摘要
目的 探讨老年2型糖尿病患者长期随访期间糖化血红蛋白(HbA1c)控制达标的影响因素。方法 选择2007年1月至2011年1月于中国人民解放军总医院第二医学中心住院,行动态血糖监测的200例老年男性2型糖尿病患者为研究对象。根据年龄(60岁≤年龄<70岁57例、70岁≤年龄<80岁51例、年龄≥80岁92例)、糖尿病病程(病程<10年57例、10年≤病程<20年89例、病程≥20年54例)、基线HbA1c(HbA1c<6.5%74例、6.5%≤HbA1c<7.5%72例、HbA1c≥7.5%54例)分别将患者分为3组。比较不同组别患者长期随访期间HbA1c水平的差异。采用SPSS 13.0统计软件进行数据分析。根据数据类型,分别采用方差分析或χ^(2)检验进行组间比较。采用logistic回归分析随访期间HbA1c控制达标的影响因素。结果 平均随访12.5年。不同年龄组随访期间HbA1c均值、HbA1c控制达标率差异无统计学意义(P>0.05);与糖尿病病程<10年组比较,糖尿病病程≥20年组随访期间HbA1c均值升高(P<0.01),HbA1c控制达标率降低(P<0.05);随着基线HbA1c增加,随访期间HbA1c均值逐渐增加(P<0.01),HbA1c控制达标率逐渐降低(P<0.01)。单因素logistic回归分析显示,糖尿病病程、基线HbA1c、空腹血糖、餐后2 h血糖、血糖波动、胰岛素治疗是随访期间HbA1c控制达标的影响因素(P<0.01)。非条件多因素logistic回归分析提示,基线HbA1c(OR=5.73,95%CI 3.02~10.88,P<0.001)是随访期间HbA1c控制达标最重要的影响因素。结论 糖尿病病程、基线HbA1c、空腹血糖、餐后2 h血糖、血糖波动、胰岛素治疗是老年2型糖尿病随访期间HbA1c控制达标的影响因素,其中基线HbA1c是最重要的影响因素。
Objective To investigate the influencing factors of glycosylated hemoglobin(HbA1c)control during long-term follow-up in the elderly patients with type 2 diabetes mellitus.Methods A total of 200 elderly male patients with type 2 diabetes mellitus were selected for the study,who received continuous glucose monitoring(CGM)in the Second Medical Center of Chinese PLA General Hospital from January 2017 to January 2011.They were divided into groups according to age(60 years≤age<70 years,n=57;70 years≤age<80 years,n=51;age≥80 years,n=92),diabetes duration(diabetes<10 years,n=57;10≤diabetes<20 years,n=89;diabetes≥20 years,n=54),or baseline HbA1c level(HbA1c<6.5%,n=74;6.5%≤HbA1c<7.5%,n=72;HbA1c≥7.5%,n=54).The groups were compared in mean HbA1c during long-term follow-up.Data analysis was performed using SPSS 13.0.Comparison between groups was performed with variance analysis or Chi-square test depending on the data types.The influencing factors of HbA1c control during follow-up were analyzed by logistic regression.Results All participants were followed up for an average of 12.5 years.There was no difference in mean HbA1c and adequate HbA1c control rate between different age groups during follow-up(P>0.05).Compared with the diabetes duration<10 years group,the mean HbA1c increased(P<0.01)and the adequate HbA1c control rate decreased(P<0.05)in the diabetes duration≥20 years group.With the increasing baseline HbA1c,the mean HbA1c increased gradually(P<0.01),and adequate HbA1c control rate decreased gradually(P<0.01).The univariate logistic regression analysis showed that diabetes duration,baseline HbA1c,fasting plasma glucose,2 h postprandial glucose,baseline glycemic variability,and insulin therapy were the influencing factors of HbA1c control during follow-up(P<0.01).Unconditional multivariate logistic regression analysis suggested that baseline HbA1c(OR=5.73,95%CI 3.02-10.88,P<0.001)was the most important influencing factor of HbA1c control during follow-up.Conclusion Diabetes duration,baseline HbA1c,fastin
作者
方福生
王宁
刘星宇
闫双通
李春霖
田慧
FANG Fu-Sheng;WANG Ning;LIU Xing-Yu;YAN Shuang-Tong;LI Chun-Lin;TIAN Hui(Department of Health Care,Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Endocrinology,Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China)
出处
《中华老年多器官疾病杂志》
2022年第7期490-495,共6页
Chinese Journal of Multiple Organ Diseases in the Elderly
基金
军队保健专项科研课题(22BJZ33)。
关键词
老年人
2型糖尿病
糖化血红蛋白
aged
type 2 diabetes mellitus
glycosylated hemoglobin
