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上海社区糖尿病及糖调节受损人群周围神经病变的横断面调查
Peripheral neuropathy in subjects with diabetes mellitus and impaired glucose regulation in 2 Shanghai communities:a cross-sectional study
【摘要】 目的了解上海社区糖尿病(DM)及糖调节受损(IGR)人群周围神经病变(PN)的患病率及其主要危险因素。方法对1998-2001年上海市华阳及曹杨社区代谢综合征流行病学基线调查建立的IGR及DM队列人群进行PN的筛查,共完成筛查739例,男347例,女392例,年龄21~104岁,平均年龄为(66.4±13.2)岁。原有IGR患者再次接受75g葡萄糖耐量试验,以进一步确定糖代谢状态,PN采用密歇根神经病变筛选法(MNSI)进行诊断。对与PN有关的各影响因素进行逐步Logistic回归分析。结果社区IGR和DM人群的PN患病率分别为24.6%和36.6%,其中在新诊断DM人群中为25.3%,在已诊断DM人群中为39.9%。Logistic回归分析显示,年龄(OR=1.076,95%CI为1.057~1.096,P<0.001)、糖尿病病程(OR=1.305,95%CI为1.122~1.518,P<0.001)、体质指数(OR=1.083,95%CI为1.026~1.143,P=0.004)及糖化血红蛋白(HbA1c,OR=1.159,95%CI为1.007~1.335,P=0.040)是与PN相关的独立危险因素,HbA1c>7.4%患者的PN患病风险约为HbA1c<6.5%患者的1.8倍(OR=1.777,95%CI为1.009~3.130,P=0.044)。结论上海社区高血糖人群中,近1/3患PN,不仅在DM,且在DM前期IGR阶段PN即有较高的患病率。加强血糖控制以及减轻体重可能对PN的防治具有重要意义。
【Abstract】 Objective To know about the prevalence and risk factors of peripheral neuropathy (PN) in subjects with diabetes mellitus and impaired glucose regulation (IGR) in 2 Shanghai communities.Methods Based on a previous epidemiological study of metabolic syndrome in Shanghai Huayang and Caoyang Communities in 1998-2001,a total of 739 hyperglycemic subjects,including 347 males and 392 females,with an average age of (66.4±13.2) years old and a range of 21-104 years,were enrolled in the present study. Standard 75 g oral glucose tolerance tests (OGTT) were performed in IGR subjects. PN was diagnosed based on the Michigan Neuropathy Screening Instrument (MNSI). Stepwise logistic regression analysis was used to estimate the potential risk factors associated with PN.Results The incidences of PN were 24.6% and 36.6% in IGR subjects and DM subjects,respectively (25.3% in newly diagnosed DM and 39.9% in known subjects with DM). Logistic regression revealed that age (OR=1.076,95%CI:1.057-1.096,P<0.001),duration of diabetes (OR=1.305,95%CI:1.122-1.518,P<0.001),body mass index (OR=1.083,95%CI:1.026-1.143,P=0.004) and HbA1c (OR=1.159,95%CI:1.007-1.335,P=0.040) were the independent risk factors for PN in hyperglycemic subjects. The risk of PN was 1.8-fold higher in subjects with HbA1c>7.4% as compared with those with HbA1c<6.5% (OR=1.777,95%CI:1.009-3.130,P=0.044).Conclusion About one third of the hyperglycemic patients in these 2 Shanghai communities have PN,not only in DM patients,but also in IGR stage. Intensive glycemic control and body weight reduction may be important for prevention of PN.
【Key words】 Peripheral neuropathy; Diabetes mellitus; Prevalence; Michigan ueuropathy screening instrument;
- 【文献出处】 上海医学 ,Shanghai Medical Journal , 编辑部邮箱 ,2009年05期
- 【分类号】R587.2
- 【被引频次】26
- 【下载频次】250