摘要
目的探究社区2型糖尿病(T2DM)患者糖化血红蛋白(HbA1c)达标现状及其与健康素养的关系,并分析影响HbA1c达标的因素。方法选取2019年2月至2020年2月在济宁医学院附属湖西医院(单县中心医院)登记建卡的T2DM患者134例作为研究对象,所有患者以HbA1c水平分为两组,HbA1c < 7%为达标组(61例),HbA1c ≥ 7%为未达标组(73例)。获取两组患者空腹肘静脉血并检查相关生化指标,且收集两组患者一般资料,并采用中国公民健康素养调查问卷评估两组患者健康素养水平。结果未达标组血清肌酐(Scr)、尿酸(BUA)、尿素氮(BUN)水平均显著高于达标组(均P < 0.05),而健康素养评分均显著低于达标组(均P < 0.05);且未达标组吸烟、相关并发症占比分别为17.81%、16.44%,均显著高于达标组的3.28%、4.92%(χ^(2)=7.05、4.43,均P < 0.05),未达标组血糖监测规律占比63.93%,显著低于达标组的80.82%(χ^(2)=4.82,P < 0.05)。Pearson分析结果显示,HbA1c水平与健康素养评分呈显著负相关,相关系数(r)为-0.80。logistic回归模型结果显示,Scr、BUA均是HbA1c未达标的独立危险因子,OR值分别为3.81(95%CI:1.60~9.09)、1.03(1.01~1.06),健康素养评分为HbA1c未达标的保护因子,OR值为0.23(95%CI:0.10~0.54)。结论社区T2DM达标率不足50%,健康素养评分与HbA1c水平呈显著负相关,且健康素养评分是HbA1c的保护因子,而Scr、BUA均是HbA1c未达标的独立危险因子。
Objective To investigate the status quo of hemoglobin a1c(HbA1c)in community-dwelling patients with type 2 diabetes mellitus and its relationship with health literacy,and analyze the factors that affect HbA1c level.Methods A total of 134 patients with T2DM who received treatment in Hbxi Hospital Affiliated to Jining Medical University(Shanxian Central Hospital)from February 2019 to February 2020 were included in this study.All patients were divided into standard group(HBA1c<7%,n=61)and substandard group(HbA1c≥7%,n=73)according to HbA1c level.Fasting elbow venous blood was collected to measure relevant biochemical indexes.General data were collected from patients in the two groups.The Chinese Citizen Health Literacy Questionnaire was used to evaluate the health literacy level in patients from the two groups.Results Serum levels of creatinine,blood uric acid and blood urea nitrogen in the substandard group were significantly higher than those in the standard group(all P<0.05).Health literacy score in the substandard group was significantly lower than that in the standard group(P<0.05).The percentage of patients who smoked or had relevant complications among all included patients in the substandard group was 17.81%and 16.44%,respectively,which were significantly higher than 3.28%and 4.92%,respectively,in the standard group(χ^(2)=7.05,4.43,both P<0.05).The percentage of patients who had regular glucose level among all included patients in the substandard group was significantly lower than that in the standard group(63.93%vs.80.82%,χ^(2)=4.82,P<0.05).Pearson analysis results showed that HbA1c level was significantly negatively correlated with health literacy score,with the correlation coefficient r of-0.80.Logistic regression model results showed that serum levels of creatinine and blood uric acid were independent risk factors for substandard level of HbA1c,with an OR value of 3.81(95%CI:1.60-9.09)and 1.03(95%CI:1.01-1.06),respectively.Health literacy score was a protective factor for substandard level of HbA1c,with an OR value of 0.23(95%CI:0.10-0.54).Conclusion Less than 50%of community-dwelling patients have standard HbA1c levels.Health literacy score is remarkably negatively correlated with HbA1c level.Health literacy score is a protective factor for HbA1c level,while serum creatinine and blood uric acid are independent risk factors for substandard HbA1c.
作者
张旋
高亮亮
刘效荣
吴燕
徐萌
Zhang Xuan;Gao Liangliang;Liu Xiaorong;Wu Yan;Xu Meng(Department of Endocrinology,Huxi Hospital Affiliated to Jining Medical University,Shanxian Central Hospital,Heze 274300,Shandong Province,China)
出处
《中国基层医药》
CAS
2022年第8期1209-1213,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
糖尿病
2型
糖化血红蛋白
健康素养
相关性
影响因素
肾功能
慢性病
社区管理
Diabetes mellitus,type 2
HbA1c
Health literacy
Correlation
Factors affecting
Renal function
Chronic diseases
Community management
作者简介
通信作者:张旋,Email:3062581566@qq.com。
