摘要
目的探讨2型糖尿病(T2DM)患者体力活动、静态行为和睡眠时间与血糖控制效果的关系。方法采用整群随机抽样,对常熟市和淮安市纳入基本公共卫生服务的T2DM患者开展流行病学调查,采用全球体力活动问卷收集体力活动信息,通过代谢当量(MET)量化能量消耗,检测糖化血红蛋白(HbAlc)和空腹血糖(FBG),分别评价血糖控制效果。采用非条件logistic回归模型调整混杂因素,计算比值比(OR)及其95%置信区间(95%CI),分析体力活动能量消耗与血糖控制效果的关联。结果最终16262例T2DM患者纳入分析,HbA1c指标评价血糖控制状况好的占41.9%;FBG指标评价血糖控制状况好的占31.4%;总体力活动、静态行为和睡眠时间的24h能量消耗中位数分别为24.9(20.9,30.1)、3.3(2.2,4.4)、7.7(6.0,8.0)MET-h/d。调整混杂因素后(模型3),与最低水平组相比,最高水平组总体力活动和睡眠时间T2DM患者HbA1c控制差的OR(95%CI)分别为0.88(0.80~0.97)(P趋势=0.018)和1.16(1.04~1.30)(P趋势=0.009);睡眠时间FBG控制差的OR(95%CI)为1.21(1.08~1.36)(P趋势=0.001)。结论总体力活动多,有助于T2DM患者长期血糖控制;睡眠时间长,与短期和长期血糖控制差均存在统计学关联。
Objective To explore the associations between glycemic control in type 2 diabetes mellitus(T2 DM)with physical activity,sedentary behavior and sleep duration.Methods The stratified cluster sampling method was used for the epidemiological investigation in which a total of 20053 T2 DM patients included in National Basic Public Health Service in Changshu county and Huai’an City were recruited.Data on physical activities were collected by global physical activity questionnaire,the energy consumption was quantified by metabolic equivalent(MET).Glycemic control status was evaluated by analysis of fasting blood glucose(FBG)and hemoglobin Alc(HbAlc),respectively.Unconditional logistic regression was used to estimate adjusted odds ratio(OR)and their 95%confidence intervals(95%CI)for the associations between physical activity,energy consumption and glycemic control in T2 DM patients.Results A total of 16262 T2 DM patients were included in this study.HbA1 cindex:good blood glucose control accounted for41.9%;FBG index:good blood glucose control accounted for 31.4%.The median 24 henergy expenditure for physical activity,sedentary behavior and sleep duration were 24.9(20.9,30.1),3.3(2.2,4.4)and 7.7(6.0,8.0)MET-h/d,respectively.After adjusting for confounding factors(model 3),the ORs(95%CI)of uncontrolled HbA1 camong patients in the highest group for physical activity and sleep duration were 0.88(0.80-0.97)and 1.16(1.04-1.30)when compared to the patients in the lowest group of energy expenditure,with corresponding Ptrendsof 0.018 and 0.009;while the OR(95%CI)of FBG in poor sedentary behavior group was 1.21(1.08-1.36),with corresponding Ptrends of 0.001.Conclusion High level of physical activity was associated with good long term of glycemic control in patients with T2 DM,whereas sleep duration was associated both short and long term of poor glycemic control rates.
作者
张昆
武鸣
潘恩春
苏健
孙中明
文进博
ZHANG Kun;WU Ming;PAN En-chun;SU Jian;SUN Zhong-ming;WEN Jin-bo(Nanjing Medical University,School of Public Health,Jiangsu Nanjing 2111669 China;不详)
出处
《江苏预防医学》
CAS
2020年第6期609-613,共5页
Jiangsu Journal of Preventive Medicine
关键词
2型糖尿病
血糖控制
体力活动
静态行为
剂量反应关系
Type 2diabetic mellitus
Glycemic control
Physical activity
Sedentary behavior
Dose-response relationship
