【摘要】 目的 了解2型糖尿病共病患者的空腹血糖波动轨迹及其影响因素，为加强2型糖尿病共病患者血糖管理提供依据。方法 于2023年10月，通过上海市闵行区慢性病健康管理系统收集2021年1—10月诊断为2型糖尿病共病患者资料，包括人口学信息、生活方式、健康状况和空腹血糖资料等；根据2021年1月—2023年10月空腹血糖值建立组轨迹模型，分析空腹血糖波动轨迹；采用无序多分类logistic回归模型分析2型糖尿病共病患者空腹血糖波动轨迹的影响因素。结果 纳入907例2型糖尿病共病患者，其中男性472例，占52.04%；女性435例，占41.96%。年龄≥65岁652例，占71.89%。组轨迹模型分析，分为低水平稳定组、中水平稳定组和高水平下降组，分别为492、287和128例，占54.24%、31.64%和14.11%。无序多分类logistic回归分析结果显示，相较于低水平稳定组，初中及以下（OR=1.420,95%CI:1.011～1.995）或大专及以上（OR=2.109,95%CI:1.249～3.560）、规律运动（OR=1.387,95%CI:1.017～1.893）的2型糖尿病共病患者归于中水平稳定组的可能性较高；超重肥胖（OR=1.675,95%CI:1.116～2.513）、血脂异常（OR=3.195,95%CI:1.642～6.216）的2型糖尿病共病患者归于高水平下降组的可能性较高。结论 2021年1月—2023年10月2型糖尿病患者空腹血糖呈低水平稳定、中水平稳定和高水平下降3组波动轨迹；相较于低水平稳定组，中水平稳定组主要受文化程度、规律运动的影响，高水平下降组主要受超重肥胖和血脂异常的影响。更多还原

【Abstract】 Objective To investigate the trajectories of fasting blood glucose fluctuations and their influencing factors among patients with comorbidity of type 2 diabetes mellitus(T2DM), so as to provide the basis for strengthening blood glucose management in this population. Methods In October 2023, data of patients diagnosed with comorbid T2DM from January to October 2021, including demographic information, lifestyle, health status and fasting blood glucose were collected through the chronic disease health management system of Minhang District, Shanghai Municipality. Fasting blood glucose fluctuation trajectories were analyzed by group-based trajectory model established based on fasting blood glucose values from January 2021 to October 2023. Influencing factors of fasting blood glucose fluctuation trajectories among patients with comorbidity of T2DM were analyzed using a multinomial logistic regression model. Results A total of 907 patients with comorbidity of T2DM were enrolled, including 472 males(52.04%) and 435 females(47.96%).There were 652 cases aged ≥65 years, accounting for 71.89%. The group-based trajectory model analysis identified three trajectory groups: a low-level stable group(492 cases, 54.24%), a medium-level stable group(287 cases,31.64%), and a high-level decreasing group(128 cases, 14.11%). Multinomial logistic regression analysis showed that,compared with the low-level stable group, patients with comorbidity of T2DM who had an education level of junior high school or below(OR=1.420, 95%CI: 1.011-1.995) or college degree or above(OR=2.109, 95%CI: 1.249-3.560), as well as those who engaged in regular exercise(OR=1.387, 95%CI: 1.017-1.893), were more likely to be in the medium-level stable group. Patients with comorbidity of T2DM who were overweight or obese(OR=1.675, 95%CI: 1.116-2.513) or had dyslipidemia(OR=3.195, 95%CI: 1.642-6.216) were more likely to be in the high-level decreasing group. Conclusions From January 2021 to October 2023, the fasting blood glucose levels of patients with comorbidity of T2DM exhibited three fluctuating trajectories: low-level stability, medium-level stability, and high-level decline. Compared with the lowlevel stable group, the medium-level stable group was mainly influenced by educational level and regular exercise. The high-level decline group was primarily affected by overweight/obesity and dyslipidemia.更多还原