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《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

20

期数:

2019年07期

页码:

967-971

栏目:

论　著

出版日期:

2019-07-28

文章信息/Info

Title:

Detection rate and influencing factors of type2diabetes mellitus complicated with high uric acid in elderly community population

作者:

徐幽琼1; 2; 张晓阳1; 2; 叶友斌2; 曹祥玉1; 李红1

1.福州市疾病预防控制中心地方病与慢性病防治科，福州 350004 2.福建医科大学公共卫生学院，福州 350004

Author(s):

XUYou-qiong * ; ZHANGXiao-yang; YEYou-bin; CAOXiang-yu; LIHong

*Fuzhou Centerfor Disease ControlandPrevention,Fuzhou350004,China Correspondingauthor:XUYou-qiong,E-mail：joancoco@163.com

关键词:

老年人; 2型糖尿病; 高尿酸血症; 影响因素; 病例对照研究

Keywords:

Elderly;  Type2 diabetes;  Hyperuricemia;  Influencing factors;  Case-control study

分类号:

R587.2

DOI:

-

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。

Abstract:

Objectives To investigate the prevalence of type2 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 ran-domly 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 match-ing, 2 056 cases of subjects served as the control group who participated in community health check-ups （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 with65 years and over in Fuzhou, of which men were lower than women（33.20% vs.36.70%,P<0.01）. The abnor-mal rates of overweight, central obesity, hypertension, glycosylated hemoglobin, aspartate transami-nase, 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 ≥17.1 μmol/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 to-tal 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 ORwere1.431, 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 type2 diabetes melli-tus 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 pres-sure, and regularly check liver and kidney function indicators, which are helpful for early diagnosis and treatment of hyperuricemia.

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备注/Memo

备注/Memo:

基金项目：国家临床重点专科（老年医学项目2015-GJLN-2-08） 作者简介：徐幽琼，博士，主任医师，研究方向：慢性病防治 通信作者：徐幽琼，E-mail：joancoco@163.com

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更新日期/Last Update: 2019-07-28