P 〈 0.05 ）. Conclusion Obesity factors might in- fluence intervention effect on diabetes patients, through the long-term intensive management,and targeted intervention for obesity factor,the effects of management of patients with T2DM in community can be improved.
出处
《中华全科医学》
2013年第11期1749-1751,共3页
Chinese Journal of General Practice
基金
首都医学发展科研基金(2007-1035)
关键词
2型糖尿病
社区
强化干预
肥胖
Type 2 diabetes mellitus
Community intervention
Obesity
作者简介
通讯作者：白薇，电子信箱：cysqdongfeng@126．com
