摘要
目的探讨福州市老年人2型糖尿病合并高尿酸患病情况及其主要的影响因素,为其预防和控制提供参考依据。方法随机选取福州市鼓楼与台江两个城区,每个城区随机抽取一家社区卫生服务中心,将2018年两个社区所有参与体检和随访的65岁及以上、确诊糖尿病合并高尿酸并在社区登记建档人群的1 028例作为病例组,采用1∶2配比选取同期参加社区健康体检居民(有糖尿病但无高尿酸血症) 2 056例作为对照组,比较两组一般情况、临床特征、生化指标等,分析糖尿病合并高尿酸血症的影响因素。结果福州市社区65岁及以上老年人患有糖尿病合并高尿酸的检出率为34.91%,其中男性低于女性(33.20%vs. 36.70%,P<0.01);病例组超重率、中心性肥胖率、高血压、糖化血红蛋白(HbA1c)、天冬氨酸转氨酶(AST)、丙氨酸氨基转移酶(ALT)、尿肌酐(Cr)、尿素氮(BUN)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)异常率均显著高于对照组,而总胆红素(TBIL)异常率显著低于对照组(P<0.05);多因素回归分析显示:TBIL≥17.10μmol/L是糖尿病合并高尿酸血症的保护因素(OR=0.819,P<0.05),年龄≥75岁、肥胖、中心性肥胖、收缩压≥140 mm Hg、血清TC≥5.2 mmol/L、LDL-C≥2.6 mmol/L、BUN≥6.5 mmol/L是糖尿病合并高尿酸血症危险因素(OR分别为1.431、1.213、1.490、1.352、1.821、1.274、1.536,均P<0.05)。结论福州市社区老年人糖尿病合并高尿酸检出率较高,与高血压、高血脂等密切相关,该人群需要控制体质量,积极防治高血压,定期检测肝肾功能指标,有助于高尿酸血症的早期诊断与治疗。
Objectives To investigate the prevalence of type 2 diabetes mellitus complicated with high uric acid and its main influencing factors among elderly citizens in Fuzhou,and provide reference for its prevention and control.Methods The two districts of Drum Tower and Taijiang were chosen randomly from the five districts of Fuzhou,and a community health service center was randomly selected from each urban area.Totally 1 028 cases of subjects with 65 years and over in the two communities were used as case group who was involved in the physical examination and follow-up,and confirmed type 2 diabetes with high uric acid and registered in the community in 2018.Using 1∶2 matching,2 056 cases of subjects served as the control group who participated in community health checkups(with diabetes but no hyperuricemia)in the same period.The indexes such as general conditions,clinical features,biochemical tests were compared between the two groups,and the influencing factors of type 2 diabetes complicated with hyperuricemia were analyzed.Results The detection rate of type 2 diabetes mellitus complicated with high uric acid was 34.91%in the elderly with 65 years and over in Fuzhou,of which men were lower than women(33.20%vs.36.70%,P<0.01).The abnormal rates of overweight,central obesity,hypertension,glycosylated hemoglobin,aspartate transaminase,alanine transaminase,creatinine,blood urea nitrogen,triglyceride,total cholesterol,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol in the case group were higher than those in the control group,but total bilirubin was lower than in the control group(P<0.05).Multivariate regression analysis showed that total bilirubin≥17.1μmol/L was a protective factor(OR=0.819,P<0.05),but age≥75 years,obesity,central obesity,systolic blood pressure≥140 mm Hg,serum total cholesterol≥5.20 mmol/L,low-density lipoprotein cholesterol≥2.60 mmol/L,urea nitrogen≥6.50 mmol/L were risk factors(the values of OR were 1.431,1.213,1.490,1.352,1.821,1.274,1.536,all P<0.05)for diabetes with hyperuricemia.Conclusion The detection rate of type 2 diabetes mellitus with high uric acid is high in the elderly in Fuzhou,which is closely related to hypertension and hyperlipidemia.The population need to control body weight,actively prevent and treat high blood pressure,and regularly check liver and kidney function indicators,which are helpful for early diagnosis and treatment of hyperuricemia.
作者
徐幽琼
张晓阳
叶友斌
曹祥玉
李红
XU You-qiong;ZHANG Xiao-yang;YE You-bin;CAO Xiang-yu;LI Hong(Fuzhou Center for Disease Control and Prevention,Fuzhou 350004,China)
出处
《慢性病学杂志》
2019年第7期967-971,共5页
Chronic Pathematology Journal
基金
国家临床重点专科(老年医学项目2015-GJLN-2-08)
